Substance use of any kind – including smoking, drinking alcohol or illegal drug use – can have major health consequences. Even minimal use of these substances can put you at risk for health issues, including heart conditions. Steven Brooks, D.O., a cardiologist at Henry Ford Health, notes that it only takes a one-time use of substances, such as cocaine or opioids, to cause acute heart issues.
“Substance abuse can have multiple adverse effects on your heart health,” says Dr. Brooks. “Speaking generally, it can lead to an increased risk of heart attacks and strokes, elevated blood pressure, heart rhythm disorders, elevated heart rates and infections in the heart.”
Substances that can have an impact on your heart include:
- Alcohol
- Opioids
- Marijuana
- Tobacco
- Cocaine
- Amphetamines (such as Adderall)
- MDMA (known as molly or ecstasy)
How Substance Use Influences Your Risk For Different Heart Conditions
The type of substance used can impact how your heart is impacted. Here, Dr. Brooks breaks down a few of the risks:
Alcohol
In a 2024 study in the Journal of the American Heart Association, it was noted that of all cardiovascular deaths related to substance use, 65% of those were the result of alcohol use. While minimal alcohol consumption was long thought to have minimal effects on your health, more research is finding that any amount can cause long-term damage.
“Alcohol abuse can lead to congestive heart failure, cardiomyopathy (weakened heart) or heart arrhythmias,” says Dr. Brooks.
Tobacco
It is well known that tobacco use can lead to build up of plaques in the arteries – causing angina or heart attacks.
“These plaque buildups do not just form on the heart,” says Dr. Brooks. “Atherosclerotic plaque can also form in the brain leading to strokes or dementia, or in the lower extremities leading to pain with walking or the need for amputation.”
Stimulants
Substances that act as stimulants (such as cocaine or amphetamines) can lead to arrhythmias, such as atrial fibrillation (AFib).
“These substances increase the oxygen demand of the heart, leading to lethal heart rhythms such as ventricular tachycardia or ventricular fibrillation - resulting in death,” says Dr. Brooks.
Additionally, substances such as cocaine have a high potential for causing heart attacks and strokes. This is because these substances cause the arteries to spasm and raise your blood pressure to dangerous levels.
Intravenous drugs
Intravenous drug abuse can lead to infections on the heart valves that may result in needing a valve replacement (or open-heart surgery). This can also cause death if symptoms are not identified quickly.
If someone struggles with substance use disorder or addiction, symptoms that may indicate a related heart issue include:
- Chest pain or discomfort
- Shortness of breath
- Heart palpitations
- Lightheadedness or loss of consciousness
- Fatigue
“Those who have underlying risk factors of heart disease such as hypertension (high blood pressure), diabetes and high cholesterol are at the greatest risk for substance use related heart issues,” notes Dr. Brooks. “And while men have a higher incidence of substance use cardiovascular disease, we are now starting to see an increase in women at a higher rate."
Treating Substance Use Related Heart Conditions
While substance use related heart issues can be treated, there are some instances where you may be left with permanent heart issues that require regular management. Fortunately, medications and procedures are available to help strengthen your heart and stabilize heart rhythm abnormalities – as well as help you avoid these substances in the future.
“Complete abstinence from any type of substance is often necessary to see the reversal of these heart issues,” says Dr. Brooks. “If you have heart issues from substance use, it is important to see a cardiologist to get the best individualized treatment possible.”
If you have a history of any type of substance use, this can increase your long-term risk of heart disease. However, it is never too late to seek help in modifying your lifestyle. The sooner you can stop abusing harmful substances, the better your chance for lowering your heart disease risk in the future.
Reviewed by Dr. Steven Brooks, a cardiologist who sees patients at Henry Ford Medical Group Genesys Heart Center and Henry Ford Genesys Heart – Pollock Road.
