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Randi FredricksRandi Fredricks, Ph.D.
Improving Anxiety, Depression, Addiction & Eating Disorders with Therapy & Natural Remedies Blog

Substance Abuse and Drug-Induced Osteoporosis

Randi Fredricks, Ph.D. Updated: Feb 24th 2014

Osteoporosis is a skeletal disorder characterized by low bone mass and deterioration of bone architecture leading to increased bone fragility and susceptibility to fracture. Primary osteoporosis refers to a reduction in bone mass related to aging and menopause, whereas secondary osteoporosis results from specific diseases or drugs.

group of senior citizens sitting on a benchDrug-induced osteoporosis typically refers to bone loss resulting from a variety of drugs, most notably oral glucocorticoids, antidepressants, antipsychotics, anticonvulsants, gastric acid-reducing agents, and thyroid drugs. However, an equally serious threat comes from nicotine, alcohol, and other commonly abused drugs, such as opioids.

The reason that this type of drug-induced osteoporosis can be more damaging than prescription drugs is because people often begin using them during adolescence before their bones are fully matured. In fact, people don't reach their peak bone mass until 35. For both men and women, healthy bones depend on bone development during these younger years so that sufficient bone mass is achieved.

There ample evidence that chronic excessive drinking, especially during adolescence and the young adult years, can significantly reduce bone quality and increase the risk of developing osteoporosis. In terms of reversing the effects of heavy alcohol use on bone architecture, research has shown mixed results.

Investigations into drug-induced osteoporosis have found that substance abuse significantly increases the risk of bone loss in both men and women. Chronic heavy drinking has been found to affect bone length and bone mineral content and density.

Nicotine is also associated with both bone loss and heavy drinking. People who drink alcohol are 75 percent more likely to smoke than are nondrinkers, and smokers are 86 percent more likely to drink than are nonsmokers. Research has found that people who smoke typically lose more bone mineral density than those who never smoked.

Recovering substance abusers often drink large amounts of coffee and smoke cigarettes, both of which are associated with an increased risk of osteoporosis. A study at the University of Tokyo reported that coffee intake is associated with low bone mineral density (BMD), whereas drinking green tea can actually increase BMD.

Although osteoporosis is a serious illness, bone loss can be halted or reversed in some instances with the following practices:

  • Get a bone density test. The results will help a nutritionist determine how much vitamin D, K, B12, folic acid, and calcium are needed to maintain or restore bone.
  • Quit smoking, drinking alcohol and using drugs.
  • Some prescription medicines promote bone loss. Check all medications to see if bone loss is one of the side effects. If it is, make every attempt to find an alternative medication or therapy.
  • After consulting with your doctor, begin an exercise program. Walking, cycling and weight lifting have all been shown to be good for building and maintaining bone mass.
  • Drink green tea instead of coffee as coffee promotes bone loss and green tea promotes bone growth.
  • Do a daily pH test at home to keep track of your pH levels. Acidity in the body has been linked to bone loss and osteoporosis.

The best diet for preventing and reversing bone loss is a whole foods diet that is low in calories and saturated fat, high in wholegrain cereals, legumes, fruits and vegetables, calcium and vitamin D, and which maintains a lean body weight. Elimination or reduction of meat is also associated with higher bone density.

There's a strong correlation between osteoporosis, depression, and alcoholism. Clinical depression encourages some people to drink large amounts of alcohol in hopes of numbing depressed feelings, with risks of alcohol abuse and dependence. Additionally, people with depression are more likely to develop osteoporosis, those with osteoporosis have an increased incidence of depression, and alcoholic consumption is linked to osteoporosis. Because of these factors, bone loss is one of the first health issues that should be addressed when treating someone with a history of chronic alcohol abuse, particularly if they started drinking during their adolescence or young adult years.


Randi Fredricks, Ph.D.

Dr. Randi Fredricks, Ph.D. is a therapist, researcher and author with a Ph.D. in Psychology and a Doctorate in Naturopathy. She works with individuals and couples and provides therapy for anxiety, depression, addiction, and eating disorders at San Jose Counseling and Psychotherapy. In her private practices in San Jose, CA. Dr. Fredricks has developed a proprietary counseling approach blending alternative medicine with traditional evidenced-based therapies such as cognitive behavioral therapy and client-centered therapies. Her therapy style is sensitive, spontaneous and enlivening. Dr. Fredricks' best-selling books include Healing & Wholeness: Complementary and Alternative Therapies for Mental Health and Fasting: An Exceptional Human Experience. For more about her work, visit

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