Liver damage review finds common trends

February 18, 2014 by Chris Thomas
"Paracetamol is more hepatotoxic with chronic alcohol consumption and older patients are more susceptible to hepatotoxicity compared to younger patients"—Dr Pateria. Credit: Daniel Mitsuo

A comprehensive review of hepatotoxicity – liver damage – caused by alcohol, illicit drugs and complementary and alternative medicines has given an insight into epidemiology, risk factors, clinical manifestations, pathogenesis, investigations, management and prognostic factors.

The study could now be used as a reference for treating patients in acute settings such as emergency departments, as well as ongoing treatment during hospitalisation, according to one of its authors. Dr Puraskar Pateria from the WA Liver Transplant Service at Sir Charles Gairdner Hospital says the research formed one of the most practical documents about .

"The potential of illicit substances to cause hepatotoxicity has been widely studied and published in the past, especially alcohol," he says.

"But some things surprised me such as the prevalence of use being far more than I expected."

Cannabis is the most commonly used illicit substance worldwide with an estimated 200 million users, followed by amphetamine-type stimulants (excluding ecstasy).

"Some of the illicit drugs can cause even with a single overdose," Dr Pateria says.

"Amphetamine-type stimulants can lead to exhaustive dancing at hot nightclub raves, leading to a heatstroke-like syndrome causing hyperthermia, shock, ischaemia and hepatic necrosis. These patients have a high risk of dying in hospital.

"Complementary and , which are considered innocuous by many people, can also cause hepatotoxicity.

"Paracetamol is more hepatotoxic with chronic alcohol consumption and older patients are more susceptible to hepatotoxicity compared to younger patients."

Researching already available statistics and information based on their relevance, accuracy, source and authenticity, Dr Pateria drew on a range of research papers, meta-analysis, textbook chapters, World Health Organization annual reports and case series from reputed journals.

"With my co-authors [Dr Bastiaan de Boer and Dr Gerry MacQuillan], we tried to focus on epidemiology, clinical manifestations, pathogenesis, diagnosis and management of hepatotoxicity caused by the most commonly used illicit substances such as alcohol, cannabis, amphetamines, khat chewing and cocaine," he says.

"The greatest concerns with illicit substances are their easy availability, widespread use, the strong association between alcohol and their use, a lack of education and awareness among users regarding their ill-effects and the high prevalence of illicit substance abuse in people with mental health issues.

"But it's important to recognise that managing addiction and use of illicit drugs is a complex and challenging process.

"It involves a multidisciplinary approach involving doctors, counsellors, psychiatrists, clinical psychologists, social workers and drug and services.

"Unfortunately, it was beyond the scope of my research to discuss these equally important issues."

Explore further: Cannabis link to other drugs

More information: "Liver abnormalities in drug and substance abusers." Pateria P, de Boer B, MacQuillan G. Best Pract Res Clin Gastroenterol. 2013 Aug;27(4):577-96. DOI: 10.1016/j.bpg.2013.08.001. Epub 2013 Aug 22.

Related Stories

Cannabis link to other drugs

July 19, 2011
Quitting cannabis use in your 20s significantly reduces the chance of progressing to other illicit drugs, according to research published in the Journal of Epidemiology and Community Health.

Synthetic drug use rapidly rising in Europe, report finds

May 28, 2013
New synthetic psychoactive substances are making their way into Europe where the Internet is becoming a big challenge in the fight against illicit drugs, the continent's drug agency warned Tuesday.

Latest global study provides snapshot of drug-related harm

January 6, 2012
(Medical Xpress) -- A new Australian drug study published today in The Lancet has found that cannabis is the most widely used illicit drug globally, while opioid use is a major cause of death.

Most babies born to mums on methadone exposed to several illicit drugs in womb

July 8, 2013
Most babies born to drug addicted mums on methadone maintenance are exposed to several other drugs while in the womb, and half are additionally exposed to excess alcohol, reveal the results of a small study published online ...

Heroin, amphetamines head list of problem drugs

August 28, 2013
Heroin accounted for more than half of the 78,000 deaths from illegal drugs in 2010, but amphetamine had most addicts, researchers reported in The Lancet on Wednesday.

Teen alcohol and illicit drug use and abuse examined in study

April 2, 2012
A survey of a nationally representative sample of U.S. teenagers suggests that most cases of alcohol and drug abuse have their initial onset at this important period of development, according to a report published in the ...

Recommended for you

Americans misinformed about smoking

August 22, 2017
After voluminous research studies, numerous lawsuits and millions of deaths linked to cigarettes, it might seem likely that Americans now properly understand the risks of smoking.

Women who sexually abuse children are just as harmful to their victims as male abusers

August 21, 2017
"That she might seduce a helpless child into sexplay is unthinkable, and even if she did so, what harm can be done without a penis?"

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

In a nutshell: Walnuts activate brain region involved in appetite control

August 17, 2017
Packed with nutrients linked to better health, walnuts are also thought to discourage overeating by promoting feelings of fullness. Now, in a new brain imaging study, researchers at Beth Israel Deaconess Medical Center (BIDMC) ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.