How drugs of abuse, including cannabis, are linked to stroke | Research

The takeaway

Cannabis and synthetic cannabinoids are among several drugs of abuse associated with stroke, particularly in young people, through mechanisms including vasospasm, acute hypertension, and effects on blood clotting.

Emergency physicians, young cannabis users, and neurologists evaluating unexplained stroke in younger patients.

Cannabis stroke cases disproportionately affect young people

What the researchers found

Cannabis-related stroke mechanisms include transient vasospasm that can cause ischemic stroke. Case reports of cannabis-induced stroke disproportionately involve young people. Synthetic cannabinoids can also cause vasospasm leading to ischemic stroke. Common stroke mechanisms across drugs of abuse include arrhythmias, cardioembolism, hypoxia, vascular toxicity, and effects on thrombotic mechanisms.

Why it matters

Stroke in young people is often unexplained, and drug use may be an underrecognized contributing factor. Understanding the specific mechanisms helps with both diagnosis and prevention.

The numbers in context

No specific incidence rates provided. Review covered multiple drug classes and their associated stroke mechanisms.

How the study worked

Narrative review examining mechanistic and pathophysiological pathways linking cocaine, amphetamines, heroin, morphine, cannabis, synthetic cannabinoids, and anabolic steroids to both ischemic and hemorrhagic stroke.

What this study cannot tell us

Based largely on case reports and mechanistic data rather than large epidemiological studies. Cannot establish how common drug-related stroke actually is. Cannabis-specific evidence is limited.

How to read the evidence

Mechanistic review based primarily on case reports rather than large population studies.

When this study was published

2019 review.

The bigger picture

The fact that cannabis-associated stroke case reports cluster in young populations is particularly concerning given that stroke in young people often has no other identified cause.

Questions still open

How common is cannabis-related stroke compared to other drug-related strokes? Do specific consumption methods or doses increase stroke risk?

Common questions

Can cannabis cause a stroke?

Case reports have linked cannabis to stroke, primarily through transient vasospasm (temporary narrowing of blood vessels). These reports disproportionately involve young people.

How do synthetic cannabinoids affect stroke risk?

Synthetic cannabinoids can cause transient vasospasm that may lead to ischemic stroke, similar to but potentially more pronounced than natural cannabis.

Read the original research

A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse.

Journal of clinical medicine, 8(9)

View on PubMed ↗Publisher’s paper ↗

Citation

Tsatsakis, Aristides; Docea, Anca Oana; Calina, Daniela; Tsarouhas, Konstantinos; Zamfira, Laura-Maria; Mitrut, Radu; Sharifi-Rad, Javad; Kovatsi, Leda; Siokas, Vasileios; Dardiotis, Efthimios; Drakoulis, Nikolaos; Lazopoulos, George; Tsitsimpikou, Christina; Mitsias, Panayiotis; Neagu, Monica. (2019). A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse.. Journal of clinical medicine, 8(9). https://doi.org/10.3390/jcm8091295