At Least Ten Percent of Cardiovascular-Related ICU Cases Connected to Drug Abuse

A new study showing that at least ten percent of ICU heart disease patients are active drug users is a warning sign for how drug use and potentially life-threatening heart conditions go hand-in-hand.

Every year, it seems new data are published connecting drug use to new health problems and maladies. A recent study published by the European Society of Cardiology has found a concerning connection between drug use and serious heart complications, such that drug use may now be a leading predictor for heart failure.

Illicit Drug Use an Increasingly Common Predictor of Heart Complications

An August 2022 study made available to the public by the European Society of Cardiology put forth two critical findings:¹

• Illicit drug use is associated with an almost ninefold greater risk of death or life-threatening heart conditions.

• One in ten patients in ICU treatment for heart conditions is an active drug user.

The findings highlight how drug use increases the risk of heart disease and exacerbates existing heart disease in users. Study author Dr. Theo Pezel of Hospital Lariboisiere in Paris, France, spoke to this point: “Our study shows that patients with acute cardiovascular conditions who take illegal drugs are more likely to die or experience cardiac arrest or cardiogenic shock while in hospital compared with non-users.” Dr. Pezel also pointed out that people who use more than one drug (called polysubstance abuse) have an 11-fold risk of severe, life-threatening heart health conditions.

The findings also showed that drug users are at greater risk of heart attacks and aortic dissection (a serious and sometimes fatal condition in which a tear occurs in the inner layer of the body’s main artery [the aorta]).

The researchers arrived at the above findings by drug testing all heart disease-related patients at 39 hospital centers throughout France for two weeks in April 2021. Reasons for hospital admission of patients tested included myocardial infarction, acute heart failure, arrhythmias, myocarditis, and pulmonary embolism. The primary outcome tested was illegal drug use, and the secondary outcome tested was major adverse events such as resuscitated cardiac arrest or cardiogenic shock.

The findings were as follows:

• Those patients who used multiple drugs were 11.5 times more likely to experience an adverse health outcome.

• Patients who tested positive for drugs tended to be young, with one-third of them under the age of 40.

• Just 6% of those tested were over 60, suggesting the problem was primarily one of youth drug use.

• During a median hospitalization of five days, 61 patients (4.1%) had a major adverse event.

• Illicit drug use was associated with almost ninefold odds of major adverse events.

• 161 patients (10.7% of patients) had a positive test for at least one illicit drug.

• Cannabis use was associated with threefold odds of major adverse events.

• Of those who tested positive for drugs, 28% took more than one drug.

• Cocaine was associated with fivefold odds of adverse events.

• 12% of men were users compared to 8% of women.

• 0.7% of patients tested positive for amphetamines.

• 9.1% of patients tested positive for cannabis.

• 0.6% of patients tested positive for MDMA.

• 2.1% of patients tested positive for opioids.

• 1.7% of patients tested positive for cocaine.

The findings should act as a clear incentive for hospital staff and medical practitioners to always test for drug abuse and to treat it when present. Dr. Pezel spoke to this point as well: “Illicit drug use was common in ICCU patients but under-reported,” he said. “Users admitted for ST-elevation myocardial infarction (STEMI) and acute heart failure had particularly high risks of death, cardiac arrest, or cardiogenic shock with odds ratios of 28.8 and 12.8, respectively. Our results suggest that patients admitted to ICCU should be tested for drugs to identify those with an increased likelihood of detrimental outcomes.” If medical practitioners can more accurately determine which patients are using drugs, they’ll be better equipped to help their patients access the needed treatment resources.

Effects on the Body: Drugs and Heart Disease

The study findings cited above bolster the existing trove of information about how drug use negatively affects heart health. Drug use negatively impacts the cardiovascular system in several ways, from abnormal heart rates to fatal heart attacks, from collapsed veins to bacterial infections of the blood vessels and heart valves. Cocaine, meth, ecstasy, and other stimulants are associated with higher heart attack risk. Opioids are associated with diminished heart rate to the point of death.²

A Problem in Europe and the U.S.

While the study out of Europe is the most recent of its kind, a 2019 study called “The Impact of Substance Abuse on Heart Failure Hospitalizations” was published by the United States Department of Health and Human Services, available to read in the online National Library of Medicine. According to that study, substance abuse was found in 15.2% of hospital patients seeking treatment for cardiovascular complications, a higher rate of substance abuse than in the European study.³

“…substance abuse disorders are significant sources of morbidity that are independently associated with emergency department visits and hospitalizations for heart failure.”

American researchers reached a similar conclusion as the European scientists did in their study. Quoting the study authors, “…substance abuse disorders are significant sources of morbidity that are independently associated with emergency department visits and hospitalizations for heart failure. Greater recognition and treatment of substance abuse may improve outcomes among patients with heart failure.” Looking to the future, health practitioners around the world must consider the effects of drug use on heart health and should always test for and ask about drug use when treating patients with heart complications.

The Need for Addiction Treatment

As drug use emerges as an increasing predictor for serious heart disease, heart failure, and death, the need for quality residential drug addiction treatment becomes more clear. If you know someone who is struggling with an addiction to drugs or alcohol, please do everything you can to get them to seek help at a drug treatment center. Please don’t wait until it is too late and their addiction damages their heart irreparably. Please get them help today.

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