Illegal Drugs and Heart Disease

Most illegal drugs can have adverse cardiovascular effects, ranging from an abnormal heart rate to a heart attack. Injecting illegal drugs also can lead to cardiovascular problems, such as collapsed veins and bacterial infections of the blood vessels and heart valves.

Many drugs, such as cocaine, heroin and various forms of amphetamine, affect the central nervous system and can alter a user's consciousness. In addition to addiction, the side effects and risks for your heart associated with the use of these drugs include:

• Changes in body temperature, heart rate and blood pressure
• The possibility of added substances, such as talc, poisons, herbicides or other particles, which may cause a toxic reaction
• High blood pressure, arrhythmias, cardiomyopathy, peripheral artery disease, increased blood clotting and arterial plaque formation
• Ischemia, heart attacks, other acute coronary events and stroke
• Increased mortality in those with preexisting cardiovascular disease

Cocaine

The "perfect heart-attack drug"

Researchers have long noticed an association between non-fatal heart attacks and regular cocaine use in adults. Researchers — who called cocaine “the perfect heart attack drug” — showed how users had higher rates of multiple factors associated with higher risks of heart attack and stroke.

Research shows that cocaine users may have:

• Angina and reduced blood flow to the heart.
• Higher blood pressure, stiffer arteries and thicker heart muscle walls.
• Sharp rise in heart rate and an increased need for oxygen in heart muscle.
• Damage to cardiac tissue.
• Heart infections.

All of these issues can lead to a heart attack, heart failure, stroke or aneurysm.      

Other drugs that pose a risk

Opioids

Opioids are a class of drugs that are often prescribed to people as pain relievers, such as oxycodone, hydrocodone, codeine, morphine and others. They also include the illegal drug heroin and synthetic opioids such as fentanyl.

All forms of opioids are highly addictive. Opioid-use disorder affects more than 2 million people in the United States. More than 80,000 people died due to opioid drug overdoses in the U.S. in 2021.

Using opioids through injection can lead to infective endocarditis, a serious infection of the heart lining, caused by needles that are shared or dirty. Opioids are also associated with cardiac arrest.

Opioids such as morphine are sometimes used in the cardiovascular setting to reduce pain and anxiety. However, researchers are finding that there is also potential for prescribed opioids to adversely affect outcomes for patients with acute coronary syndrome. Recent data from American Heart Association researchers suggests that opioid use may interfere with medications used to manage and treat cardiovascular disease and stroke.

Additional drugs of concern

Amphetamines, marijuana and ecstasy can also have adverse effects on the cardiovascular system.

• Amphetamines, a class of drugs which includes methamphetamines, can be habit-forming and prone to abuse. The drugs stimulate the central nervous system (nerves and brain), which increases heart rate and blood pressure, among other effects.
• Ecstasy, or MDMA, is illegal. It is known as a synthetic "club drug" with stimulant and hallucinogenic effects. MDMA affects blood pressure and heart rate.
• Marijuana is the most commonly used federally illegal drug in the United States. Researchers are finding that most of the risks associated with marijuana use comes from smoking it. Smoking marijuana can make the heart beat faster and can make blood pressure higher immediately after use. It could also lead to an increased risk of stroke, heart disease and other vascular diseases.