Substance Misuse and Tissue Pathology with Special Reference to the Heart

Abstract

Common drugs of misuse include alcohol, nicotine (and tobacco products), cannabis, cocaine and, to a certain extent, caffeine. Other lesser used drugs include amphetamines, opiates, sedatives/hypnotics, phencyclidines, hallucinogens and anabolic steroids. In Europe there are many millions of drug misusers and, similarly, the extent of drug misuse in North America is staggering. Thus, in the UK there are between 1 and 3 million alcohol abusers and a third of the adult population smoke tobacco products. The biomedical implications of this prevalence are considerable. In comparison with psychomotor, neuropsychiatric and cognitive reports on the above substances, investigations into organ damage are comparatively limited. This particularly relates to the biochemical mechanisms responsible for tissue specific lesions. It is a truism that virtually every single tissue system or organ in the mammalian body is adversely affected to some degree by one or more of the above drugs of misuse. At the extreme, there is organ failure and death. At the very least, there may arise compensatory mechanisms, that may be considered to be either adaptive or destructive but, nevertheless, impair organ function.