consequences of drug abuse on bone health

Drug use, both prescription medications and illicit substances, has been long associated with a range of short-term and long-term health consequences. One health consequence that often falls under the radar is the effect drugs have on bone health and bone mineral density (BMD).

The Connection Between Substance Use and the Musculoskeletal System

Regular use of substances, such as tobacco, alcohol, opioids, or stimulants, can significantly affect the musculoskeletal system. Tobacco use has been the cause of a variety of chronic diseases, cancer, and death. Tobacco smoke directly influences bone mass through the osteogenesis and angiogenesis of bone, leading to lower bone mass and making the skeletal more susceptible to fractures and osteoporosis.

drug abuse and bone loss

Chronic alcohol consumption inhibits bone growth and remodeling, which is the replacement of bone tissue. Alcohol can also cause malabsorption of vitamin D and calcium, leading to decreased bone mineral density (BMD) and increases the risk of fracture and osteoporosis. Opioids, like oxycodone or heroin, interfere with the endocrine system and cause lower levels of estrogen and testosterone, sex hormones that are critical for maintaining bone density. Chronic opioid use makes the musculoskeletal more susceptible to bone fractures and bone diseases like osteoporosis.

Stimulants, like cocaine or methamphetamine (meth), often used to treat attention-deficit hyperactivity disorder (ADHD), have been associated with lower bone mineral density (BMD) and bone mineral content. Regular stimulant use has led to malnutrition, bone density loss, hormonal imbalances, and increased cortisol levels. Poor dietary habits, insufficient mineral intake, and physical inactivity are commonly associated with substance use disorders (SUDs), which indirectly affect bone health.

The Long-Term Effects of Drug Abuse on Bone Health

Long-term drug use, whether you’re someone who has been taking prescription medications, over-the-counter (OTC) drugs, or illegal substances, can have a range of adverse effects on musculoskeletal health. Opioids, tobacco, alcohol, cocaine, corticosteroids, NSAIDs, and other substances can cause osteopenia, osteoporosis, osteonecrosis, oral changes, and a higher risk of bone fractures.

Depending on the type of drug, the duration of use, the dosage, and the individual’s health condition can affect its impact on bone health. The potential long-term effects of drug abuse on bone health can include decreased bone health, nutritional deficiencies, hormonal imbalances, increased risk of fractures, and musculoskeletal disorders.

1. Decreased Bone Density

Drug abuse has made bones weaker and at a higher risk of fractures due to decreased bone density. Osteoporosis, a bone disease from a decrease in bone mineral density (BMD) and bone mass is often a result of tobacco, alcohol, and opioid abuse.

2. Nutritional Deficiencies

Many drugs impact appetite, diet, and nutrient absorption, leading to nutritional deficiencies in minerals and vitamins essential for bone maintenance and health. Individuals with substance use disorders (SUDs) often have nutritional deficiencies, specifically calcium and vitamin D.

3. Hormonal Imbalances

Estrogen, testosterone, and cortisol are all hormones that play a role in bone maintenance and development. Drug abuse, such as opioids, can significantly disrupt the balance of these hormones, contributing to bone mineral density (BMD) loss.

man with bone fracture from drug abuse

4. Increased Risk of Fractures

In addition to the effects of drug abuse, like impaired coordination and motor skills, nutritional deficiencies and decreased bone density can increase the risk of falls, injuries, and fractures. Individuals who struggle with drug abuse may take longer to heal or not heal properly when dealing with bone fractures or injuries.

5. Osteonecrosis

Osteonecrosis, or avascular necrosis, is the death of bone tissue due to a lack of blood supply. Antihistamines (Benadryl, Claritin), Beta-blockers (Propanolol, Carvedilol), and NSAIDs (Ibuprofen, Aleve) are all OTC drugs that can affect blood flow. Other substances, such as amphetamines, cocaine, nicotine, and ethanol, can lead to a decrease in cerebral blood flow (CBF). Reduced cerebral blood flow (CBF) from drug abuse increases the risk of stroke and osteonecrosis.

6. Impact on Bone Growth and Development

Especially in adolescents and young adults, chronic drug abuse can inhibit bone development and growth. This impact can lead to stunted growth and other developmental issues in the musculoskeletal system.

7. Chronic Pain and Musculoskeletal Disorders

Substance use disorders (SUDs) can lead to chronic pain conditions alongside musculoskeletal disorders. This can include inflammatory arthritis, connective tissue diseases, bone diseases, myopathies, and periarticular disorders. Drug-induced musculoskeletal disorders and chronic pain can make it difficult for drug users to maintain an active lifestyle, further exacerbating the risk of osteoporosis.

8. Interaction with Medications for Bone Health

Drug and alcohol abuse commonly have negative interactions with certain medications, especially those prescribed for improving bone health or treating bone diseases. Certain substances can interfere with these prescription medications, potentially causing harmful side effects or reducing their effectiveness.

woman dealing with consequences of drug abuse on bone health

Improving Bone Health: Substance Abuse Treatment and Recovery

Substance abuse has adverse effects on nearly every system in the human body, including the musculoskeletal system. The most effective way to improve bone mineral density (BMD) and overall bone health is through abstaining from substances and medications that harm the bones. For individuals who struggle with drug abuse and addiction, addiction treatment can provide essential strategies, rehabilitation, therapies, and nutritional support for addiction recovery and bone health. Since some bone conditions may require more extensive medical care outside of drug rehab, tailored treatment programs are provided for patients and their situations.

With drug detox treatment, proper nutrition, and physical therapy, individuals with SUD can get sober and improve their bone health.


For drug detox near Stuart, FL, reach out to us at Coastal Detox today. We’ll get you connected with one of our addiction specialists and on your way to a life of sobriety!