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Illicit drug use or substance abuse is the excessive and compulsive intake of illicit or prescription drugs that can cause alteration in the different parts of the human body. It may lead to excessive cravings and the need for drugs and may ultimately cause impairment in the functional ability of the human body. These drugs can have many negative effects on the human body and particularly the heart. It can also worsen pre-existing diseases like heart problems or diabetes and high blood pressure. In addition to these, it may cause infections in different parts of the body including the heart by using shared needles. 

Drug abuse is one of the causes of heart attacks and different types of heart problems in young adults. The use of illicit drugs, especially cocaine, amphetamines, and alcohol, are clearly associated with a step-by-step deterioration in the health of the heart and the blood vessels which supply the heart. This is referred to as cardiovascular disease and may increase the morbidity and mortality of the users. 

The heart is the major pumping organ in our body and the blood vessel originating from the heart (the aorta) then supplies blood to all the body parts. This blood is full of oxygen and enables us to carry out our activities of daily living. Cardiovascular disease refers to the damage in the heart or the blood vessels so that they are unable to provide oxygen or pump blood properly. One of the major causes of cardiovascular disease in young people is stroke. It not only increases the risk of heart attacks by causing the vessels supplying the heart to go into a spasm and thus causing obstruction to the flow of drugs, but it may also cause an increase in blood pressure (amphetamines).

Long-term drug use may cause the heart to fail completely so that it is unable to pump, carry oxygen to our different body parts, or may even cause a stroke in the brain by causing an interrupted blood flow to this vital organ. In addition drugs like amphetamines and ecstasy may also cause disturbance in the natural rhythm of the heart quickly giving rise to sudden fatal arrhythmias. If you are reading this article, you may be worried about your or your loved ones’ health. Please do not hesitate to seek help as substance use disorder is curable. Seeking help can save your or your loved one’s life. 

Myocardial Infarction

Myocardial infarction is also known as a heart attack. It is due to the blockage of blood flow to the heart through its coronary arteries. The heart muscle does not get blood supply and a part of the heart may die completely. The drugs which are notorious for causing heart attacks are cocaine and other stimulants. It does so by causing the heart arteries to go into a complete spasm as a result of the toxic side effects of cocaine. This can be severe enough to cause sudden cardiac death. In fact, cocaine is called the “perfect heart attack drug”. It can be snorted, injected by dissolving the powder in water, and can even be inhaled. Crack is a type of processed cocaine into a rock crystal that is inhaled through smoking. Long-term use of cocaine produces irreversible changes in the walls of the blood vessels. These patients may have stiff arteries and thick heart muscles leading to an increased risk of a heart attack.

High blood pressure 

Drugs like cocaine can cause permanent changes in the vessel wall and can lead to hypertension. Other drugs causing high blood pressure or hypertension include amphetamines and methamphetamines. These occur due to the stimulation of the sympathetic nervous system. Methamphetamines include meth, crystal, and ice. Ecstasy or MDMA can also cause high blood pressure which not only increases the risk of heart attack but also stroke and brain hemorrhage. 

Low blood pressure or hypotension 

Drugs like opioids can stimulate the parasympathetic system to cause a decrease in heart rate and low blood pressure. 

Rhythm disturbance of the heart 

Cocaine, amphetamines, ecstasy, and opioids can all cause rhythm disturbance of the heart which can lead to cardiac arrhythmias and sudden death. These occur due to a combination of increased or decreased heart rate, stiff and narrow blood vessels, and increased release of adrenaline by drugs like cocaine. 

Infection of the heart valves 

Intravenous drug use may result in the introduction of bacteria or viruses into the bloodstream. These travel through the blood into the heart and may cause infection of the heart valves or the lining of the heart known as infective endocarditis. This infection is very difficult to treat and needs a long duration of intravenous antibiotics. In addition, infectious diseases like HIV may occur due to the use of contaminated needles. 

Heart failure:

Long-term use of the drugs can cause the heart to fail completely. The heart becomes enlarged and looks like a boggy water-filled balloon. It will not be able to pump blood effectively and result in fluid retention in the body. This manifests as swelling of the feet and difficulty in breathing. 


Angina or chest pain occurs due to an imbalance between supply and demand. Any narrowing of the arteries may hinder blood flow through the region. Cocaine can cause angina as the muscles in the arteries clench or go into a spasm due to the toxic effects of the drug. 

Although all recreational drugs are harmful, some can cause widespread damage to the heart. 


Cocaine or “coke” is a naturally occurring, highly addictive, stimulant drug that is extracted from the leaves of the coca plant. Cocaine can be rubbed on the gums, snorted, injected, or smoked. Freebase cocaine is known as “crack” and is processed to make rock crystals. This rock crystal is then heated and vaporized and inhaled directly into the lungs. It gets its name from the

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cracking sounds made by the rock as it is heated. Other street names include snow, flakes, twinkie, nose candy, white dragon, and rock. It is the perfect heart attack drug as it can cause thickening and narrowing of the vessel wall, cause heart attacks, rhythm disturbance, and high blood pressure. It can also block the coronary arteries. When combined with alcohol, it forms cocaethylene which can double the risk of cardiac toxicity. 

Amphetamines and methamphetamines: 

These drugs also have disastrous effects on the proper functioning of the heart. These drugs along with ecstasy can cause a surge of adrenaline in the body leading to the fight, fright, and flight response with increased heart rate (tachycardia), rhythm disturbance of the heart (arrhythmias), sudden intense narrowing of the blood vessels impeding blood flow (vasoconstriction) and massive increase in the blood pressure. 


It is often thought of as a harmless drug and is known by the names of cannabis, weed, or pot. Marijuana can cause an increase in blood pressure in mild to moderate doses. Excessive consumption or toxicity can lead to bradycardia and severe hypotension. Rare cases of myocardial infarction have been documented with its use. 


These drugs exert their actions on the heart by activating the parasympathetic nervous system. A profound drop in blood pressure and heart rate can occur and increase the tendency of the heart to develop an abnormal rhythm. In addition, it causes disturbance in the electrical conduction of the heart called drug-induced long QT syndrome. 

Drugs like cocaine can cause damage to the heart in various ways. If you experience chest pain on exertion, it is an indicator that you might have angina due to narrowing and stiffening of the arteries of your heart. Other signs and symptoms include intense pain in your heart or the upper part of your abdomen particularly radiating to your left jaw or shoulder.

This may be accompanied by nausea, vomiting, a pressure-like sensation on your chest, palpitations, and a feeling of impending doom. It may show that you are having a heart attack. If you experience these symptoms please seek immediate medical help as it can be lifesaving. Shortness of breath, swelling of feet, worsening of shortness of breath on exertion, or lying down flat at night may indicate that your heart is not pumping blood appropriately and all these can be a sign of heart failure due to drugs. 

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Sudden sharp palpitations associated with syncope or near syncope or blackouts may be due to drugs like amphetamines disturbing the electrical rhythm of the heart. Arrhythmias can be fatal unless prompt help is sought. 

Other signs that drugs can potentially be damaging your heart are high or low blood pressure and difficulty treating hypertension. Long-term effects of high BP may cause the pumping action of the heart to fail.

Smoking, alcohol consumption, type A personality, diabetes, hypertension, high cholesterol, and family history of heart diseases increase the risk of heart attacks. However, drugs can also cause heart attack and may worsen damage to the already impaired working of the heart. One such drug is cocaine. It can cause the coronary arteries (the arteries that supply our heart) to go into intense or severe vasospasm. This can cut the oxygen supply to our heart, resulting in a heart attack with irreversible damage to the heart muscle.

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Other drugs like amphetamines can increase blood pressure to alarmingly high levels and can cause heart attacks also. Moreover, drugs like ecstasy, crack, and amphetamines can disturb the heart rhythm (arrhythmias) which can also lead to a heart attack. If you are reading this, you might be worried about yourself or a loved one. Seeking help is crucial to prevent further damage to the heart as cumulative drug abuse can lead to irreversible changes in the myocardium of the heart. 

Drugs can cause an enlarged heart and may cause heart failure. It is defined as the failure of the pumping action of the heart so that it is unable to maintain the metabolic needs of the body. Several drugs can cause an enlarged heart. Cocaine is the best example of such a drug. It can cause a heart attack or myocardial infarction, hard stiff arteries, increases the risk of stroke, and an enlarged heart with a poor pumping action. According to the National Institute on Drug Abuse (NIDA), cocaine has been linked to increased risk of stroke, inflammation of the heart muscle, deterioration of the ability of the heart to contract, (heart failure), heart attack, and aortic rupture.

Other drugs like amphetamines and methamphetamines cause hypertension and cause the heart muscles to become thick and hypertrophied (left ventricular failure). This can ultimately lead to heart failure with an enlarged heart with poor ability to contract or pump. Other stimulants like ecstasy and LSD also increase heart rate (tachycardia) blood pressure (hypertension), and stiff arteries which can lead to a poor impact on the cardiovascular system, especially over time. Inflammation and infections like HIV may occur from using shared needles, particularly when injecting opioids. HIV can then damage the heart by causing it to become enlarged (HIV-associated dilated cardiomyopathy). 

In addition, intravenous drugs can cause infective endocarditis due to bacteria introduced during needle sharing. This can damage the heart, cause the valves to leak, and the heart to become bigger over time. Patients need long-term antibiotics and may need surgery to replace the heart valves. The artificial valves are then prone to more infection than the native valves producing a vicious cycle. You can prevent damage to your heart by being heart healthy. Seek help today before irreversible changes occur. Your health is important to us and drug addiction can be treated by skilled professionals. 

Many illicit drugs or illegal use of prescription medications can cause a heart attack. Cocaine is the ideal heart attack drug and data shows that cocaine-induced cardiac damage is a known entity. In fact, 0.7% to 6% of those presenting with chest pain after cocaine ingestion may be having a heart attack. Other illegal drugs causing heart attacks include stimulants like amphetamines and methamphetamines. They do so by causing elevated blood pressure,

increased heart rate, and increased sensitivity of the heart to adrenaline. They may also cause strokes or rupture of brain aneurysms leading to brain hemorrhage. Young people are particularly prone to heart attacks after using amphetamines. These also cause narrowing or spasm of the arteries and their inflammation, limiting the amount of blood that flows to the heart. If you are reading this, you might be worried about developing a heart problem. Knowing the dangers of heart problems is not enough. Fighting addiction alone might be difficult for you. There are many resources available that can help you or your loved ones. Please do not hesitate to seek help.


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