Diabetes and Addiction

Drug addiction is associated with a host of short-term and long-term physical and mental health problems.

This is one reason why it is so vital to prevent drug abuse or to seek treatment as soon as possible after a substance use disorder takes hold.

In some instances, medical conditions exist in conjunction with addiction, and co-occurring medical issues like this can complicate addiction recovery treatment. Regarding diabetes and addiction, research does not suggest that these two conditions are causally connected; however, diabetes and addiction are related in significant ways.

Diabetes Basics

illicit drug addiction and diabetes impacting a young woman's health

The American Diabetes Association (ADA) is a foremost authority on diabetes and explains that this condition arises from disordered glucose functioning in the body. Speaking broadly, the cells in the body require glucose to operate; it’s their fuel. Certain foods, such as carbohydrates, break down into glucose in the body. But it’s not enough that glucose is in the body, it actually has to be moved into the cells.

There are two main types of diabetes: type 1 and type 2. Type 1 diabetes typically occurs in children and young adults. In the case of type 1 diabetes, the body produces little to no insulin. This is because the body’s immune system, through disordered functioning, destroys the beta cells in the pancreas that produce insulin. Type 1 diabetes can be thought of as an insulin deficiency condition.

In America, 90 percent of adults with diabetes have type 2 diabetes. Unlike type 1 diabetes, the beta cells in the pancreas do produce insulin, but not enough for adequate glucose functioning, or the body’s insulin receptors (in cells) resist glucose. In the latter case, since glucose cannot get into the cells, the cells are not properly nourished, and there will be a buildup of glucose in the blood, which results in high blood sugar. The negatives of having too much glucose in the blood include eye, kidney, and nerve problems, including in the feet and hands.

As WebMD discusses, there is no cure for diabetes, but it is manageable. Individuals with type 1 diabetes have different options, including insulin injections, a continuous pump, inhaled insulin (Afrezza), or degludec (a long-acting medication). Individuals with type 2 diabetes may take medication or be able to manage this condition through a balanced diet and adequate exercise.

Irrespective of a person’s exact diabetes treatment, it is clear that this condition requires constant care and attention. The good news is that many Americans adjust to their daily diabetes management regimen, and it only minimally, if at all, interferes with their day-to-day living.

Alcohol Abuse and Diabetes

It is well established that alcohol use can impair the liver’s ability to properly regulate blood sugar levels in the body. WebMD explains that while a moderate amount of alcohol can lead to an increase in blood sugar, the opposite is true when higher amounts are imbibed. Drinking too much alcohol can actually lower a person’s blood glucose level. In the case of a person with type 2 diabetes, the glucose level can fall to a dangerous level.

There are also behaviors associated with alcohol abuse that can increase a person’s risk for gaining weight, thereby elevating the odds of developing diabetes.

First, alcohol can stimulate appetite, which can lead to overeating while at the same time predisposing a person to inactivity. Second, alcohol is itself high in calories, which can directly lead to weight gain. In short, for individuals who already have diabetes, alcohol abuse can frustrate their self-care efforts. In individuals who do not have diabetes, alcohol abuse can increase their risk for diabetes.

Illicit Drug Abuse and Diabetes

Much of the literature on illicit drug addiction and diabetes focuses on individuals who already have diabetes or who develop it after drug addiction sets in. Understandably, there is a concern that individuals who regularly engage in drug abuse will not be able to adequately self-manage their diabetes.

Different drugs have different side effects, but many drugs can induce forgetfulness or long periods of sleep, so a person may not take their prescribed diabetes medication at the required times. Drug abuse can also:

  • Increase the risk of experiencing severe hypoglycemia (low blood sugar): Certain drugs, such as stimulants and benzodiazepines, can suppress a person’s appetite. As a result of not eating, hypoglycemia can occur.
  • Elevate the risk of hyperglycemia (high blood sugar): Overeating is one way a person can self-induce hyperglycemia. Certain drugs, such as marijuana, can stimulate appetite. Due to an uptick in caloric intake, especially of sweet or carbohydrate rich foods, a person may become hyperglycemic.
  • Up the risk of diabetic ketoacidosis: When the body has an insulin dysfunction and cannot get glucose into the cells to fuel them, the body will start to break down less desirable, alternate sources of energy. As a result, acids called ketones build up in the bloodstream and cause the condition known as diabetic ketoacidosis.
  • Increase the likelihood of inactivity: A lack of physical activity can exacerbate diabetes, especially in people with type 2 diabetes who are self-managing through lifestyle efforts alone and do not use any medication.

Since there is no established causal link between drug abuse and diabetes, it is particularly helpful to consider the causes of diabetes and see how drug abuse could potentially negatively interact with them. According to the National Institute of Diabetes and Digestive and Kidney Diseases, genes, behaviors, and environment can all play a role in the onset of diabetes. Regarding environment, factors include food, viruses, and toxins. Regarding genes, research shows that genes can directly or indirectly lead to diabetes. In the case of an indirect genetic cause, individuals may have gene variants that predispose them to become overweight or obese. Obesity can cause a person to become insulin-resistant (type 2 diabetes). Regarding behaviors, physical inactivity is strongly associated with diabetes.

There is likely to be some misinformation in circulation about diabetes, especially regarding food and sugar in particular.

As the Nemours Foundation explains, in the case of type 1 diabetes, the medical cause does not relate to a person’s sugar intake.

In the case of type 2 diabetes, sugar consumption can, as noted, lead to weight gain, which can increase the risk of diabetes.

It is critical to keep in mind that separate research in the areas of diabetes and substance abuse is ongoing. Research studies may find connections between diabetes and substance abuse that are currently unknown. For instance, scientific research on opioid abuse has found a connection to a taste preference that can bear on weight. Opioids activate mu-opiate receptors in the brain, which are associated with glycemic control and the level of glucose consumption. Mu-opiate receptor activation can also directly act on cells in the pancreas and cause hyperglycemia. A person’s behavioral response to these biological events is likely going to be to eat sugar, which can lead to weight gain and in turn increase the risk of diabetes.

There may not be a cure for diabetes or addiction, but both conditions are treatable and can be effectively managed. A person who has diabetes and is experiencing drug addiction has an added incentive to seek help from a drug rehab center. Entering a drug treatment program can potentially reverse the negative impact a person’s drug abuse is having on their diabetes. In addition, drug treatment can help a person live a balanced life, including eating a healthy diet and engaging in physical activity. Some rehab programs provide nutritional counseling, which is vital for anyone with diabetes. For a person with diabetes, or individuals who wants to lower their risk, the benefits of entering rehab are manifold.