Medical Disorders and Complications of Alcohol and Other Drugs, Pain and Addiction: An Introduction

The health consequences of drugs are major problems throughout the world with billions of people using legal (tobacco and alcohol) and illegal drugs (amphetamines, cocaine, opiates, hallucinogens, and marijuana). Drug use is associated with burdensome social, economic, and health consequences, the latter involving almost every physiological/biochemical system. These may include psychiatric, cardiovascular, metabolic, and hepatic complications and infectious diseases. Although there is a myriad of problems related to drug use, it is the medical consequences that are the leading causes of death, and consequently, these are of great medical concern. It is evident that this section on medical consequences of drug abuse is an important component of a comprehensive textbook of addiction medicine that should describe, most if not all, these health effects and their clinical management. In general, the principles of assessment and management of these disorders are no different from people who do not abuse drugs or alcohol, but this section of the textbook describes particular patterns of morbidity and approaches to management that distinguish this population. The typical patient with a substance use disorders has multiple problems rather than single pathology as described above, yet it is not generally feasible for multiple specialists to become involved. Consequently, the addiction medicine specialist needs a broad range of clinical skills to adequately manage patients with complex health problems including pain. Alcohol and other drugs particularly affect the