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The Link Between Addiction and Canker Sores Revealed

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If you are recovering from an addiction and suddenly have canker sores, there is one likely cause. Read more below.

Addiction to a substance, “substance abuse disorder,” is a mental illness, an alteration of brain function. That a sizeable percentage of people are pre-disposed to being susceptible to an addiction to something (nicotine, marijuana, alcohol, opioids, stimulants, sleeping pills, and other drugs, gambling, excessive exercise, and even fanatical spirituality) points heavily to a genetic risk that is inherited.

Often a family history for substance abuse spans many generations, and studies involving twins have demonstrated a strong link to one’s inherited DNA.

Canker Sores

Canker sores, called “aphthous” ulcers, are different from cold sores. Cold sores are herpes simplex infections, which are due to the herpes simplex virus (HSV) being harbored in nerve roots distant from the site of the cold sores. They are not inside the mouth, which is where canker sores are seen exclusively.

Between 10-15% of the general population suffer from canker sores, which can appear in one spot, many spots, and even clumped together.

They are round or oval-shaped, with a reddish ring around a grey ulcerated base.

They are usually very painful and may make it difficult to eat, which addiction already jeopardizes to the point of poor nutrition.

Canker sores can range from 3-5 millimeters to over a centimeter in diameter. Smaller ones can merge into a single larger one. They usually disappear within a week and treatment with steroids may decrease the severity of a particular outbreak, but won’t affect the recurrence rate. They usually go away in one to two weeks on their own.

Addiction’s Association with Canker Sores

There is a definite connection between the development of canker sores in persons who suffer addiction. In fact, many have recurrent attacks (Recurrent Aphthous Stomatitis) of these painful ulcerations that add to the significant problem-load already suffered at the hands of the addiction. The connection between the two is complex [see below], and it is frequent enough to consider canker sores an accepted complication of addiction.

What Causes Canker Sores?

Whereas cold sores have a definite infectious cause, canker sores have no distinct cause that’s been identified. (Unlike cold sores, they can’t be spread. Although a viral cause has not been ruled out, there is no evidence yet of an infectious cause.)

Canker Sore Causes
Immune problems: either an exaggerated inflammatory response from the immune system or a very weak anti-inflammatory capability, or both, alternating between the two. HIV infection can cause them.
Inherited: a family history of canker sores indicates an inherited, genetic tendency to develop them.
Trauma to the mouth, especially dental procedures or hardware.
Certain foods, but there isn’t any evidence that they’re the result of a food allergy.

Food sensitivities.

Certain foods, but there isn’t any evidence that they’re the result of a food allergy.

Vitamin (B vitamins, i.e., niacin, folic acid, B12) and/or mineral deficiencies (zinc, iron, calcium).

Emotional stress.

Certain drugs.

Hormonal shifts (menstrual cycle, puberty).

Gastrointestinal disease, such as gluten sensitivity, ulcerative colitis, Crohn disease.

Quitting smoking: nicotine decreases inflammation and promotes anti-inflammatory chemicals in the body; smoking cessation increases inflammation and decreases anti-inflammation.

What Is the Medical Connection Between Addiction and Canker Sores?

There have been many studies exploring why aphthous ulcers seem to present when quitting smoking.

There are proteins in the human body that exist in a balance between inflammation-causing ones (to begin fighting infection and begin healing) and inflammation-decreasing ones (so the inflammation won’t overshoot its function).

It seems that nicotine affects this balance more toward anti-inflammation, so when it is withdrawn, inflammation—in an attempt to rebalance—may swing toward inflammation; hence, the aphthous ulcers. This finding only strengthens the argument that canker sores are strongly related to one’s immune system.

But if you know someone who has quit smoking or tried to quit—or if you, yourself, have done so—then you know the obvious psychological effect of withdrawing something you’ve grown dependent on: stress.

Stress—the Common Denominator of all Causes of Canker Sores

Stress has been linked to immune function in humans. Since canker sores are promoted by changes in the immune system, it stands to reason that stress indirectly promotes their occurrence by altering the immune system.

While some suspected causes of canker sores (above) may be due to direct tissue changes from vitamin/mineral deficiencies and food sensitivity, the rest of them all involve stress of some sort (hormonal shifts, GI disease, and mouth trauma). This has been supported by the fact that stress in even non-addicted persons increases the recurrence of canker sores.

The connection between addiction and canker sores, therefore is this: the dependence and addiction associated with substance abuse disorder are stressful.

What Are the Stressors in Addiction?

The types of illicit drugs, symptoms of abuse, and signs of dependence and addiction are well described throughout the Internet. However, the stressors from substance abuse, including alcohol abuse, are often side-stepped as less significant, which they are not:

  • Physical symptoms of withdrawal
  • Anxiety of how one will obtain or afford the substance
  • Fear of law enforcement at every attempt to procure the substance
  • Poverty from significant cash flow outward to maintain a drug habit
  • Jeopardy to intimate relationships from the problems caused by substance abuse
  • Risk to employment as substance use dominates all other responsibilities

Of course, addiction to substances takes front-and-center for attention in one’s life, leaving good nutrition and fitness a distant second…or third…or even more. This can easily result in the B-vitamin and mineral deficiencies that co-conspire with stress to promote the development of canker sores.

Also, the stress of canker sores is like a breeder-reactor: having them can cause stress, such that you can develop more, which then can cause more stress—a vicious cycle.

The Solution to Canker Sores Associated with Addiction

Medical science is at a disadvantage when it comes to an actual solution to canker sores or the recurrent aphthous stomatitis associated with addiction. Since there is no discrete identifiable cause, treatment and prevention has to circle around the suspected causes. No doubt, however, that stress is one of these that can be addressed.

Like addiction itself, stress is a mental derangement of the normal cognitive function of the brain. Thus, lowering the stress load will help both addiction and the ulcerations that come with it. It must be pointed out, however, that addiction is life-threatening, while canker sores are a nuisance. (True, a very large nuisance, but not fatal.)

Addiction Treatment Comes with a Bonus

When addiction and canker sores occur together, putting first priority on a treatment for the addiction will also provide a bonus of reducing the incidence of canker sores, and that only adds one more benefit (besides saving lives) to treatment for addiction and substance abuse.

Since addiction treatment is heavily weighted toward the psychological after the medical withdrawal has been tamed, the same stress-adaptation techniques used in addiction therapy will make the recurrence of canker sores less frequent and less severe. 

Next Article: Herbs and Supplements for Canker Sores