Other Commonly Abused Substances

Diuretics speed the elimination of salt and water by the kidneys and are used to treat a variety of disorders, including high blood pressure and heart failure. However, some people, including athletes and people with eating disorders such as anorexia nervosa, take diuretics to help them lose weight quickly. Inappropriate use of diuretics may cause dehydration and severe abnormalities of electrolytes, such as low potassium. Such deficiencies can lead to severe illness or death.

Erythropoietin is a hormone produced by the kidneys. It stimulates bone marrow to produce red blood cells. Erythropoietin is also manufactured as a medication. Darbepoetin is a medication similar to erythropoietin. Both medications are used to increase production of red blood cells in people with certain kinds of anemia. Athletes may take erythropoietin or darbepoetin because they believe that with more red blood cells, more oxygen can get to their muscles, enabling them to perform better.

Using erythropoietin or darbepoetin without medical need may change the body’s regulation of red blood cell production, so that the number of red blood cells suddenly decreases when these medications are stopped.

Growth hormone is produced by the pituitary gland to help the body control how proteins, carbohydrates, and fats are used to stimulate growth. Growth hormone is also manufactured as a medication and is sometimes given to children of small stature when their body is unable to make enough growth hormone. Some athletes abuse growth hormone because they believe it can increase muscle growth and strength while decreasing body fat.

Use of growth hormone without medical need over a long period can cause an increase in fat levels in the blood, diabetes, and an increase in heart size, which may result in heart failure.

Laboratory tests to identify growth hormone not made by the person’s own body are not routinely available.

anorexia nervosaelectrolytes, weakness, irregular heart rhythms, and heart failure.

Laxatives speed the passage of substances through the digestive tract and are used to treat constipation. However, people who falsely believe they must have frequent bowel movements as part of being healthy often abuse laxatives. In addition, people with eating disorders such as anorexia nervosa sometimes take laxatives because they believe doing so can help them lose weight.

Laxatives used often and without medical need may cause dehydration and severe deficiencies of electrolytes. Regular use of laxatives can also interfere with absorption of other medications, causing them to stop working. Inappropriate use of laxatives over a long period can damage the muscle layers of the large intestine. Severe constipation and other intestinal disorders (such as diverticulosis) may result.

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

1. National Institute on Drug Abuse (NIDA): Federal agency that supports scientific research into drug use and its consequences and supplies information about commonly used drugs, research priorities and progress, clinical resources, and grant and funding opportunities.

2. Substance Abuse and Mental Health Services Administration (SAMHSA): US Department of Health agency that leads public health efforts to improve behavioral health and provides resources, including treatment locators, toll-free helplines, practitioner training tools, statistics, and publications on a variety of substance-related topics.