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Substance Use And Cardiovascular Disease

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Several illicit drugs have been linked to cardiovascular disease. Many used substances, legal or otherwise, damage the heart in various ways. Prolonged use and polysubstance use can compound the risks associated with heart problems and cardiovascular disease.

What Is Cardiovascular Disease?

Any heart condition that involves damage to or dysfunction of the blood vessels is referred to as cardiovascular disease. This is generally caused by atherosclerosis—the accumulation of plaque in the arteries. There are several different heart conditions that fall into this category:

Coronary Artery Disease

Over half of the annual heart disease deaths in the U.S. result from coronary artery disease notes the Centers for Disease Control and Prevention (CDC). This is a cardiovascular issue caused when the buildup of plaque in the heart arteries disrupts blood flow. It can lead to chest pain (angina), heart attack or stroke, and may be fatal.

Myocardial Infarction

About 735,000 Americans per year suffer from a myocardial infarction or heart attack. This happens when the arteries are narrowed to the extent that the supply of oxygen to the heart is heavily or completely blocked. The heart may be permanently weakened after a heart attack, depending on how much blockage occurred and how soon treatment was received.


“Ischemic heart disease” is another name for coronary artery disease. Since blocked arteries prevent proper blood flow, a problem that originates in the heart can affect everything else. The term “ischemia” means the lack of adequate blood in some part of the body, which can cause serious issues.

An ischemic stroke, for example, occurs when blood vessels in the brain become clotted. The brain cells that are unable to receive enough blood will die, leading to bodily dysfunction such as inability to walk or talk. Some people suffer from silent ischemia, which means they do not know they have it until it causes a heart attack.

Substance Use And Cardiovascular Disease

Many of the factors that increase someone’s risk for heart disease are related to poor health or lifestyle choices. People who suffer from drug or alcohol addiction often have misaligned priorities. Health and nutrition are not always at the top of the list.

Some drugs can suppress appetite and cause insomnia or poor sleep habits. The body needs good nutrition and quality sleep to stay healthy, and a weakened immune system opens the door for a number of other health problems.

A particular threat to the body’s immune system is the human immunodeficiency virus (HIV). People who share paraphernalia to inject drugs put themselves at risk for HIV. Substance use can also lead people to unsafe sexual behavior, which is another way to spread the virus. Several studies have found that HIV comes with a greater risk of heart attack, heart failure or stroke.

If someone has cardiovascular disease and begins or continues to use substances, their condition could worsen rapidly. A diseased body is not operating optimally, and substance use can further drain its strength. The weaker the body, the harder it is to fight illness.

Even if the used substance does not directly lead to cardiovascular disease, other negative health effects can increase the likelihood of heart problems.

Substance Use And Heart Disease

“Heart disease” is a broad term describing many health issues that can occur in the heart, including cardiovascular issues. Substance use can affect the heart beyond the cardiovascular system, and the consequences can be just as deadly. Other heart problems caused by substance use may include:

  • Hypertension: high blood pressure; increases risk for many heart issues
  • Arrhythmia: irregular heart rate that may become serious or fatal
  • Coronary Thrombosis: a blood clot in the heart that can lead to heart attack
  • Congestive Heart Failure: narrowed arteries lead to difficulty pumping or filling the heart
  • Hemorrhagic Stroke: blood vessel in brain bursts (usually caused by hypertension)

Many of these complications are interconnected. Congestive heart failure, for example, may result from the cardiovascular condition of coronary artery disease, which is an advanced stage of atherosclerosis, a blockage of the blood vessels. Abusing substances that can have negative effects on heart health in any way can raise someone’s chance of developing cardiovascular disease.

Alcohol Use And Cardiovascular Disease

For years, people have believed that drinking alcohol in moderation can be heart-healthy. A glass of red wine contains antioxidants like flavonoids that may have a positive effect on the heart. However, there is little conclusive evidence that the actual alcoholic beverage is healthy, or if the same benefits can be reaped from other grape products without the risks associated with alcohol.

The American Heart Association (AHA) cautions against drinking as a way to boost heart health. Given that alcohol is the most commonly used substance in the United States, many people struggle to drink it in moderation. Studies over the years have concluded that excessive alcohol use can harm the heart and lead to cardiovascular disease.

The Journal of the American College of Cardiology (JACC) recently found that people struggling with alcohol addiction have increased risks of:

  • irregular heart rate (atrial fibrillation)
  • heart attack (myocardial infarction)
  • difficulty pumping blood (congestive heart failure)

They also discovered that high blood pressure (hypertension) is a major contributing factor to many heart issues. Alcohol use can raise blood pressure. It may also increase the amount of fat in the blood or lead someone to consume too many calories. Any of these may put a person at risk for obesity or diabetes, which cause more strain on the heart.

Another problem with alcohol is that it is often used by other substances. Many people mix drugs with alcohol to enhance or balance out the effects. They may not be aware of the impact this has on their body, but the chance of adverse effects can increase drastically when there are two substances negatively affecting the heart.

Illicit Substance Use And Cardiovascular Disease

Many illicit substances cause heart issues, especially when regularly used. The AHA notes that cocaine, amphetamines, and ecstasy are most strongly associated with cardiovascular disease.


Cocaine is a stimulant that is especially dangerous when it comes to cardiovascular effects. Even occasional use of cocaine or crack can lead to hardened arteries, enlarged heart muscles, and high blood pressure. “Cocaine use is linked with increased risk of stroke, as well as inflammation of the heart muscle, deterioration of the ability of the heart to contract, and aortic ruptures,” states the National Institute on Drug Abuse (NIDA).

In 2011, over 40 percent of emergency room visits in the U.S. were related to cocaine use. Many people who use crack cocaine experience intense chest pain that leads them to the hospital. Cocaine use increases the risk of a heart attack and may cause arrhythmia.

Beta-blockers are common medications used to treat heart issues like heart attacks. Cocaine use can inhibit these medications from working properly. Someone who continues to use cocaine after being diagnosed with cardiovascular disease may be exponentially increasing their chance of further complication or death.


Amphetamines are stimulant drugs that may be used to treat attention-deficit hyperactivity disorder (ADHD), narcolepsy or obesity. While many versions of these drugs are prescribed legally, that does not mean that they are without long-term consequences. Stimulants increase heart rate and blood pressure, which can lead to negative heart health effects, especially over time. Inflammation may result, which can harm blood vessels and heart muscles.

Methamphetamine can be especially damaging to the heart. Like cocaine, methamphetamine may cause arrhythmia. It can also lead to congestive heart failure, in which the heart is either too stiff to fill with blood or too weak to pump it out properly. This makes it difficult for the entire body to receive the blood it needs and can make a person feel exhausted, as well as increasing the risk of other heart-related problems.


3,4-Methylenedioxymethamphetamine (MDMA) is generally called “Ecstasy” in tablet form and “Molly” when it comes as a powder or capsule. It can be profoundly dangerous to the heart, potentially causing inflammation, palpitations, increased heart rate and rapid change in blood pressure. It has been linked to heart damage, severe heart attacks, and strokes.

While Molly is believed to be a purer form of MDMA, it has often been found to be laced with other substances such as cocaine, ketamine, over-the-counter cold medicine or “bath salts” (synthetic cathinones). Bath salts may cause chest pain, arrhythmia, heart attack or cardiac arrest, and any of these substances can increase the risk of heart problems when combined.

Other Substances That Can Cause Heart Problems

Some drugs have short-term effects on the heart that can be fatal. Rohypnol (flunitrazepam) is known as a “club drug,” like Ecstasy. As a central nervous system depressant, Rohypnol slows the heart rate. It can cause heart failure when taken in high amounts or when combined with other drugs, especially depressants. Conversely, lysergic acid diethylamide (LSD or “acid”) increases heart rate and blood pressure. When taken in excessive doses, it may also cause heart failure and death.

Smoking cigarettes pose a greater risk of cardiovascular disease. Besides increasing blood pressure and clotting, smoking decreases a person’s ability to exercise and can promote an unhealthy lifestyle. Prescription opioids have also been found to raise the likelihood of cardiovascular death with long-term use.

Injection drug use, which may include opioids like heroin or fentanyl, has been linked to an infection of the heart called infective endocarditis. This is when bacteria collect in the heart. It may cause flu-like symptoms, chest pain and damage to the heart valves.

People who share needles may be at a higher risk for infective endocarditis, but even if a person reuses their own needle, bacteria may enter the body. Many people with infective endocarditis also have HIV, as the two conditions are associated with the same unsafe practices.

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Finding Treatment For Substance Use

Substance use can cause many problems within the body, from decreased immune function to cardiovascular disease. A person with cardiovascular disease who uses drugs or alcohol may experience even more health issues. This destructive cycle does not have to continue.

Treatment for substance use and addiction can be personalized. Everyone has different needs when it comes to addiction treatment, and inpatient drug rehab programs assess the individual to ensure that their needs are met. Someone with a high risk of cardiovascular disease may be able to learn about fitness, nutrition and new interests that promote a healthier lifestyle.

Most importantly, an inpatient addiction treatment program can help someone break free from drug or alcohol use. Whether poor health is degrading someone’s quality of life, or they are just beginning to recognize signs of addiction, there is hope.

Through methods like medication-assisted treatment, behavioral therapy, and community support groups, a person can revive their health and reclaim their life.

Learn more about the customized addiction treatment programs at Vertava Health.