H)+Adverse+Effects

It is important that those involved in the care of people with substance abuse issues and eating disorders are aware of the co-morbity of eating disorders and substance abuse. Each, on their own, present substantial health concerns; the presence of both will increase health risks. “Eating disordered patients are already at an increased risk for morbidity and mortality, so alcohol and drug use pose additional dangers for these patients.” (Conason, Klomak & Sher, 2006) There are differences between the classifications of eating disorders and their relationships with substance abuse issues. Use of alcohol and other substances have been found to be more prevalent in those with Binge Eating Disorder and Bulimia Nervosa. (Conason, Klomak & Sher, 2006) It is believed that overeating and substance abuse are self-medicating behaviours, in part, related to feelings of guilt, social anxiety and family dysfunction. (Conason, Klomak & Sher, 2006)   
 * Some Adverse Effects of Alcohol Misuse**
 * Physical Effects such as damage to brain tissue, liver disorders, heart disease, malnutrition, susceptibility to infectious diseases. (Hart, 2009) (Catterson, 1995)
 * Dangerous effects resulting from the disinhibiting characteristic of alcohol, for example impaired driving and unsafe sex practices.
 * Lifestyle consequences, including neglecting important responsibilities like work or school (Dunn, 2001)
 * Social and behavioural consequences which can have dramatic effects on important relationships and general social functioning.
 * Psychological and withdrawal effects including depression, anxiety, irritability and suicide attempts and completed suicide. (Conasen, Klomak, & Sher, 2006)
 * Some Adverse Effects of Eating Disorders **
 * Repeated vomitting causes significant loss of dental enamel (DSM IV TR, 2000)[[image:bulimiaFuzzy.jpg width="221" height="171" align="right"]]
 * Fluid and electrolyte imbalances (DSM IV TR, 2000)
 * Irregular menstruation or amenrrhea (DSM IV TR, 2000)
 * "Rare but potentially fatal complications include esophageal tears, gastric rupture and cardiac arrhythmias." (DSM IV TR, 2000)
 * Malnutrition
 * Decreased bone density
 * <span style="font-family: Verdana,Geneva,sans-serif; font-size: 90%;">Heart disease
 * <span style="font-family: Verdana,Geneva,sans-serif; font-size: 90%;">Attempted suicide and completed suicide (Conasen, Klomak & Sher, 2006)

<span style="font-family: Verdana,Geneva,sans-serif; font-size: 99%;">High rates of mortality are associated with eating disorders and substance use. If a person suffers from both, the risk of negative consequences are even greater. (Conasen, Klomak, & Sher, 2006)

It is obvious that the combined consequences of these co-morbid conditions can have substantial effects on the health and well-being of those affected. It is, therefore, necessary to <span style="font-family: Verdana,Geneva,sans-serif; font-size: 90%;"><span style="font-family: Verdana,Geneva,sans-serif; font-size: 110%;">address both eating disorders and alcohol use as well as their contributing factors.

Effective interviewing and the use of effective assessment tools will be important in determining the presence of these often co-morbid conditions.