Substance use disorder (SUD) is the misuse of potentially dangerous substances that can affect normal body function to the extent that it affects the capability of the individual to participate in everyday activities. According to a study conducted by Najafipour and Beik (2016, p. 437), opioids and alcohol are the leading sustenance abuse. The abusers of opioids do not even know that they are experiencing addiction. As result, they can be affected with lifestyle diseases that are caused by the drugs. As opposed to other forms of addiction, substance abuse disorder requires lab diagnosis and medical treatment rather than a moral failing. Therefore, Opioid, alcohol, Meth, and cocaine use disorder is reviewed distinctively in this literature review in order to determine their independent relationship with the biochemical markers such as AST and GGT.
The Origin and Derivatives
The original opium is a chemical extracted from a poppy plant, scientifically known as Papaver somniferum. The substance is usually milky in its natural state, but it eventually solidifies and turns dark brown if exposed to the air (Najafipour and Beik 2016). Opium can be used to make two categories of substances that can lead to abuse. Benzylisoquinolines and Phenanthrenes in addition to other minority groups. Najafipour and Beik (2016, p. 438) demonstrate that phenanthrenes encompass morphine, thebaine, and codeine. Pawan, Choudhary, Mathur, Choudhary, and Kamla (2011, p. 123) assert that all morphine-like analgesics, irrespective of their origin, are categorized as opioids. In medical use, opioids are used to manage severe pain, especially where major surgery is required. As a result, it is recommended that access to such drugs be limited and only used accurately for the purposes they are intended for.
The use of opium can be traced back to several centuries ago. The substance can consume either through inhalation or oral administration. For smoking, opium is often heated until the alkaloids are ready for smoking (Najafipour and Beik 2016). However, smoking causes a considerable amount of morphine to be lost. In regards to oral administration, morphine is steadily absorbed by the small intestine into the bloodstream. As a result, the process takes time before it commences compared to the inhalation procedure, which takes effect immediately, and the action process is shorter.
Pharmacology And Receptors of Opioids
Opioids form a particular group of analgesic agents that are preferred for clinical use. According to Wang (2019, p. 234), there are mainly three opioid receptors and are classified into MOP, Kop, and DOP. However, Najafipour and Beik (2016, p. 440) demonstrate that NOP is an opioid receptor family regarded as a non-opioid branch. Opioids can function as partial agonists, antagonists, or agonists. Crilly, Ko, Weinberg, and Puthenveedu (2021, p. 8) demonstrate that opioids bind with G-protein to produce cellular hyperpolarization. However, the clinical use of opioids analgesics combines with the nervous system to produce analgesia. Although opioids have been used for several centuries to elevate pain, Crilly, Ko, Weinberg, and Puthenveedu (2021, p. 3) indicate that the past two centuries have contributed to understanding the current opioids used in a variety of medical settings. As a result, Crilly et al. (2021, p. 11) conclude that despite the longevity experienced in administering opioids, it is still a crucial measure where all other analgesics are compared to.
Opioids can be classified based on the receptors which produce their effects. Wang (2019, p.236) summarizes the opioid receptors into three categories, G protein, delta, and kappa. Each group’s name was adopted using the Latin words; however, it was changed in the year 2000 when the International Union of Pharmacology (IUPHAR) adopted DOP, KOP, and MOP (Wang, 2019). According to the study conducted by Crilly et al. (2021), the research indicated that many opioid receptors are mainly located in a person’s nervous system; however, fewer receptors are found within the knee joint, periphery, immune system, heart, gastrointestinal among others. In medical practice, the activation of opioid receptors produces numerous effects that usually depend on the receptor’s location and the analgesia. For example, a study conducted by Najafipour and Beik (2016, p. 439) revealed that morphine has a high affinity for the m receptors than other receptors. However, an opioid antagonist inhibits all the receptors. However, the stimulation of k receptors never causes physical damage compared to the activation of the m receptors.
Effect of Opioid on the body (Liver)
According to the research conducted by Beik and Najafipour (2016, p. 437), it was discovered that the use of opioids could cause the failure of the beta cells and accidentally produce hyperinsulinemia because of the change in the rate of hepatic extraction of insulin. However, a report by Moretti (2019) offers a variant opinion. The study indicates that opioids have a positive impact on the fall of Fasting blood glucose (FBS) (Moretti (2019). However, Beik and Najafipour (2016, p. 438) research differs from the sturdy, indicating that opioids have minimum impact on the FBS. In a different finding, Afarinesh et al. (2014, p. 138) illustrate that FBS is lower in people experiencing opioids addiction. The low concentration of insulin that can be witnessed can result from delayed intestinal glucose absorption. The controversial results are also indicated in the diabetes prevalence, with some showing that opioids use can cause diabetes. In contrast, others suggest that non-addicts are highly vulnerable to experiencing diabetes compared to addicts.
Numerous pieces of evidence link opioid use and liver-related diseases. According to Rubin, Hameed, Gottfried, Lee, Sarkar, and Acute Liver Failure Study Group (2018, p. 940), opioids can directly or indirectly affect the liver, leading to liver failure. However, there is wide use of opioids as anesthesia or painkiller, and this makes this exposes many people to liver failure. Therefore the toxicity of the drug becomes imminent. Although liver failure is not often experienced when there is the proper use of opioids as a painkiller, overuse of the medication leads to the intoxication of the liver, which causes the failure. Rubin et al. (2018, p. 943) also note that improper use of opioids causes acute liver injury (ALI) because of dehydration, which causes infection. Additionally, the author indicates that liver lipoids on liver biopsy are also caused by methadone, Opioid. Finally, according to Mallappallil, Sabu, Friedman, and Salifu (2017, p. 223), older adults are more vulnerable to suffering from side effects due to the alteration in opioid pharmacokinetics.
In the elderly, the liver performance is lowered hence exposing the organs to metabolites that accumulate for a long duration. With the exception of buprenorphine and morphine, all opioids undergo oxidation, leading to liver diseases and a number of liver malfunctions. In addition, with the elderly, the blood flow decreases, which creates an opportunity for drug-drug interaction to occur, thus causing toxicity. Mallappallil, Sabu, Friedman, and Salifu (2017, p. 225) also concludes that there is inadequate research determining the extent of liver failure caused by the use of Opioid. However, in their submission, the researchers agree that ALI can be triggered by toxins that are not necessarily opioids.
Nevertheless, illicit drugs and alcohol contribute to 46% of the cases reported in hospitalized patients (Mallappallil et al., 2017). However, there is a lack of any recorded information on the patients who are not reported in the hospitals. Despite the lack of scientific proof on the effects of opioids in patients that do not seek medical treatment (Mallappallil et al., 2017). illustrate in their research when they report that complex body interactions are often experienced in the liver when the body responds to the elements of opioids. In all these studies, researchers conclude that the increase in the use of opioids across the globe is directly linked to the increased liver diseases experienced. Therefore, when it comes to pain control, Rubin et al. (2018, 939) advise medical practitioners to consider non-renal clearance of drugs when managing acute and chronic pain.
Also, sturdy conducted by Pawan et al. (2012, p. 125) on the adverse effects of opium presence on the liver and lungs indicated that there is a significant number of negative effects that are posed to the organs. The research used a controlled experiment in order to achieve the objectives. The controlled group was subjected to no amount of opium, while the second group was composed of individuals addicted to opium. The sturdy discovered that AST, ALT, and alkaline phosphate levels were significantly present in the addicts than those in the controlled group. However, the amount of FVC was lowered considerably in the addict group. The findings of the research are consistent with those from other studies that have been conducted previously. In the liver, the secretion of enzymes is enhanced due to the metabolites Vuong, Van Uum, O’Dell, Lutfy, and Friedman (2010, p. 100) illustrate that the biotransformation of the morphine creates the metabolites by a process known as hepatic glucuronidation. The morphine then changes its state to inactive metabolite morphine, popularly abbreviated as M3G. as a result, continued intake of opioids can damage the liver and expose an individual to a long-time health risk.
The research also reveals that metabolizes of morphotaxa’s place in the liver and it has a prolonged clearance mainly due to the enterohepatic flow, which facilitates the steady blood flow and elements of morphine and its elements while also preventing the components of the drug from intestinal hydrolysis of glucuronides. As a result, it is concluded that morphine has a direct negative impact on the respiratory organs, which lowers the organ’s ability to achieve its maximum performance. Furthermore, Anty administration of opioids into the body system depresses the functionality of the respiratory activity in regards to rate, tidal, and minute volume. Moreover, overuse of the drug can lead to non-cardiogenic pulmonary oedema. Also, it causes the rigidity of various body systems, such as the abdominal wall and chest. Therefore, it has alluded that the use of opium for a period that is more than two years increases the chances of an individual experiencing pulmonary and hepatic damage (Pawan et al., 2012).
The use of opioids and alcohol elevates the levels of AST, which is a significant indication that the liver is negatively affected. According to research conducted by Łangowska-Grodzka, Ziółkowski, and Czarnecki (2016, p. 12), the authors discovered high levels of AST, cholesterol, GTP, and ALT were high among the opiates addicts and the alcohol users compared to those who were addicted to the amphetamine. The purpose of the study was mainly to discover the deviations of the blood chemistry in patients suffering from drug use disorder. However, the study findings supported the previous studies that reported that amphetamine-addicted patients had better biochemical parameters of liver functioning than those addicted to alcohol and opiate products. This was mainly evident when the scientific analysis demonstrated that opiate and alcohol addicts had high levels of AST, biochemical primarily associated with liver damage. For instance, the opiate and alcohol addicts subjected to the experiment revealed that AST levels were 16.1% higher than the recommended levels (Łangowska-Grodzka et al. 2016). The rate is even higher on adults and those who have used these drugs for an extended period. Thus, despite the experiment being conducted on many people with different addictions, alcohol and opiate users show significant liver damage.
However, a study conducted by Afarinesh, Haghpanah, Divsalar, Dehyadegary, Shaikh-Aleslami, and Mahmoodi (2014, p.138) revealed that fasting blood sugar (FBS) reduced in people who were using opium compared to the non-users. Additionally, the research indicated that blood serums are highly affected when there is a high concentration of opium. Morphine effects decrease the functionality of the morphine receptors and the cells’ ability to detect the changes in the body. The withdrawal from opium increases cell activity, and this gives up syndrome indications. For instance, the study indicates that withdrawal from cocaine enhances plasma corticosterone levels, leading to suppression of the immunity system. Therefore, the investigation findings led to the conclusion that long-term use of cocaine and other opioids causes addiction and results in changes in protein and lipid serum biochemicals; therefore, it causes liver diseases.
A study conducted by Nakhaee, Ghasemi, Karimzadeh, Zamani, Alinejad-Mofrad, and Mehrpour (2020, p. 8) indicated that opium does not improve cardiovascular problems. Although the research findings were conflicting with some articles suggesting that continuous use of opium improves the liver. The majority of the literature used to conclude indicated that opium does not protect against cardiovascular problems. Additionally, the research stated that opioids increase AST levels and ALT, which usually affects the liver by causing severe atherosclerosis in the coronary artery. These findings are supported by the report of Łangowska-Grodzka et al. (2016, p.12) when they indicated that enhanced presence of AST and GGT causes liver injury, and this can cause tremendous health problems to people. In their submission, the authors suggest that opium and alcohol are the leading causes of the increase in ASTL and GGT biochemicals.
Also, Sanli, Bilici, Suner, Citak, Kartkaya, and Mutlu (2015, p. 3) discovered that opium interferes with the composition of the serum biochemicals. It decreases the glucose levels in the patients, thus causing gluconeogenesis, which reduces blood sugars. Despite these findings, the researchers acknowledge that numerous studies have also shown that opium can benefit blood lipids. However, the clinical results of the study show that the continuous use of opium can lead to atherosclerotic plaque formation, which can negatively affect the serum composition in any animal. Although the biochemical composition of the serum cannot be immediately realized, the study reported that the use of cocaine could have long-term adverse effects on the liver. However, the effects can be presented at a later stage, even after withdrawing from the use of the drug.
Alcohol In More Details
The Origin and Derivatives
According to Zhao, Liu, Li, Feng, Chang, and Lyu (2020, p. 84), alcohol is ranked as one of the leading causes of global disease burden. The research indicated that China had experienced increased consumption and production of alcohol, which exposed most middle-come earners to experience numerous health conditions. The research shows that alcohol consumption can enhance the prevalence of lifestyle diseases such as hypertension in both males and the female gender. The findings correlate with the previous studies performed by Ifeanyi, Ndukaku, Ndubuisi, Kalu, and Obioma (2014, p.834), indicating that nondrinkers were less prevalent hypertension compared to the drunkards. Although the general population consumes alcohol, the research stated that the Chinese male population consumes alcoholic content more than the female gender. However, the research acknowledges that there is inadequate data to determine the rate of alcohol and prevalence of the diseases because of the inconsistencies in the previous studies. Generally, the research concluded that there is a direct relationship between alcohol consumption and hypertension in China.
Alcohol also causes hypertension and stroke, according to the research conducted by Hillbom, Saloheimo, and Juvela (2011, p. 211). However, people’s drinking patterns have not been determined; therefore, the impact of alcohol on human health may be more significant than what is currently established. There was solid evidence indicating that men with severe hypertension had a strong habit of consuming alcohol. At the same time, those made a habit of being a significant risk factor in experiencing a stroke. As any other country, United Arabs Emirates (UAE) is also struggling with the healthcare problem. According to Hamda (2019) research, the number of people consuming alcohol has increased in the past two decades. As a result, there are many health problems linked to alcohol consumption, and it has become a social problem and a medical problem.
Pharmacology Of Alcohol and Its Impact on Liver
Alcohol is a unique substance because it has different pharmacokinetics, which is often similar to numerous drugs. According to Dadiomov (2020, p. 17), alcohol metabolism takes place at a specific metabolic rate, mainly because ethanol undergoes. Ethanol’s presence in the alcohol metabolizes at that particular rate regardless of the contraception of the alcohol. However, speed can be affected by race, weather, sex, body mass, and the nutrients available in the body. Although ethanol has a short life span in the body, it is converted to ethyl sulfate and ethyl glucuronide during the metabolizes, excreted from the body through the urine. Gamma-glutamyl transferase (GGT) is an enzyme from the liver that can determine the presence of alcohol content in the body (Dadiomov 2020). The enzyme increases when there is heavy consumption of alcoholic drinks. This, therefore, implies that non-alcohol users should have a low concentration of GGT which should be lower than 54 IU/L (Dadiomov 2020). however, the study suggests that GGT can also increase based on various reasons, not necessarily alcohol.
Additionally, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the liver also increases when there is the intensive use of alcoholic drinks. Liver functions can be elevated with toxins from alcohol, and this can cause hepatic cellular damage. However, the findings obtained from the research are general, and therefore they are less sensitive than the previous studies. An analysis performed by Peterson (2004, p. 130) on the biomarkers for alcohol also asserts that ALT, AST, and GGT increase with prolonged consumption of alcohol products. These are some of the enzymes secreted in the liver, and they are crucial in breaking down chemicals, especially carbohydrates found in alcohol. The GGT in the liver is composed of Proteins and Carbohydrates, while AST and ALT are enzymes that break down the amino acids, the main components of proteins. Therefore, any slight increase in the levels of GGT is an indication of the presence of the disease in the liver. However, the levels of GGT cannot be exclusively used to determine the presence of the disease because the rise can be triggered by a number of factors that can not necessarily be alcohol consumption.
Also, the study conducted in Korea revealed that controversies are surrounding the relation of alcohol to hypertension. Even though some studies show that high alcohol consumption never contributes to hypertension, Yoo, Park,Kim, Jang, Lee, and Park (2019, p. 24) reveal that alcohol consumption directly increases the risk of hypertension. The study was one of its kind because it’s the first to determine the relationship between alcohol consumption and risk of incident hypertension in Korea. The main difference between this study and the previous research is that it measured alcohol consumption for ten years while previous studies had only alcohol measured at the one-time point. The study also validates the recent findings of Zhao et al. (2020, p. 86) that illustrated that more men risk getting hypertension than women. Additionally, the GGT in the liver also increased, demonstrating significant damage posed to the liver.
The UAE is not spared from substance abuse disorder, and the health department is overwhelmed with the health-related issues caused by substance abuse. According to the research conducted by Doran (2016, p. 752) indicated that there is a significant increase in substance abuse in the UAE. Based on the investigation, the sturdy the number of crimes as increased in the UAE, with the majority of the crimes linked to substance abuse. Although alcohol is the leading substance abuse in the country, Meth and cocaine are on the high rise, especially in Dubai and Abu Dhabi, the major cities in the country (Doran 2016). In addition, the number of health-related cases has also increased in the country, with the majority of the issues being attributed to substance use disorder. Therefore, the researcher concluded that substance abuse had put a lot of economic stress on the economy of the UAE as a lot of incomes earnings are spent on illicit substances, and substantial financial resources are also used in rehabilitating the addicts (Alsuwaidi, 2019).
Also, a dissertation submitted to Harvard University indicated that the UAE experiences addiction problem in most parts of the world. As a result, the study suggests that numerous resources should be channeled to supporting rehabilitations facilities to reinstate the recovering addicts to their normal state (Alsuwaidi, 2019. This, therefore, implies that a financial burden will be posed to both the state and the family members. The families suffer the burden by building the recovery centers and the hospitals to cater to the increased number of patients. However, the families bear the pain of seeing their keens suffer and the financial responsibilities they incur while seeking medical attention. The individuals experiencing addiction also suffer from stigmatization, which deters them from seeking medical help, and as they are there at the risk of experiencing substance disorder. As a result, the whole society experience a problem that needs to be controlled. Addiction also causes crimes in the society. Majority of the addicts get into criminal activities in order to raise the funds that are used to purchases the drugs. Also, being that these drugs are illegal, criminal gangs thrive as they strive to control their territory.
However, Husain, Ansari, and Ferder (2014, p. 245) that alcohol consumption is beneficial to the body because it helps the cardiovascular system and lowers blood pressure. The sturdy ins were also supported by a pre-clinical study that indicated that moderate ethanol helps in reducing systolic blood pressure in rats. Therefore, moderate drinking is advised to be two bottles of the bear a dear for men under 65, while elderly adults above 65 should only take one bottle a day. However, heavy consumption of alcoholic contents can lead to hypertension. However, the research indicates no specific medication for alcohol-induced hypertension, which exposes the addicts to the health risk that can lead to their untimely death. Moreover, it is difficult for the addicts to control the amount of alcohol they consume in a day. The moment an individual takes one bottle of alcohol the more they get the urge to drink more. The addictive nature of the alcohol makes it difficult to control the amount of alcohol therefore it is certain that the liver will be subjected to high amount of alcohol.
According to Das, Nayak, and Vasudevan (2003, p. 112), laboratory tests can be used to determine the effects of alcohol on the liver. The study reveals that the changes in the biomarker of the liver can demonstrate the presence of liver cirrhosis. The increase in GGT than the average level indicates that the liver is negatively affected by alcohol consumption. However, the research disagrees with the recent studies that suggest that increase in AST also is an indication of liver diseases caused by alcohol. As a result, AST should not be used in screening activities because they have limited sensitivity. Levels of AST levels can also be elevated in non-hepatic sites such as the heart and muscles. This is often triggered by the trauma caused in the skeletal muscle and the myocardial infarction (Das, Nayak, and Vasudevan, 2003). However, the authors suggest that the ratio of AST to Alt can, however, be used to determine the levels of liver diseases instead of determining only the elevation levels of AST. Nevertheless, the GGT levels should be used to determine the extent of the liver injury because of its high sensitivity. Usually, the elevation is detected two days after consumption, and the levels normalize after six weeks of denying the individual alcohol. Therefore, the research concludes that GGT can be used singly to determine the levels of liver injury while AST can only be used in comparison to ALT.
The research is supported by the findings of Yoo, Park, Kim, Jang, Lee, and Park (2019, p. 24), which states that GGT can be used exclusively to determine the liver injuries caused by the consumption of alcohol. The GGT is described as a risk factor of metabolic syndrome, thus detecting any changes within the liver, being that alcohol metabolism occurs in the liver. As a result, the GGT is considered a biomarker of alcohol intake because it has recently been associated with alcohol-induced hypertension. Therefore, any increase in the levels of GGT suggests an injury to the liver.
The Origin and Derivatives Methamphetamine and Cocaine
Methamphetamine (Meth) was initially introduced in the 1900s, and the soldiers mainly used it in World War II to enable alertness and weight loss (Richards and Laurin 2020). Therefore, the drug was not expected until the early 1990’s when it gained popularity across the world and became illegal in most parts of the world. There is substantial evidence that links abuse of Meth leads to extensive artery dissection and aneurysm formation within a short period after consuming the drug (Richards and Laurin 2020). In addition, the drug is highly addictive, and the majority of those who recover from the disease suffer from a long-term cognitive deficit.
Cocaine is obtained from an Erythroxylon coca shrub which has more than 20 species (Armentia et al. 2018). The shrub is mainly obtained from South America and other tropical regions. Cocaine was initially used in 1884 when it was discovered that it could act as anesthesia and also be used to treat morphine and alcohol addiction. The drug is used for surgery because it usually numbers the regions where it is applied within a short period of time. Although the drug was initially popular in the USA and most South American countries, its use has spread to other parts of the world. The UAE is also emerging as a potential market for illegal drugs. Cocaine can be administered to the body through inhalation or injection. Inhalation takes effect immediately because the drug is administered directly into the bloodstream. The study, however, concludes that cocaine can trigger allergic attacks if abused.
Pharmacology of Meth and cocaine and their impact on the liver
According to de Carvalho et al. (2018, p. 4), Meth can treat liver injury. The experiment carried out by the authors showed that the consumption of Meth could reduce ALT and Alt which are often elevated by the consumption of alcohol. Alcoholic liver injury releases activated Kupfer cells which bind to promote target genes. The consumption of Meth, however, unbound the genes of the activated cells this promoting repairing of the cells (Fowler et al. 2018). However, the sturdy discourages the overuse of Meth since long term use can suppress the production of AST serum, affecting the liver’s performance. However, the findings of Singh (2019, p. 16) discover that cocaine affects the liver by elevating AST levels in the liver. This, therefore, causes liver injury, and the level of AST can be restored to the average level after abandoning the use of cocaine for an extended period. Unlike alcohol that can stay for a few weeks in the body system, cocaine can take several years before it is finally careered for the system. Therefore, the research demonstrates that long-term use can affect the liver, which can take long periods to restore average performance.
Contrary to de Carvalho et al., Zhang et al. (2018, p.1595) establish that Meth increases the AST serum in the liver. As a result, it demonstrates that it causes significant injury to the liver because any increase in the levels of AST shows liver diseases. This, therefore, conflicts with the studies conducted by de Carvallo et al in 2018, which illustrated that it lowers the AST levels. However, there no recognizable changes in the anatomy of the liver. The research further demonstrates that cocaine also raises the levels of AST in the liver, which supports most of the findings that show that cocaine consumption causes liver injury. Additionally, the study discovered a reduction in glucose levels in meth addicts than those using cocaine. Therefore, maenad that meth addicts should energy drinks to replace e the glucose levels lowered by meth consumption.
Additionally, Zhao et al. (2020, p. 88) conducted an experiment on the effects of induced Meth on the serum makers and liver damage. The study indicated that many people subjected to meth experience increase AST levels, which is a crucial enzyme in the liver; it shows damage to the liver. Additionally, cocaine also sturdy reveals that continuous administration of cocaine n into the body interferes with AST levels in the body, increasing the levels of AST in the liver. Therefore, it is evident from the study that both cocaine and meth consumption interferes with the biomarker of the liver serum by raising the levels of AST, and this indicates that the drugs impose a lot of damage to this vital body organ.
Comparing Alcohol, Opioid, Meth, and Cocaine in Terms of Affecting AST and GGT Biochemical Markers
Based on the information collected, alcohol, opioids, Meth, and cocaine affect the AST biochemical makers in the same manner. Continuous administration of these substances in the body raises the levels of AST in the liver and theses, therefore, means that these substances pose injury to the liver. Although studies conducted by Zhang et al. (2018, p. 1594) illustrates that Meth lowers the levels of AST and therefore can be used to treat the injuries imposed by alcohol, subsequent studies indicate that there is no clinical evidence to support this sturdy because Meth itself raises the level of AST. However, in regards to GGT, alcohol consumption indicated GGT was increased in the liver, which showed significant damage to the liver. The studies, however, agreed that cocaine, Meth, and opioids had limited effect on the GGT and therefore could not be used to determine the effect in the liver.
Critical Analysis of The Reviewed Articles
The studies indicate that AST and GGT are essential biomarkers that are interfered with substance abuse. However, there are conflicting results in some of the studies that have been previously conducted; a survey by Dadiomov (2020, p. 19) indicated that a number of issues such as body mass, sex, and nutrients taken by a person could also interfere with the biomarkers, for instance, the study reveals that it can raise the levels of AST. Therefore, this means that the desired can never be obtained if there are other external factors involved. Although most studies reviewed agree that GGT levels are only raised when alcohol is involved, the studies are not adequate because there is no modern evidence to indicate the same as more studies rely on past studies and can not reveal the real impact of alcohol on past studies the liver.
Additionally, the controversial studies indicated that Meth could lower AST, and therefore, it is a suitable medication; reducing the AST should be investigated. Furter. Research conducted by Singh (2019, p. 16) indicated that most addicts use all four drugs at the same time. This, therefore, means that a patient can be using both Meth and alcohol, and Meth can be used to lower the AST levels raised by the alcohol. In this case, the levels should be normal. However, the research reveals that GGT and AST are increased, which shows that there is damage to the liver.
Moreover, the review indicates that opioids, alcohol, cocaine, and Meth are used for medication in one way or another. However, the overuse of drugs can lead to the deformation of the liver. This, therefore, means that substance use disorder can be controlled if adequate precautions are taken. However, withdrawal does not necessarily mean that the individual will be freed from the risks immediately. Substances such as alcohol can have an immediate effect; however, some, such as cocaine, can have long-term consequences, which can be expensive and almost impossible to restore the patient to their normal state. Additionally, the levels of AST and GGT cannot be immediately restored once they are subjected to toxins caused by excessive consumption of alcohol, meth, cocaine and opioids. Lifestyle diseases introduced by the drugs can also stay with the addict and eventually leading to the untimely death or low quality of life. Therefore, the medication could only be taken according to the physician’s prescription to avoid the misuse of the drug.
However, all the studies provide conflicting information to the research. Some sources indicate that the substances do not harm the liver. For instance, Zhao et al. (2020, p. 88) suggest that AST can increase; however, no changes can be detected in the livers. As a result, the liver can still perform effectively, and therefore the increase in AST should not be viewed as necessary as a health risk. However, numerous studies suggest otherwise AST and GGT increase is a sign that there is infection; however, they can be controlled by reducing the use of the substances that arise them. As a result, confusion is raised as each study convinces the readers equally.
Additionally, the results obtained from the sturdy are rarely convincing ion that there are conflicting this it is difficult to determine which is correct. Most of the authors who have participated in the work acknowledge that further studies should be conducted to determine how alcohol, opioids, cocaine, and Meth interferes with AST and GGT. The studies regarding this topic have not been conducted as the previous research only implicates one or two substances and not all the four. Even for the few studies linking two or more substances, the findings are conflicting, making it difficult to determine the drug’s actual effects on the biochemical markers in the liver. However, being that the liver is a vital organ in the body that its collapse can lead to death or severe health conditions, there should be consistency in the findings related to the use of drugs and the effects on the body. Therefore, there is a need to conduct research that harmonizes the present and the past studies that have been performed.
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