02. Experts Corner

Substance Abuse Creates Immunological Changes Important in the Current COVID-19 Pandemic

April 28, 2020

Substance abuse causes a unique overlap of physical challenges, psychological stress, and immunological changes in a person. Add to that the current ravages of the COVID-19 pandemic, and there emerges a perfect storm of significant danger to patients struggling with substance abuse.

Physical Challenges

Those dependent and/or addicted to substances—from nicotine to prescriptions or illicit drugs—have a general deterioration in their health. This is because the normal checks and balances of the body are overridden. Homeostasis, the moment-by-moment adjustments made for these balances, becomes misdirected toward the needs imposed by the substance. This is why withdrawal is so unpleasant—physically and psychologically.

Psychological Stress

Being dependent or addicted to a substance creates a powerful stress-maker for an individual. Besides the fear of the significant physical discomfort that would result from running out, there is the additional stress that comes from the scheming and plotting of trying to acquire them, often in conflict with law enforcement and healthcare oversight (doctors, nurses, emergency departments, and pharmacies).

Stress releases hormones both acutely and over the long-term. Acutely, adrenaline—the “flight or fight” hormone, jacks up alertness which causes heart rate and blood pressure to rise to a challenge. Chronically, however, cortisol is released, which is anti-inflammatory at first but over time becomes inflammatory itself, taxing the immune system.

The Immune System

When the immune system is taxed, it is not a significant event because it happens every day. We are designed to engage it and are not the worse off for it. In fact, it’s a crucial part of our survival abilities. However, when the immune system is taxed continuously and the damaging effects of unremitting cortisol are in progress, one’s ability to use the immune system effectively is reduced; this is the reason why drug abusers suffer illnesses more frequently and are less capable to fight them with the typical fervor that other people can muster.

There is no better example of how immunosuppression can compromise one’s health than the HIV/AIDS viral illness. Although drug abuse does not create the tendency to fall ill as much as HIV/AIDS does, it still is a similar—and comparable—mechanism.

Enter COVID-19

COVID-19, the novel coronavirus which is a never-before seen challenge to our immune systems, takes advantage of people’s weaknesses. This is why it seems to target the elderly and those with predisposing conditions, like diabetes, heart disease, emphysema/COPD, or kidney failure.

In fact, most of the deaths from COVID-19 have been in just those groups of vulnerable individuals. But it is important to understand that substance abusers and the addicted are equally fertile targets for this new invader to our biology.

A Gumbo of Elements Targeting those Suffering Substance Abuse

Along with medically compromised persons, COVID-19 is also targeting those with alcohol abuse, and drug abuse patterns. While one’s immune system is already compromised by the immunosuppression that comes from chronic stress and cortisol in the system, COVID-19 also compromises the immune system further by reducing the number of lymphocytes for battle against pathogens (germs).

Additionally, those who abuse one substance are more likely to abuse others, so it is frequent that alcohol (impacting the liver’s function) and smoking/vaping (impacting the lungs) create a “double whammy” for such persons.


In a new world of new diseases that impact one’s immune system, one should not place him- or herself into a category that is already at the highest risk for mortality. Those suffering from a substance use disorder should pay special attention to the warning signs of COVID-19, because they clearly have targets on their backs. Suffering addiction is devastating enough, but the COVID-19 adds yet another unfair factor that puts their lives into jeopardy.

About SubstanceAbuse.com

Support from SubstanceAdbuse.com

This blog was provided by expert medical writers at SubstanceAbuse.com. Since 2006 SubstanceAbuse.com has been helping to bring awareness to substance abuse, dependence, and addiction. Their team of medical experts strive to help those struggling with substance use disorders get the information, and tools they need to overcome their dependencies. If you (or someone you know) needs to get help to put addiction behind you today, then start by visiting their website.


If you are interested in learning more about recovery from addiction, then also read our previous Experts Corner blog by Addictions.com

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