Cannabis has been linked to at least 13 cardiovascular deaths and dozens of serious emergencies | Research

The takeaway

A review of case reports identifies at least 35 people with serious cardiovascular emergencies and 13 deaths attributed at least in part to smoked cannabis, alongside numerous cases of stroke and vascular arteritis.

Cannabis users, particularly those with cardiovascular concerns, and anyone interested in the safety profile of cannabis.

At least 13 cardiovascular deaths and 35 emergencies linked to cannabis in published reports

What the researchers found

At least 35 people presented with significant cardiovascular emergencies after recently smoking cannabis, and at least 13 deaths from cardiovascular mechanisms have been reported. Multiple cases of stroke and vascular arteritis (sometimes requiring limb amputation) have also been documented.

Why it matters

Cannabis is widely perceived as physically safe, but these documented cardiovascular deaths and emergencies challenge that assumption. The true incidence is likely higher than reported, given that cannabis is rarely considered as a contributing factor in sudden death investigations.

The numbers in context

At least 35 cardiovascular emergency presentations reported. At least 13 deaths from cardiovascular mechanisms documented. Multiple cases of stroke and vascular arteritis with limb amputation. These figures are described as likely underestimates.

How the study worked

Review of published case reports of hospital admissions for cardiovascular events associated with cannabis use, epidemiological studies, and case reports of sudden death attributed to cannabis, spanning the forensic and clinical literature.

What this study cannot tell us

Based on case reports, which are the weakest form of evidence for establishing causation. Positive THC levels after death don't prove causation. Many cases involved cofactors like tobacco or other substances. Prevalence-based risk estimation is not possible from case reports alone.

How to read the evidence

Moderate: compiles multiple case reports and epidemiological data, but case reports cannot establish causation or risk rates.

When this study was published

Published in 2019.

The bigger picture

With cannabis legalization expanding and use increasing, even a rare cardiovascular risk becomes significant at population scale. The forensic community has historically underconsidered cannabis in sudden death investigations, meaning the evidence base may be systematically underestimating the risk.

Questions still open

What is the actual population-level risk of cardiovascular death from cannabis use? Are certain users (those with pre-existing conditions, older users) at disproportionate risk? How do different consumption methods affect cardiovascular risk?

Common questions

Can cannabis cause heart problems?

This review documents at least 35 serious cardiovascular emergencies and 13 deaths linked to recent cannabis use. Cannabis causes significant changes in heart rate and cardiac output, which in rare cases may trigger fatal events.

How common are cannabis-related cardiovascular deaths?

The review found at least 13 documented cases but describes this as likely an underestimate, since cannabis is rarely considered a contributing factor in sudden death investigations.

Read the original research

Cannabis as a cause of death: A review.

Forensic science international, 298, 298-306

View on PubMed ↗Publisher’s paper ↗

Citation

Drummer, Olaf H; Gerostamoulos, Dimitri; Woodford, Noel W. (2019). Cannabis as a cause of death: A review.. Forensic science international, 298, 298-306. https://doi.org/10.1016/j.forsciint.2019.03.007