Can Opioid Abuse Cause Liver Damage?

Liver Damage From Opioid Abuse

In rare cases, excessive opioid abuse alone may lead to liver damage. The risk of liver damage increases when people share needles to inject opioids, which may cause infection and hepatitis C or abuse opioids that contain over-the-counter medications such as acetaminophen.

Can Opioid Abuse Cause Liver Damage?

While rare, potent opioids may cause liver damage, especially in the case of overdose. However, there is little evidence linking opioid abuse to liver damage. Nonetheless, some opioids, like heroin and other opioids mixed with acetaminophen, may lead to liver damage when abused.

As one of the most important organs, the liver plays a role in the basic functioning of the human body. The liver breaks down carbohydrates, proteins, toxins, drugs, cholesterol, and fats. As an essential organ, liver disease is one of the main causes of death among Americans, killing around 25,000 people a year.

Once the liver is damaged, cells are destroyed. In mild cases, these cells may come back or regenerate. But, if severe, the liver will never be the same and the damage will be permanent. Permanent liver damage can lead to adverse health effects, including liver destruction and brain damage.

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Liver damage is mostly caused by infections or drug and alcohol abuse. Drug induced liver injury occurs when substances directly lead to liver damage. Proving this is problematic and challenging for medical professionals and researchers because of the number of medications and individuals taking drugs.

While the exact cause of liver damage will depend on personal genetics and what a person puts in their body, opioids will rarely cause liver damage. However, there are some opioids that increase the risk of liver damage and disease.

How Do Opiates Affect The Liver?

Opioids are a class of drugs derived from the poppy plant, and can be either synthetic (man-made) or natural. As highly potent medications, opioids are usually prescribed to treat moderate to severe pain. Due to how opioids affect the brain and nervous system, they have a high potential for abuse.

When abused, opioids are likely to cause intoxicating effects. These effects may include abrupt mood changes, euphoria, drowsiness, and a decrease in mental alertness. Beside psychological effects, abusing opioids are also likely to cause adverse health effects, and may risk damaging the liver.

Opioids pass through the liver when they’re both taken as medication and abused, and the drugs may remain in the liver for longer if the person has pre existing liver problems. As a person’s liver gets worse, opioids will likely breakdown in the liver at a slower rate, further increasing the risk of damage and disease.

Since opioids are a large class of drugs with a wide variety medications, it’s likely best to examine some of the most commonly abused opioids that may or may not cause liver damage.

Hepatitis C From Heroin Abuse

Derived from the natural substance morphine, heroin is an illicit opioid. Heroin is commonly abused by smoking, snorting, and injecting, and can lead to a variety of medical and health complications.

People suffering from severe heroin abuse and addiction are likely to inject the drug for a quicker and stronger high. Heroin likely contains additives, or other substances, that may not adequately dissolve in the bloodstream, potentially resulting in clogged blood vessels, which can lead to infection and cause liver damage.

Sharing needles to inject heroin may also lead to hepatitis C, which is a major cause of liver disease.

Live Damage From Morphine Abuse

Morphine is a natural opioid, or opiate, and is highly potent. Used in medical settings, morphine is available as a tablet or liquid, and can be injected or taken orally. When people share needles to inject morphine, they increase the risk of infection and hepatitis C, which causes liver damage.

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90% of morphine is broken down by the liver, and repeatedly abusing morphine will likely cause the toxins of the substance to remain in the liver for longer than normal. While there is little evidence linking morphine abuse to liver damage, medical professionals use caution when administering morphine to patients with liver disease.

Liver Damage From Vicodin (Hydrocodone/Acetaminophen) Abuse

Hydrocodone is one of the substances found in the commonly abused prescription drug Vicodin. Acetaminophen is combined with hydrocodone in Vicodin and Percocet, and high acetaminophen toxicity (toxin levels) has shown to cause liver damage.

Hydrocodone abuse may lead to liver damage because toxins may remain in the liver for extended periods of time. If the liver is already damaged, hydrocodone is even more likely to take longer to metabolize, or breakdown, and may result in further damage.

Fentanyl: An Opioid That Does Not Affect The Liver

Fentanyl is a powerful opioid that is said to be much stronger than both heroin and morphine. While fentanyl abuse is likely to lead to overdose, and possibly death, there is no evidence to show fentanyl abuse causes liver damage. Fentanyl is mostly broken down by the liver, and is often recommended for use in medical settings to treat pain in patients with liver disease.

Abusing Opioids With Alcohol Harms The Liver

Alcohol abuse is one of the main causes of liver damage, and cirrhosis is a condition of the liver caused by excessive alcohol use. Drinking alcohol and abusing opioids combined with acetaminophen may increase the risk of cirrhosis because higher doses of acetaminophen can lead to liver damage.

Because liver damage may occur as a result of excessive substance abuse, a person should be aware of the symptoms of liver damage.

Signs And Symptoms Of Liver Damage

Although opioid abuse is rarely connected to liver problems, abusing heroin and opioids that contain acetaminophen may lead to liver damage or injury, especially when mixed with alcohol.

Symptoms of liver damage are likely to include:

  • abdominal pain
  • clay or white colored stool (poop)
  • dark urine
  • diarrhea
  • fatigue (tiredness)
  • fever
  • headache
  • loss of appetite
  • nausea
  • rash
  • yellow skin

A person experiencing any symptoms of liver damage should seek medical treatment immediately. While the exact cause of liver disease depends on a person’s medical and substance abuse history, treatment for opioid abuse and addiction is likely needed to prevent further complications.

Treatment For Opioid Abuse And Addiction

Treating opioid abuse and addiction can also help treat other adverse health issues, like liver damage and disease. The likely best course of action for people with liver problems who are addicted to opioids is entering an inpatient treatment center. A person will likely have access to doctors and other medical professionals who can assess liver damage and advise the safest route of treatment, likely treating both addiction and liver damage.

Effective addiction treatment usually involves the combination of medications and behavioral therapy. There are three government approved medications to treat opioid abuse and addiction: methadone, buprenorphine, and naltrexone.

While these medications are typically used to reduce drug cravings and help with symptoms of withdrawal, doctors may want to access liver damage before administering these medications. People with liver disease or damage may worsen their conditions with opioid medications, so it may depend on a person’s overall health to receive medications to help with addiction and dependence.

Inpatient treatment centers will also likely have access to behavioral therapy. Behavioral therapy is the most common form of addiction treatment, and aims to change a person’s thinking and attitudes towards drugs. Behavioral therapy may include one on one therapy sessions, group therapy, or other more intensive therapies like dialectical behavioral therapy (DBT).

Contact today for more information on opioid abuse and liver damage.

LiverTox - Opioids

MedlinePlus - Drug-induced Liver Injury

National Institute on Drug Abuse - Liver Damage

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