The Cardiovascular System: The Damage from Substance Abuse
Cardiovascular Issues Caused by Drug Abuse:
- Abnormal heart rhythms and rates
- Loss of heart function
- Damaged heart muscle
- Problems with pumping blood
- Blocked arteries and veins
- Blockage or rupture of a vein or artery in brain
- Scarring of arteries
- Bacterial infections of the blood or heart (from injecting)
- Collapsed veins (from injecting)
Jump to Section
- General Substance Abuse
- Cocaine and Amphetamines
- Alcohol Usage
- Tobacco Abuse
- Narcotic or Opioid Drugs
- Treatment Help
Chronic abuse of drugs in general is a significant risk factor in the development of cardiovascular disease. This means that individuals who abuse drugs are increasing the probability of developing these conditions; however, it does not guarantee that they will develop a cardiovascular issue.
Chronic abuse of drugs is a significant risk factor for developing any number of different health issues, and drug abuse interacts with other risk factors to produce the specific issues that occur in specific individuals. Several different types of cardiovascular issues are more likely to be associated with drug abuse, and these are outlined below.
- The American Heart Association offers good information on this topic.
- The National Institute of Drug Abuse has several sources of information that readers may find useful related to cardiovascular issues and substance abuse.
Cardiovascular Issues and Substance Abuse
According to the American Heart Association, there are a number of different types of cardiovascular conditions. A few that are commonly associated with substance abuse include the following:
- Arrhythmias: Arrhythmias represent abnormal heart rhythms or heart rates. There are a number of different classifications of arrhythmias, some can be life-threatening and others may not be dangerous. For example, tachycardia is a very rapid heartbeat, whereas bradycardia is a very slow heartbeat. Depending on the specific issue with the person, these may or may not be dangerous conditions in the short-term, but when these conditions become prolonged, they can be associated with potentially dangerous consequences.
- Cardiac arrest: This is a sudden loss of heart function. This is obviously a potentially dangerous situation.
- Cardiomyopathy: This term refers to a number of issues with the heart muscle, most often leading to problems with pumping blood in the system.
- High blood pressure: This can be a serious condition if it remains chronic. Chronic high blood pressure can result in scarring, damage to the arteries, and increased risk of heart attack.
- Heart attack: When the flow of oxygen to the heart stops or is blocked in the blood, individuals can experience a heart attack.
- Heart failure: When the person’s heart is not pumping enough blood, the condition is typically referred to as chronic heart failure. This can be managed in some individuals.
- Peripheral artery disease: This occurs when issues with the veins and arteries in the arms and legs or even in the torso are blocked and blood flow cannot move smoothly.
- Stroke: This is also termed cerebrovascular accident or CVA. This condition occurs as a result of a blockage in the veins and arteries in the brain or a rupture of a vein or artery in the brain.
Heart attacks and conditions that produce strokes or cardiac arrest can occur in individuals who overdose on a number of different drugs and can also occur over time as a result of chronic drug abuse. Issues such as peripheral artery disease, high blood pressure, and cardiomyopathy typically occur as a result of chronic drug abuse. They interact with a number of other factors, including the individual’s genetic makeup and other lifestyle issues, such that their presentation is dependent on the presence of multiple risk factors.
Individuals with substance use disorders are at an increased risk to develop a number of different cardiovascular issues, and the use of most drugs of abuse has been tied to many different cardiovascular issues. A few of these drugs are discussed next.
Cocaine and Amphetamines
Stimulant medications and drugs, such as cocaine, crystal meth, Ritalin, amphetamine, etc., have been long recognized to increase the risk for cardiovascular disorders. Research has indicated that even occasional or recreational users of cocaine often have harder arteries, thicker heart wall muscles, and higher blood pressure than individuals who do not use cocaine at all. These conditions can lead to an increased risk for heart attack. Research has also indicated that cardiovascular abnormalities often occur or remain in individuals who have stopped using cocaine for quite some time.
Prolonged use of cocaine and other stimulant medications leads to chronic constrictions of the veins and arteries, causing the heart to work harder and blood pressure to increase.
This then leads to scarring and thickening of the veins and arteries. Research has suggested that cocaine users:
- Demonstrate as much as 18 percent greater thickness of the left ventricle wall
- Demonstrate a 30-35 percent increase in aortic stiffening (hardening of the arteries)
- Demonstrate significantly higher systolic blood pressure levels
- Demonstrate significantly higher odds of developing a heart attack when using cocaine than individuals who do not use cocaine
The effects on the cardiovascular system of other commonly abused stimulant medications, such as amphetamines, methamphetamines, ecstasy, etc., are similar to cocaine abuse. Treatment for these conditions in cocaine users first requires that the individual stop using cocaine (or other stimulant drugs of abuse) and then specific medications for the cardiovascular condition can be prescribed. If one is going to continue to use cocaine, the treatment for the cardiovascular problem will most likely not be successful. These individuals are typically treated in the same manner as other individuals who have these types of conditions, with the initial aspect of treatment aimed at getting the individual to stop abusing cocaine or other stimulant medications.
Chronic, heavy use of alcohol is associated with a number of different medical conditions; however, organizations such as the American Heart Association and the National Institute of Health also recognize that light to moderate drinking might be a protective factor against cardiovascular disease. According to this information, moderate to light drinking would be an average of 1-2 drinks per day for men and one drink per day for women. These organizations define an alcoholic drink as either one 12-ounce beer, 1.5 ounces of 80 proof liquor, 1 ounce of 100 proof liquor, or 4 ounces of wine.
The American Psychiatric Association specifies the diagnostic criteria for an alcohol use disorder. These criteria indicate that individuals drinking alcohol within these levels would not be considered to have a substance use disorder.
Individuals who chronically abuse alcohol raise the levels of fats in the blood known as triglycerides that can lead to high blood pressure and even to heart failure. Over time, individuals who chronically abuse alcohol can develop serious issues, such as arrhythmias, cardiomyopathy, stroke, and/or cardiac arrest. In addition, chronic alcohol use leads to the potential to develop diabetes, a condition that can also result in cardiovascular damage. Long-term chronic alcohol abuse leads to damage to the liver and kidneys, which can also indirectly negatively affect the functioning of the cardiovascular system.
Cardiovascular issues due to alcohol abuse are treated in the standard fashion as they would be in other individuals, except that the first order of business is obviously to get the person to stop drinking. These individuals are able to combine treatment for alcohol abuse with treatment for their cardiovascular disorder. Individuals may have to take medications for blood pressure issues, go on special diets, and undergo other medical procedures when there is significant tissue damage.
A claim by The World Heart Federation shows that smoking causes 10 percent of cardiovascular diseases and is the second leading cause of cardiovascular disease behind high blood pressure. Like other drugs of abuse, the use of tobacco products results in an increase in blood pressure due to constriction of veins and arteries. This leads to scarring, the buildup of plaque, and issues with the heart muscle. In addition, chronic use of tobacco products leads to decreases in the amount of oxygen that the blood can carry, and this results in an increased risk to develop blood clots that also can lead to a number of issues, including stroke or cardiac arrest.
Chronic use of tobacco products also results in a number of other health issues, including respiratory issues and the increased potential to develop cancer. These conditions can also negatively affect the cardiovascular system.
Individuals who quit smoking significantly decrease their risk for developing cardiovascular issues. Within five years of quitting smoking, the risk of having a heart attack falls to about half of what it was when an individual was smoking. After 15 years of not smoking, the risk of developing any cardiovascular disease is nearly the same as for any nonsmoker. Thus, any treatment program for cardiovascular issues in individuals who abuse tobacco products mandates that they stop using tobacco.
Narcotic or Opioid Drugs
Opioid abuse has received quite a bit of media press recently following the death of a number of celebrities due to an overdose of opioid medications. These medications are primarily designed to control chronic pain, and they perform this function very efficiently. According to the American Association of Addiction Medicine, when given in therapeutic doses, their effects on the cardiovascular system are minimal; however, individuals who abuse these drugs are risking serious damage to their bodies. Individuals who inject drugs like heroin and other opioid drugs are opening themselves up to the possibility to develop blood-borne infections that will affect their entire body, including the cardiovascular system. Chronic drug injectors risk issues with collapsed veins that will also affect the cardiovascular system.
Individuals who chronically abuse narcotic drugs also risk damage to the cardiovascular system as a result of decreased oxygen volumes in the blood. When used in large amounts and over lengthy periods, these drugs will significantly decrease one’s respiratory rate. This leads to increased potential for the development of blood clots, stroke, and a weakened heart. In some cases, these conditions may not fully resolve even after years of abstinence.
The first issue to resolving cardiovascular issues that are related to the abuse of opioid drugs is to get the individual to become abstinent from using these drugs as they are treated for whatever cardiovascular issues they have. A substance abuse treatment program will be most effective if maintained over the long-term. Many individuals will need to be involved in some form of care, such as a long-term aftercare program, for the rest of their life.
The treatment of any substance use disorder should be considered a long-term process that continually addresses the short-term issues of the individual. What this means is that treatment should address the current issues faced by each individual case and should be ongoing over the course of many years. In many cases, substance use disorder treatment extends over the entire lifetime of the person.
Individuals who have chronic substance use disorders and also develop cardiovascular issues are at increased risk for serious health issues if they continue their substance abuse. The first goal of any treatment intervention for these individuals is to address any acute cardiovascular issues that are potentially dangerous or life-threatening and at the same time get them to abstain from using their drug of choice. Once the individual is stabilized, the person should enter a formal substance use disorder treatment program in addition to receiving any other medical interventions they need.