Alcohol and Comorbid Medical Conditions
Alcohol use disorder (AUD) is a disease that may occur parallel with other medical or psychiatric diseases, which are then referred to as co-occurring or comorbid disorders.1 Alcoholism and other diseases may be related in several ways:2
- Alcoholism and comorbid diseases may occur simultaneously by coincidence.
- AUD can worsen existing comorbid medical conditions or mental health issues.
- Substance abuse comorbidity may occur when people resort to substance abuse to alleviate the symptoms of their existing condition.
- Both alcoholism and a comorbid condition may be caused by a third condition.
- The symptoms of alcohol withdrawal may resemble those of other disorders.
Alcohol and Common Comorbid Medical Conditions
A person struggling with alcohol abuse may experience different comorbidity issues.
As the liver is the organ which metabolizes alcohol, it suffers the most significant tissue injury due to excessive drinking. Around 35% of heavy drinkers develop advanced liver disease. The common liver-related comorbid medical conditions are the following:3
- Steatosis (fatty liver), which is the earliest condition that happens in relation to heavy drinking and is very common. At least 90% of heavy drinkers show evidence of abnormal fat accumulation in their liver.
- Alcoholic hepatitis, which is an inflammatory liver injury that occurs in 10-35% problem drinkers.
- Alcoholic cirrhosis, which is excessive liver damage which can result in liver failure.
In contrast to the first two comorbid diseases, cirrhosis is not reversible with abstinence. It can only be stabilized.2
Alcohol abuse is one of the most common causes for both acute or chronic inflammation of the pancreas. This effect of alcohol on the pancreas typically occurs in patients after five years of excessive drinking. Pancreatitis increases the risk that a person will develop pancreatic cancer by 20 times. In addition, alcoholic pancreatitis can cause pancreatic diabetes, splenic vein thrombosis, and bile duct obstruction.4
When a person drinks excessively, the gastrointestinal tract does not have enough time to recover from the toxic effects of alcohol and its metabolites, which among other conditions results in:
- Alcohol bloat.5
- Increased risk of gastrointestinal cancer.6
- Alcohol-induced gastritis.7
Gastritis is the inflammation of the stomach lining, which may result in stomach aches from alcohol, vomiting, diarrhea, heartburn, ulcers, bacterial infections, and bleeding. When the lining of the intestines that filters alcohol is damaged, more toxins are allowed to pass into the bloodstream and cause more damage to other organs.8
While low to moderate alcohol consumption, optimally in the form of red wine before or during a meal, is proved to be good for the heart, excessive drinking has adverse cardiovascular effects that include high blood pressure, cardiomyopathy, irregular heart beat, heart failure, or stroke.9 Cardiovascular alcohol-related comorbidity issues are a clear example of how the dose makes the poison or the remedy.10
Diabetes mellitus can appear as a complication of AUD. Chronic and heavy alcohol consumption is a risk factor for the development of type 2 diabetes.11 In addition, as alcohol interferes with blood sugar control in people who are already suffering from diabetes, heavy alcohol consumption can worsen the comorbidities associated with diabetes and result in severe health consequences.12
Alcohol abuse can contribute to the spread of HIV infection as intoxication often causes people to engage in risky sexual or drug abuse behavior that can get them infected with HIV.13
In addition, alcohol has a negative impact on the treatment of HIV patients: the comorbid disorders such as liver disease can accelerate the progression of HIV. Moreover, HIV patients are required to follow a strict medication regimen and this is difficult to accomplish if they are struggling with AUD.13
Alcohol often helps relieve pain. However, if people start drinking excessively to alleviate chronic pain, then they put themselves at risk of developing AUD. Moreover, if a person is already taking painkillers, there is a risk of harmful drug-alcohol interactions and even overdose in case of opioid medications.14
Mental Health Comorbidities and Alcoholism
There are three possible connections between mental health issues and substance use disorders, which can explain their high level of comorbidity:15
- Some common genetic factors put people at an increased risk of developing mental health conditions and substance use disorders..
- Mental health disorders are proven to be risk factors for substance use disorders. People sometimes use alcohol to self-medicate and relieve symptoms of mental diseases. This effect is rather short, while in the long run, alcohol abuse makes the mental health condition even worse.
- Substance abuse can damage certain brain structures that are also disrupted in mental disorders such as anxiety, mood disorders, or schizophrenia. Substance abuse can therefore trigger the development of these diseases.
When it comes to specific psychiatric comorbid conditions connected with alcohol abuse, it has been shown that:16
- About 30-40% of individuals struggling with alcohol abuse experience depression.
- Among manic patients, 50-60% abuse alcohol or other drugs.
- 19.4% of people diagnosed with AUD also suffer from an anxiety disorder.
- The percentage of individuals suffering from post-traumatic stress disorder (PTSD) who abuse alcohol is higher than the percentage of individuals who do not have PTSD.17
- 24% of people with obsessive-compulsive disorder meet the criteria for AUD.18
Where to Find Help for Alcohol & Comorbid Diseases
If a situation with comorbid disorders is particularly complicated, planned professional interventions of family and friends may not be sufficient to help the person who is suffering from alcohol addiction. In such cases, professional treatment may be necessary to help the person detox safely. When a person who is struggling with AUD has some mental health and medical comorbidities, it is very important that they find a treatment facility and a program that can appropriately recognize and address these issues at the same time.
American Addiction Centers is well equipped to treat alcohol addiction alongside both physical comorbidities and co-occurring mental disorders. Some patients with more severe conditions may need 24/7 inpatient care, especially in cases when there is a high risk that the symptoms of comorbid disorders may worsen during the stage of detoxification, i.e. alcohol withdrawal.19 After this supervised detox, treatment users can proceed with medication-assisted treatment, which means that in addition to behavioral therapy, FDA-approved medications are prescribed to help patients overcome alcohol cravings and remain sober in the long run.20The process of admission into treatment usually starts by calling a helpline that provides guidance and support for treatment seekers. American Addiction Centers offers such a helpline 24/7 to people who want to acknowledge their issue with alcohol, find the best way to overcome it, or identify the best treatment option for their loved one. Treatment navigators can immediately check the availability of treatment centers, payment options and insurance coverage, so the patient can start their treatment as soon as possible.
Frequently Asked Questions