21% of Elderly Cardiac ICU Patients Tested Positive for a Psychoactive Substance
Among 760 elderly patients in French cardiac ICUs, 21% tested positive for at least one psychoactive substance, with cannabis detected in 18% of those testing positive, three times less than younger patients.
Quick Facts
What This Study Found
Among 760 elderly patients (65+) in 39 French cardiac ICUs, 21% tested positive for psychoactive substances. Of those testing positive, benzodiazepines were most common (44%), followed by opioid medications (42%), cannabis (18%), tricyclic antidepressants (9%), and cocaine (7%). Elderly patients had 3-fold lower cannabis use than younger patients (18% vs. 53%) but 2-fold higher benzodiazepine use (44% vs. 22%).
Key Numbers
1,499 total patients; 760 elderly (65+); 21% tested positive; 5% positive for recreational drugs; cannabis 18% of positives in elderly vs 53% in younger; benzodiazepines 44% in elderly vs 22% in younger; 22% of positive patients had multiple substances; 39 French centres
How They Did This
Systematic prospective urine screening (NarcoCheck) of all consecutive patients admitted to 39 French ICCUs over a 2-week period in April 2021. Both recreational drugs and psychoactive medications were tested.
Why This Research Matters
Psychoactive substance use in elderly cardiac patients is rarely screened for and may interact with cardiac medications. This study reveals that one in five elderly ICU patients test positive, a prevalence that likely surprises most clinicians and suggests routine screening could improve care.
The Bigger Picture
The shift from cannabis to benzodiazepines as the dominant substance in elderly cardiac patients reflects generational patterns but also raises its own concerns, as benzodiazepines carry significant cardiovascular and cognitive risks in older adults.
What This Study Doesn't Tell Us
Cross-sectional urine screening captures recent use only, cannot distinguish chronic from acute use, French healthcare context may not generalize, NarcoCheck sensitivity varies by substance, 2-week window in April 2021 may not be representative
Questions This Raises
- ?How does psychoactive substance use affect cardiac outcomes in elderly patients?
- ?Should routine substance screening be standard in cardiac ICUs?
- ?Is the lower cannabis rate in elderly patients changing as the legalizing-era generation ages?
Trust & Context
- Key Stat:
- 21% of elderly cardiac ICU patients tested positive for at least one psychoactive substance
- Evidence Grade:
- Large multicenter prospective study with objective biological testing; strong methodology but limited to French cardiac ICUs over a 2-week window
- Study Age:
- Published 2025
- Original Title:
- Psychoactive substance use in elderly patients: Insights from the addiction in intensive cardiac care units (ADDICT-ICCU) study.
- Published In:
- Archives of cardiovascular diseases, 118(6-7), 356-364 (2025)
- Authors:
- Bouali, Nabil, Benmansour, Othmane, El Bèze, Nathan, Trimaille, Antonin, Bouleti, Claire, Brette, Jean Baptiste, Schurtz, Guillaume, Lim, Pascal, Millischer, Damien, El Ouahidi, Amine, Gonçalves, Trecy, Gall, Emmanuel, Lequipar, Antoine, Singh, Manveer, Thuaire, Christophe, Piliero, Nicolas, Noirclerc, Nathalie, Andrieu, Stéphane, Fauvel, Charles, Florence, Jeremy, Delmas, Clément, Toupin, Solenn, Dillinger, Jean Guillaume, Henry, Patrick, Pezel, Théo
- Database ID:
- RTHC-06105
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
How common is substance use among elderly cardiac patients?
In this study of 760 elderly patients across 39 French cardiac ICUs, 21% tested positive for at least one psychoactive substance through urine screening, with 5% testing positive for recreational drugs.
Do elderly cardiac patients use cannabis?
Cannabis was detected in 18% of elderly patients who tested positive for any substance, about three times less than younger cardiac patients (53%). Benzodiazepines were twice as common in elderly patients.
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Cite This Study
https://rethinkthc.com/research/RTHC-06105APA
Bouali, Nabil; Benmansour, Othmane; El Bèze, Nathan; Trimaille, Antonin; Bouleti, Claire; Brette, Jean Baptiste; Schurtz, Guillaume; Lim, Pascal; Millischer, Damien; El Ouahidi, Amine; Gonçalves, Trecy; Gall, Emmanuel; Lequipar, Antoine; Singh, Manveer; Thuaire, Christophe; Piliero, Nicolas; Noirclerc, Nathalie; Andrieu, Stéphane; Fauvel, Charles; Florence, Jeremy; Delmas, Clément; Toupin, Solenn; Dillinger, Jean Guillaume; Henry, Patrick; Pezel, Théo. (2025). Psychoactive substance use in elderly patients: Insights from the addiction in intensive cardiac care units (ADDICT-ICCU) study.. Archives of cardiovascular diseases, 118(6-7), 356-364. https://doi.org/10.1016/j.acvd.2025.02.007
MLA
Bouali, Nabil, et al. "Psychoactive substance use in elderly patients: Insights from the addiction in intensive cardiac care units (ADDICT-ICCU) study.." Archives of cardiovascular diseases, 2025. https://doi.org/10.1016/j.acvd.2025.02.007
RethinkTHC
RethinkTHC Research Database. "Psychoactive substance use in elderly patients: Insights fro..." RTHC-06105. Retrieved from https://rethinkthc.com/research/bouali-2025-psychoactive-substance-use-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.