Is biological aging accelerated in drug addiction?

•Accelerated aging happens when biological age outpaces chronological age.•In addiction the early-onset of comorbid diseases remains mostly undetected.•Oxidation, inflammation, stress hormones may lead to telomere attrition expediting aging.•Cognitive decline in addiction may be attributed to premature accumulation of amyloid.

Drug-addiction may trigger early onset of age-related disease, due to drug-induced multi-system toxicity and perilous lifestyle, which remains mostly undetected and untreated. We present the literature on pathophysiological processes that may hasten aging and its relevance to addiction, including: oxidative stress and cellular aging, inflammation in periphery and brain, decline in brain volume and function, and early onset of cardiac, cerebrovascular, kidney, and liver disease. Timely detection of accelerated aging in addiction is crucial for the prevention of premature morbidity and mortality.