Other Commonly Abused Substances

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 electrolyte imbalances that can lead to severe illness or death.

Erythropoietin and darbepoetin are typically used to increase production of red blood cells in people with certain kinds of anemia. These drugs may be taken by athletes to increase red cell production in order to increase the cells' oxygen-carrying capacity, which can enhance performance especially in endurance events.

Using erythropoietin or darbepoetin without medical need may alter normal regulation of red blood cell production, so that red blood cell production suddenly decreases when these drugs are stopped.

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 alter cholesterol levels, increase risk of diabetes, and cause cardiomegaly and resultant heart failure.

Laboratory tests to identify synthetic growth hormone are not routinely available.

People with eating disorders such as anorexia nervosa often take ipecac syrup after eating to help them lose weight. Ipecac induces vomiting reducing the total food available for digestion and decreasing total caloric intake. Inappropriate use of ipecac may cause diarrhea, severe deficiencies of electrolytes, weakness, arrhythmias, and heart failure.

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 too often and without medical need may cause dehydration and severe electrolyte deficiencies. Regular use of laxatives can also interfere with absorption of other drugs. Inappropriate use of laxatives over a long period can alter the normal motility of the large bowel. 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.