In other cases, a patient with fever, abdominal pain and jaundice may have a form of chemical injury that can be confused with conditions such as stones blocking the bile ducts that may require other surgery. Chemicals can also cause chronic liver disease and cirrhosis. Usually, chronic liver disease develops only after long-term use of the drug. Excessive exposure to certain drugs and chemicals may cause tumors of the liver. An important example is the group of drugs known as anabolic steroids, best known for their use in body building.
Liver damage is common in people who are regular, illegal drug users.
Most instances of liver damage in these individuals result from viral hepatitis caused by sharing contaminated needles and using alcohol. Usually it must be based on circumstantial evidence, as there are no specific tests. In any patient with liver disease, close attention needs to be given to the drugs used and the environmental and occupational exposures. No chemical is too trivial to be considered. Timing may be helpful, since many forms of chemical liver injury will occur days to weeks after the first exposure.