Substance Abuse and Metabolic Syndrome

Metabolic syndrome is the collective term for a group of risk factors that, when present together in a given individual, significantly increase long-term risks for serious, potentially fatal health problems such as heart disease, strokes, diabetes and some forms of cancer. The syndrome gets its name because it describes harmful changes in the body’s normal ability to metabolize (process and use) its chemical resources. Substance abusers have heightened risks for the development of metabolic syndrome. The specific underlying causes of those risks vary according to the specific substance in use.

Metabolic Syndrome Basics

The roots of metabolic syndrome are found in two linked problems in the body: unusual changes in a form of deep abdominal fat called visceral fat and an increased resistance to the normal effects of the glucose-processing hormone called insulin. Visceral fat sits in the spaces between and around the abdominal organs and commonly appears externally as “belly fat.” Potential harmful changes inside this fat include abnormal enlargement of individual fat cells and abnormal increases in the presence of immune system components called macrophages. Both of these abnormalities can lead to increased levels of abdominal inflammation. In turn, this inflammation can reduce insulin’s ability to properly promote absorption of dietary glucose, which supplies the energy needed to support the body’s metabolic processes. Types of cells harmed by poor glucose absorption include liver, muscle, and fat cells.

Syndromes are not diseases, per se; instead, they’re more informal collections of symptoms that have some sort of medical significance when they appear together. In most people, five major factors can increase the risks for the onset of metabolic syndrome. They include high, abnormally low levels of HDL (i.e., “good”) cholesterol, abnormally high levels of a blood-borne fat called triglyceride, blood pressure, an unusually high blood glucose level after a period of short-term fasting, and the presence of excessive amounts of body fat in the abdomen or at the waistline. In order to receive an official metabolic syndrome diagnosis from a doctor, any given individual must have at least three of these risk factors at the same time. Obesity is heavily associated with high levels of abdominal fat, and therefore acts as an independent risk factor for metabolic syndrome.

Substance Abuse’s Role

Substance abuse functions as a de facto additional risk factor for the development of metabolic syndrome. As stated previously, the nature of the risk varies according to the substance being abused. For instance, alcohol abuse can contribute to the syndrome by worsening the normal state of health in the body’s cardiovascular system (heart and blood vessels). According to the results of a study presented in 2004 to the American Heart Association, alcohol abusers clearly have worse risks for metabolic problems than people who drink in moderation. In fact, men who consume six or more drinks per day, and women who consume four drinks or more per day, have a 60 percent greater chance of developing metabolic syndrome than men who consume 1.3 drinks or less per day and women who consume a single drink or less per day.

Amphetamine abusers can develop both cardiovascular and nerve-related problems that increase their overall risks for metabolic syndrome. Methamphetamine users can develop several problems-including energy-processing abnormalities, mental impairments and severe dental damage-that reduce their ability to properly meet their nutritional needs. In turn, nutritional deficiencies can contribute to the effects of metabolic syndrome by decreasing the body’s ability to produce energy, lowering the body’s ability to produce protective substances called antioxidants, generally increasing the body’s susceptibility to cell damage and death, and specifically contributing to a form of excessive nerve stimulation that can damage and kill nerve tissue.

In people who have metabolic syndrome-related cases of diabetes, substance abuse can significantly reduce willingness or ability to follow an appropriate treatment plan, according to a study published in 2007 in the Annals of the New York Academy of Sciences. In turn, lack of compliance with an effective treatment plan can lead to the onset of severe symptoms associated with advanced diabetes, including serious or fatal heart disease and debilitating nerve damage.


Some people apparently have genetic susceptibilities to the fat- and insulin-related problems that trigger metabolic syndrome. People with these susceptibilities who also abuse drugs or alcohol may seriously increase their chances of actually developing the syndrome, or worsening existing cases of the syndrome. These risks are especially high in substance abusers who have both genetic susceptibilities and serious nutritional deficiencies.

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