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The effects of alcohol and illicit drug use are far reaching, extending to all aspects of a person’s life, particularly to their physical, psychological and social health. With recreational use, users are interested in the effects of acute intoxication and long-term consequences are rarely considered. However, following addiction or dependence to a substance, chronic misuse becomes associated with a variety of physical health issues and disorders. This chapter begins by providing the practising clinician with information about the impact of alcohol on the cardiovascular, respiratory, gastrointestinal, haematological and nervous systems. The second half covers the impact of illicit drugs, starting with the opioids and the physical complications of intravenous drug use. The unique patterns of morbidity associated with cannabis, stimulants, depressants, hallucinogens, ketamine, solvents and nitrous oxide are then considered.
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