Can Cocaine Cause Pancreatitis?

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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Can Cocaine Use Lead to Pancreatitis?

Cocaine is a highly addictive stimulant that directly influences the deep structures of the brain. Even moderate cocaine use over a short time can seriously impact decision-making and lead to several poor, if not irreversible, life choices. Developing a tolerance for this illicit drug is hardly difficult, at which point more frequent use is required to register the desired effects.

While humans have been consuming coca leaves as a stimulant for thousands of years – U.S. companies even marketed cocaine as a wonder drug, adding it to soft drinks – it wasn’t until the early 20th century that the true health impacts of cocaine use became apparent. Consuming the substance comes with several negative side effects, but is drug-induced pancreatitis one of them? This article will offer background information and context about acute pancreatitis and its connection to cocaine in an attempt to answer this question. 

What Is Pancreatitis? 

Pancreatitis is a painful and potentially lethal condition that is responsible for over 100,000 hospitalizations every year. It’s a disease in which the pancreas swells and becomes inflamed to the point where it can no longer work properly. The enzymes within the pancreas that enable digestion in the small intestine start attacking the pancreas itself, usually after a blockage. The three primary types of pancreatitis are acute, chronic, and hemorrhagic. 

Acute pancreatitis leads to all gastrointestinal-related hospitalizations and is the 10th most common non-malignant cause of death among the cluster of gastrointestinal, pancreatic, and liver diseases. 

The condition in its acute form manifests suddenly. Symptoms can range from mild discomfort to a potentially life-threatening illness. Chronic pancreatitis, in contrast, develops slowly over time, leading to permanent damage to the pancreatic tissue. Acute pancreatitis, on the other hand, is a severe illness that comes on quickly and releases toxic enzymes that can injure other organs like the heart, lungs, and kidneys

Hemorrhagic pancreatitis is a condition that describes pancreatic over-swelling. In this state, the pancreas becomes mushy as it aggregates tissue called a “pseudocyst.” The type of cyst is prone to infection and can lead to a pancreatic abscess. 

Hemorrhagic pancreatic attack causes low blood pressure and poor blood circulation to the various body organs. This is where kidney failure becomes a dangerous health risk. Treatment of hemorrhagic pancreatitis in this stage often requires dialysis.

Many people can experience mild forms of pancreatitis throughout their lives. These cases tend to resolve quickly, usually after only a few days. Under normal circumstances, the residual damage after a mild pancreatic attack is minimal, if it exists at all.

What Causes a Pancreatic Attack?

Gallstones, excessive alcohol use, and drugs – including medications – are the leading causes of acute pancreatitis. Gallstones typically form in the gallbladder. Once a gallstone starts passing into the bile duct, it will lodge itself at the exit of this duct where it gets stuck at what’s referred to as the “duodenum.” 

Incidentally, the pancreatic duct shares this exit hole with the bile and cystic ducts, so the impacted stone effectively blocks the pancreas. This ultimately contributes to the inflammatory condition known as pancreatitis. 

Alcohol is a major contributor to acute pancreatic attacks. The condition starts when excessive alcohol begins poisoning the gland. Pancreatic sensitivity to alcohol varies from person to person, however. Most medical experts and addiction specialists concur that there is essentially no safe level of toxin consumption when it comes to protecting the pancreas. 

That aside, some alcohol users can drink regularly and generously for decades without developing pancreatic or other organ damage whereas others can develop issues such as liver and heart disease rather quickly. 

In the following sections, we’ll discuss drug-induced pancreatitis in more detail and some relatively new, if limited, findings about the role of cocaine in acute pancreatic attacks.

Drug-Induced Pancreatitis

The research about pancreatitis and drugs has focused primarily on medication. The World Health Organization (WHO), for example, has identified 525 pharmacological drugs known to produce acute pancreatitis in people. 

A substantial portion of these drugs is used by doctors to treat common health conditions. This means that drug-induced pancreatitis is developing into a notable emergent concern among many medical professionals and addiction specialists. 

Unfortunately, researchers have only recently started paying close attention to drug-induced pancreatitis. Few high-quality studies covering large sample pools exist. There is, therefore, a lot more to know about drug-induced pancreatitis as it exists in the general population. 

Identifying risks for developing acute pancreatitis, in general, also poses several unique challenges. This makes prevention difficult. While strict abstinence from all drugs and alcohol is the best approach for reducing the risk of a pancreatic attack, it is not realistic for everyone, especially those who rely on life-saving medications. 

There are several reasons why clinicians struggle to link acute pancreatitis with drugs, including cocaine. The ostensible lack of mandatory adverse drug reporting systems means many such cases are not sufficiently aggregated and analyzed. 

Many doctors tend to be biased toward the drugs they prescribe and are, therefore, less likely to associate pancreatic attacks with the medications. If they do attribute the pancreatic inflammation to the drug, it is bound to be considered a rare adverse event. 

Likewise, clients who are already taking prescribed or illicit drugs frequently suffer from comorbidities and other risk factors that can trigger pancreatic attacks. Under these circumstances, ruling out one thing over another often proves difficult. 

Currently, there is no imaging technology or serial monitoring system for identifying pancreatic enzymes that could be linked to drug-induced pancreatitis. So how, then, do doctors detect and diagnose pancreatic attacks associated with drugs? 

In general, clinicians use a tiered classification system to determine the likelihood of a drug causing acute pancreatitis. While no established classification exists, most medical health professionals who treat pancreatitis divide the risk factors into three distinct classes. 

Interestingly enough, of the 100 most frequently prescribed medications, 44 of them fell into Class III. Fourteen of these medications were in the Class I and II categories. 

Cannabis, which is the most commonly used illegal recreational substance, has been associated with acute pancreatic attacks. Some research indicates the linkage may be dose-dependent, but there is still much to be learned about the connection between cannabis and acute pancreatitis. 

Similar reports of cocaine-induced pancreatitis exist, as well. However, clinicians believe the cause is explicitly related to a ductal obstruction, similar to gallstone-induced cases of pancreatitis.

While the documented instances of cocaine-induced pancreatitis are rare, with only eight cases described in medical literature, doctors remain concerned about it. Now, let’s take a look at the reasons below.

Cocaine Use and Acute Pancreatitis

Cocaine is among the most toxic illicit drugs, and it’s also among the most prevalently used recreational substances across the globe. The drug impacts multiple organ systems, most notably the brain. Frequent use of cocaine may also lead to gastrointestinal complications. 

Heart problems, chest pains, strokes, agitation, and other cardiovascular problems are all part and parcel of the negative health impacts that frequent cocaine users experience. The gastrointestinal complications associated with the drug include bowel issues and sometimes abdominal pain linked to pancreatic inflammation.

Doctors typically identify cocaine-induced pancreatitis through the process of elimination. Foremost, the client must meet at least one of the diagnostic criteria for cocaine substance use disorder. 

After running ultrasounds and CT scans that reveal no gallstones or other structural problems with the pancreas, clinicians will start exploring whether any medications could be the primary cause of the inflammation. 

Once doctors rule medications out, they will look at the individual’s history of smoking, alcohol, and cannabis use. The difficulty here is that cocaine users partake in other recreational substances like alcohol and marijuana. 

Those struggling with some form of cocaine use disorder often smoke cigarettes as well, which can also lead to non-gallstone-related acute pancreatitis

The individual’s history with other drugs is remote, and if there is a cocaine use disorder issue documented, the healthcare provider can safely attribute the acute pancreatitis to cocaine. 

In seven of the eight documented cases of cocaine-induced pancreatitis, symptoms of acute pancreatitis developed within 48 hours. One person showed signs of the condition within 72 hours. Some had a history of alcohol use but were not active drinkers.

It’s safe to say that, while more research is needed, the pancreas is highly susceptible to damage after using any drug, including cocaine. The best strategy for preventing a pancreatic attack is complete abstinence from drugs and alcohol. Anytime you introduce a foreign substance to the body, there is a risk. 

Documented cases of cocaine-induced pancreatitis are uncommon, but this is likely because they are widely underreported. People with comorbidities and other underlying factors, such as smoking and alcohol use, are at increased risk of developing the condition. 

Treatment Options for Cocaine-Induced Pancreatitis

In a case where cocaine is a potential cause of drug-induced acute pancreatitis, the first consideration should be ensuring the individual doesn’t reintroduce the suspected chemical into the body. 

The pancreatic inflammation in the typical cocaine user could be attributable to a diverse range of causes, and doctors have to complete multiple toxicology screenings to determine the precise root of the cause. 

While the pancreatitis condition itself is serious and often urgent, there is no specific course of treatment for it. Clinicians will monitor clients with these symptoms in the hospital for signs of threatening problems while providing supportive treatments like fluids and oxygen. 

If the condition is mild, but there’s a documented cocaine use disorder, a recovery treatment plan should be the first priority to prevent future complications. 

In the short term, doctors will provide oxygen, antibiotics, painkillers, and nutritional support until the pancreatic attack subsides. Once cocaine-induced pancreatitis stabilizes, the person should consider utilizing the resources of a certified addiction center like Defining Wellness as a holistic recovery plan. 

Addressing the Dual Challenge of Ill Health Effect and Addiction

Facing drug-induced pancreatitis is bad enough, but dealing with addiction on top of it all can be especially challenging, particularly for those who need to access drug and alcohol recovery services for the first time. 

If you’ve recently learned that you have pancreatitis and are battling a cocaine addiction, an effective approach to recovery is going to entail a multidisciplinary strategy for treatment.

Our integrated methods at Defining Wellness have been proven to help dozens of clients in similar situations overcome the multiple health impacts of cocaine use disorder. 

After recovering from an acute pancreatic attack associated with cocaine or other drugs, you’ll need to abstain completely from cocaine, alcohol, and all other mood-altering substances to ensure an optimal recovery.

Of course, for many, this means dealing with the onset of a chemical addiction. At Defining Wellness, we take a process-based approach to addiction treatment that doesn’t just focus on helping you overcome the physical cravings. We help you adopt a healthier approach to life that keeps you on the path to wellness over the long term. 

Our team will assist you in addressing both your mental health and addiction recovery needs while providing a supportive, judgment-free environment as you seek the appropriate medical care for conditions like acute pancreatitis. We understand your addiction likely stems from past life traumas, and we’ll help you address this factor as you get on a lasting path to sobriety. 

Ready to Take the Next Steps Toward Recovery?

The team at Defining Wellness is committed to supporting your journey at every step of the way. If you or a loved one is struggling with substance use disorder, we can offer expert support to enable a healthy, long-term recovery.

We’re ready to guide you through a personalized transformation through a unique blend of traditional and modern holistic treatments. We always tailor each of our recovery modalities to your individual preferences and specialized needs. 

Regain control of your life today by contacting Defining Wellness to learn more about our personalized recovery plans and how we can put you on the path to a healthier, happier lifestyle.

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