Recreational Drugs Including Marijuana Are Driving Early-Onset Heart Disease | Research

The takeaway

A review of cardiovascular evidence found that cocaine, amphetamines, alcohol, and marijuana all contribute to premature heart disease in young and middle-aged adults, with substance abuse worsened by the COVID-19 pandemic.

Cardiologists seeing younger patients; public health professionals; anyone concerned about the heart effects of substance use.

US crossed 100,000 overdose deaths in a single year

What the researchers found

All four substances (cocaine, amphetamines, alcohol, marijuana) are cardiotoxic and contribute to rising levels of premature cardiovascular disease including hypertension, arrhythmias, heart failure, stroke, myocardial infarction, and sudden cardiac death in younger populations.

Why it matters

Cardiovascular disease has traditionally been associated with aging, but substance abuse is shifting its burden to younger populations. Understanding marijuana's place alongside better-studied cardiotoxins like cocaine and alcohol helps contextualize its cardiac risks.

The numbers in context

The US crossed 100,000 overdose-related deaths in a calendar year for the first time. The review covered hypertension, arrhythmias, heart failure, stroke, myocardial infarction, arterial dissection, and sudden cardiac death across all four substances.

How the study worked

Narrative review examining the cardiovascular effects of cocaine, amphetamines, alcohol, and marijuana, published in the Canadian Journal of Cardiology. Focused on the link between recreational substance abuse and early-onset cardiovascular disease.

What this study cannot tell us

This is a narrative review grouping four very different substances together, which may oversimplify their individual cardiovascular risk profiles. The cardiovascular evidence for marijuana is weaker than for cocaine or alcohol. The review did not quantify relative risks across substances.

How to read the evidence

Moderate: published in a major cardiology journal as a clinical review, though it is narrative rather than systematic.

When this study was published

Published in 2022.

The bigger picture

As cannabis becomes more widely used and accepted, its cardiovascular effects deserve attention alongside better-publicized risks from stimulants and alcohol. The pandemic-era increase in substance use adds urgency to understanding these cardiovascular consequences.

Questions still open

How does the cardiovascular risk of marijuana compare quantitatively to cocaine or heavy alcohol use? Are the cardiac effects of marijuana dose-dependent? Would cardiovascular screening be warranted for heavy cannabis users?

Common questions

Can marijuana cause heart attacks?

The review identifies marijuana as one of several recreational substances linked to cardiovascular events in younger people, including myocardial infarction. However, the risk is generally considered lower than for cocaine or amphetamines.

Is the cardiovascular risk from marijuana the same as from cocaine?

No. The review groups these substances together as contributors to early-onset heart disease, but cocaine and amphetamines have much more acute and severe cardiovascular effects. The relative risk of marijuana is less well quantified.

Read the original research

Early-Onset Cardiovascular Disease From Cocaine, Amphetamines, Alcohol, and Marijuana.

The Canadian journal of cardiology, 38(9), 1342-1351

View on PubMed ↗Publisher’s paper ↗

Citation

O'Keefe, Evan L; Dhore-Patil, Aneesh; Lavie, Carl J. (2022). Early-Onset Cardiovascular Disease From Cocaine, Amphetamines, Alcohol, and Marijuana.. The Canadian journal of cardiology, 38(9), 1342-1351. https://doi.org/10.1016/j.cjca.2022.06.027