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Addiction Treatment for Those With Diabetes

Diabetes is a common disease, impacting nearly 9.5 percent of the American population. It is one of the top 10 leading causes of death in the United States.

Drug abuse can complicate and increase the hazards of diabetes on the brain and body and raise the risk of potentially life-threatening outcomes. Addiction further compounds the odds for negative social, physical, and emotional issues.

Specialized treatment facilities approach diabetes and addiction as co-occurring disorders that are optimally managed together,  in an integrated fashion. It is important to manage the medical aspect of diabetes with the psychological and physical ramifications of addiction at the same time.

Addiction treatment should be comprehensive. It will often use medical, therapeutic, pharmacological, complementary, and supportive methods together to promote and enhance the management of both disorders.

Diabetes and Drug Abuse

Just as diabetes is a common disease, so is addiction. The National Survey on Drug Use and Health (NSDUH) publishes that over 10 percent of adults in the United States reported using an illicit drug in the month prior to the 2016 survey, and more than 20 million people battled addiction.

With such a broad population base for both disorders, it is not surprising that they often co-occur. A study in 2012 indicated that among a group of 504 people with type 1 diabetes, more than three-quarters had used a recreational drug at least one time in their lives, and close to half reported past-year drug misuse. Among those that used drugs, over two-thirds abused at least three different drugs. Marijuana, cocaine, ecstasy, and speed were some of the most commonly abused drugs by these individuals. 

Another study indicated that close to 30 percent of surveyed individuals struggling with type 1 diabetes between the ages of 16 and 30 reported street drug abuse, and nearly 70 percent said regular, frequent drug abuse.

Drug abuse in the diabetic community, as in the overall population, is often most common in young adults and adolescents. Young people who struggle with a chronic disease like diabetes may be at an even higher risk for experimenting with drugs and dealing with addiction.

A vast majority of individuals struggling with diabetes, close to 75 percent of those studied, did not realize the potential risks of drug abuse to a diabetic.

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Hazards of Drug Misuse With Diabetes

Diabetes is a disease that impacts insulin levels in the body. 

With type 2 diabetes, you may be able to control blood sugar (glucose) levels with diet and exercise, but with type 1 diabetes, your pancreas does not produce insulin, and therefore you will need to provide it to the body in another way. Typically, this is done via injection.

Diabetes self-care involves managing diet to control blood sugar levels. Illicit drug abuse interacts with brain chemistry and the ability to think clearly and make good decisions. It can negatively impact a person’s ability to successfully manage their diabetes.

Drug abuse, poor nutrition, and unhealthy habits often go hand in hand as well. This can lead to choices that negatively impact the body’s glucose levels, which can be life-threatening in someone who is diabetic.

Drug use can also lead to unhealthy weight management, a potential issue for diabetics. Bariatric surgery, which is often used to help manage diabetes, is not an option for someone struggling with drug abuse.

Psychiatric disorders, such as addiction, can increase the risk factors and negative ramifications of medical diseases like diabetes. When a psychiatric disorder and diabetes co-occur, the following hazards can present:

  • Lower quality of life
  • Increased emergency room visits
  • Poor treatment compliance and adherence
  • More hospitalizations
  • Complications in treatment
  • Higher medical care costs

Social, occupational, interpersonal, and emotional states are all impacted by both diabetes and addiction.

Physical Risks of Drug Use for a Diabetic

Hyperglycemia occurs when the body’s glucose level spikes too high. In a diabetic, insulin is used to control glucose levels, and drug abuse often inhibits a person’s ability to monitor blood sugar levels and introduce insulin when needed.

Drug abuse also increases a diabetic person’s risk for diabetic ketoacidosis (DKA), which can be fatal. This occurs when the body breaks down fat too fast, and fat is processed into ketones, which then makes the blood too acidic. This can happen if blood sugar levels are too high for too long, and insulin is not present to break down the glucose and bring it back to normal levels.

Diabetes is one of the top causes of death in America, and drug abuse and addiction only raise the risk for fatal outcomes.

A study of type 1 diabetic organ donors found that the number one cause of death was anoxia (a lack of oxygen in the body), which can commonly be related to substance abuse, including overdose. More than a quarter of those who die from anoxia have a history of illicit drug abuse. A diabetic person incurs extreme risks when abusing drugs, including possible death. 

Specific Drugs and Risks 

Specific drugs can have the following adverse effects on a diabetic:

  • Marijuana: increased appetite and therefore poor food choices, snacking, and uncontrolled blood sugar as a result
  • Cocaine: hyperglycemia and cardiac issues
  • Amphetamines, including speed and ecstasy (MDMA): dehydration
  • Ketamine: significant acidosis
  • Heroin, opioids, and benzodiazepines: sedation and difficulties managing insulin and glucose levels

Addiction Treatment and Managing Diabetes

Addiction treatment involves learning how to manage triggers, cope with stress, and decrease episodes of relapse to improve the overall quality of life. Detox, therapies, holistic measures, medication management, and support groups are commonly integral parts of a complete addiction treatment program.

When someone battling addiction is a diabetic, specific considerations will need to be made. For example, medical needs will need to be addressed appropriately. During detox, this often means monitoring vital signs and ensuring that blood sugar and other life-sustaining functions remain at normal levels. A medical detox program is often ideal for this, as it provides a supervised and secure environment to allow drugs to process out of the body while managing potentially difficult withdrawal symptoms. 

Other considerations should include the following:

Medications are often part of both medical detox and addiction treatment in general. They will need to be managed carefully in someone who is also diabetic and has additional health concerns.

Nutrition management is imperative for a diabetic and will need to be part of a complete addiction treatment program to manage both diabetes and healthy lifestyle choices.

Physical fitness can help to relieve stress and work as a coping mechanism for triggers. It can also help to manage weight and therefore, positively influence blood glucose levels for a diabetic.

Therapy and counseling sessions for addiction treatment include individual sessions as well as group sessions. It can be helpful to be in groups that are made up of others who are also struggling with similar issues.

Relapse prevention programs will need to address the potential issues related to injecting insulin (particularly if injection drug use was involved). Injected insulin with a syringe may be able to be switched for a pen injector to help with this.

Support groups specifically for people dealing with both diabetes and addiction at the same time can be very beneficial to provide peer interactions with others who understand and can offer empathy and tools for relapse prevention.

Aftercare programs can provide a check-in point to ensure that individuals are still managing both disorders. They can offer tools on how to enhance recovery.

Tips on Choosing a Treatment Facility 

Both addiction and diabetes are chronic disorders. Integrated, comprehensive treatment programs that can manage both disorders, at the same time, with the aid of mental health, medical, and substance abuse professionals are optimal. All doctors, mental health, and medical providers work together and communicate to achieve the same goals for a healthy lifestyle.

When searching for a treatment facility for a person who is diabetic and dealing with addiction, look for places that treat co-occurring disorders. Ideally, the addiction treatment facility should have experience in managing diabetes, specifically.

 It’s even better if they offer specific support groups for people who are treating both addiction and diabetes at the same time. Being around other people with similar struggles can provide high levels of insight and support.

Medical staff will need to be on-site and knowledgeable in managing diabetes and associated complications.

Programs will need to include nutritional management, exercise programs, and behavioral therapies.

Co-occurring diabetes can complicate addiction treatment by increasing medical needs, stress and emotional distress, and incidence of relapse.

Addiction treatment programs will need to be sensitive to the needs of each individual and specifically work to manage all factors of both addiction and diabetes simultaneously.

Holistic and complementary options, such as meditation and yoga, may be beneficial as well. Addiction treatment programs can help to improve life on all levels for a healthy and long-lasting recovery.

Sources

(March 2018) Statistics About Diabetes. American Diabetes Association. Retrieved April 2019 from http://www.diabetes.org/diabetes-basics/statistics/

(September 2017) Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Retrieved April 2019 from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm

(January 2015) Breaking the Habit: Treating Diabetes in Drug Addicted Patients. Endocrine News. Retrieved April 2019 from https://endocrinenews.endocrine.org/breaking-the-habit-through-routine/

(May 2018) The Challenges of Type 1 Diabetes and New Psychoactive Substance Misuse. Practical Diabetes. Retrieved April 2019 from https://www.practicaldiabetes.com/article/the-challenges-of-type-1-diabetes-and-new-psychoactive-substance-misuse/

(October-December 2011) Diabetes and Psychiatric Disorders. Indian Journal of Endocrinology and Metabolism. Retrieved April 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193776/

(July 2008) "Mind the Gap" When Managing Ketoacidosis in Type 1 Diabetes. Diabetes Care American Diabetes Association. Retrieved April 2019 from http://care.diabetesjournals.org/content/31/7/e58

(September 2017) High Illicit Drug Abuse and Suicide in Organ Donors with Type 1 Diabetes. Diabetes Care American Diabetes Association. Retrieved April 2019 from http://care.diabetesjournals.org/content/40/9/e122

(January 2013) Integrating Substance Abuse Care With Community Diabetes Care: Implications for Research and Clinical Practice. Substance Abuse and Rehabilitation. Retrieved April 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3558925/

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