In a prospective longitudinal study, 136 women with anorexia nervosa and 110 with bulimia nervosa were interviewed and assessed for drug use disorder every 6 to 12 months for roughly 9 years.
A total of 42 (17%) had a history of illicit drug use, Dr. David B. Herzog of Massachusetts General Hospital in Boston and colleagues report.
It is "of interest," they say, that 19 of these women -- 4 of 22 with anorexia and 6 of 20 with bulimia -- started abusing illicit drugs for the first time over the course of the study.
"Although the absolute numbers are small, these data suggest that the risk for drug use disorder in women with eating disorders continues over time and should be an ongoing part of assessment for these patients," the investigators write.
It's also noteworthy, they say, that of the 19 women with drug use disorder onset during the study, 12 (63.2%) had an episode of major depression and 6 (31.6%) had a diagnosis of hypomania.
"The finding that affective disorder was very likely to occur in participants with anorexia nervosa and bulimia nervosa with a prospective drug use disorder onset confirms earlier studies linking affective disorders, eating disorders, and substance abuse," Dr. Herzog and colleagues note.
Cocaine, amphetamines, and marijuana were the most commonly abused drugs.
"These data indicate that clinicians should take a careful history of drug use when assessing substance use in patients with anorexia nervosa and bulimia nervosa," the authors conclude.