How Addiction Affects Diabetes

According to the CDC, more than 38 million Americans have diabetes (approximately 1 in 10), and millions more are at risk due to prediabetes. Some engage in substance use despite their medical condition, and others have diabetes because of their substance use disorder.

Substance use disorder and diabetes can have dangerous complications. Many substances affect glucose (blood sugar) levels. Some substances damage organs, creating conditions that lead to diabetes. Still others create lifestyle conditions that affect or instigate diabetes.

What Is Diabetes?

Diabetes is a chronic disease that affects adults and, increasingly, children and teens.

People managing diabetes cannot naturally regulate sugar because their pancreas does not produce insulin, the hormone that your body uses to control sugar, or their bodies are insulin resistant or both.

As a result, they have to carefully monitor their body’s insulin levels and give themselves enough when needed, but not too much.

Diabetes has many effects, including:

• low blood sugar (hypoglycemia)
• insulin shock (when there is too much insulin)
• high blood sugar levels (hyperglycemia)
• increased risk of nerve damage
• amputations due to poor blood flow

There are two types of diabetes that may affect people.

Type 1 Diabetes

Type 1 diabetes is when the pancreas doesn’t make enough insulin or doesn’t make any insulin at all. People with type 1 diabetes need to take daily doses of insulin through an injection.

Usually, people with type 1 are diagnosed when they are children or teens.

This type of diabetes is caused by an immune process that damages the pancreas, but it is not known why the immune process does this or what causes the process.

Type 2 Diabetes

Type 2 diabetes is more common than type 1 and comes about because of a body’s insulin resistance. Being overweight or obese is a common cause of type 2.

It used to be that type 2 diabetes only affected adults, but with growing obesity rates in young people, children and teens are now being diagnosed with type 2 diabetes.

Ways In Which Addiction Affects Diabetes

In general, alcohol and drug addiction have a negative impact on many aspects of your life. Diabetes is one area that could prove to have lasting consequences if you use recreational drugs.

Drug and alcohol use affect diabetes in two ways:

• drug- or alcohol-specific effects on diabetes
• lifestyle-specific effects on diabetes

Drug-Specific Complications

Drug- or alcohol-specific complications mean that something inherent in the substance causes complications with diabetes.

These complications have mostly to do with blood sugar levels. Substances may cause glucose levels to be too high or too low.

Other complications include organ damage that may result from drug or alcohol use disorders, or effects on the body that may exacerbate diabetes like blood flow restriction.

Lifestyle-Specific Complications

Lifestyle complications have to do with the kind of lifestyle that usually goes with the misuse of certain drugs or alcohol.

Depending on the substance, lifestyle complications may result from eating too much, which causes weight gain, exacerbating diabetes.

Or it may have to do with the lack of personal hygiene or healthcare that often accompanies alcohol or other substance use disorders. This may make it difficult to practice diabetes care.

Alcohol And Diabetes

Drinking alcohol, especially in excess, can cause complications with diabetes.

Alcohol use disorder commonly causes high blood pressure. Because obesity is often associated with type 2 diabetes, high blood pressure is likely already a problem, causing stress on the heart.

Alcohol is also a diuretic, which can cause blood vessels to constrict, further exacerbating blood pressure and heart issues.

Long-term alcohol use can also cause organ damage, especially to the liver and pancreas. Alcohol addiction has been known to instigate diabetes because it has damaged the pancreas’s ability to create insulin.

For people with diabetes, one of the most immediate dangers of alcohol use is hypoglycemia (dangerously low blood sugar). Alcohol inhibits the liver’s ability to release glucose into the bloodstream. This can cause blood sugar to drop sharply, particularly in people who take insulin or certain oral diabetes medications.

This risk is compounded by the fact that hypoglycemia symptoms can closely resemble intoxication, making it harder for others to recognize a medical emergency.

People with diabetes should never drink on an empty stomach and should always inform companions of their condition.

Cocaine And Diabetes

Cocaine is an illicit drug similar to methamphetamines or MDMA (molly). Some studies have shown a connection between cocaine use and diabetic ketoacidosis (DKA).

This risk is most pronounced in people who already have diabetes, particularly type 1. For people managing diabetes, cocaine use can make blood sugar levels significantly harder to control and can trigger DKA even when insulin management has otherwise been stable.

DKA is a condition in which you don’t have enough insulin to allow blood sugar to be absorbed for energy. As a consequence, your liver begins to break down fat for fuel, which releases acids called ketones. High ketone build-up is potentially fatal.

Symptoms of DKA include being very thirsty and urinating more than usual. If you don’t address the condition, symptoms could become more severe.

Severe symptoms of DKA include:

• fast breathing
• flushed face
• fruity smelly breath
• muscle stiffness and aches
• stomach pain
• nausea
• vomiting

Methamphetamines And Diabetes

In addition to similar consequences to diabetes as cocaine, methamphetamine addiction may have other consequences.

People who use methamphetamine often develop skin sores on their bodies from the fierce itching that meth can cause. These sores are slow to heal and become infected because of repeated use of the drug.

Healing may be more difficult for people with diabetes. Diabetes makes it difficult for the body to heal from wounds and infections.

Methamphetamine and cocaine are appetite suppressants, which can cause significant weight loss and nutritional neglect.

For people managing diabetes, this creates additional challenges. Skipping meals or eating irregularly while using stimulants can cause unpredictable swings in blood glucose levels that are difficult to manage with insulin.

Malnutrition also impairs the immune system and wound healing, compounding the health risks that diabetes already creates.

Marijuana And Diabetes

Marijuana use can negatively impact diabetes as well. While some illicit drugs, such as stimulants, suppress your appetite, marijuana encourages it.

Research has also found associations between regular cannabis use and increased insulin resistance independent of weight gain. This suggests that the relationship between cannabis and diabetes is more direct than appetite effects alone.

People managing diabetes who use cannabis should monitor their blood glucose levels carefully and discuss use with their healthcare provider.

Opioids And Diabetes

Opioid addiction can also create complications for people managing diabetes. Misuse of an opioid can disrupt insulin secretion, causing hyperglycemia.

Opioid use disorder can also create health problems concerning blood pressure, which can be exacerbated by diabetes.

Complications From Diabetes And Addiction Treatment

If you are facing both diabetes and drug or alcohol addiction, look for treatment options that can address both conditions.

You may be suffering from physical problems as a result of poor diabetes care and you may need medical attention for these issues while you are in treatment.

Treatment facilities that are part of hospital networks may be able to provide addiction treatment while addressing complications from diabetes.

Treatment providers will want to know if you have diabetes because hyperglycemia could negatively affect medication-assisted treatment for opioid addiction.

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Written by the Addiction Resource Editorial Staff