Drugs, even those considered ‘soft’, are bad for the heart. “But above all they trigger cardiac diseases caused by narcotic substances which can manifest themselves acutely – generally temporally associated with and proportional to the last dose taken – or develop slowly over time. So even those who try it once or do it occasionally and have no symptoms acute after intake, but if it continues, heart damage may develop over time.” Hence the alarm of the cardiologists of the Foundation for Your Heart of the Anmco (National Association of hospital cardiologists) in underlining how it is necessary to “stop taking substances before the damage manifests itself or becomes irreversible” and the importance of undergoing check-up visits.
“Cocaine – explains Domenico Gabrielli, president of the Foundation for your heart and director of Cardiology at the San Camillo hospital in Rome – can favor the onset of any type of cardiac pathology and increases the risk of myocardial infarction in the first hours by up to 23%. after hiring. Non-medical use of cannabis has been associated with an increased risk of cardiovascular and cerebrovascular disease. The fact that there is cannabis used for medical purposes does not mean that smoking marijuana is not harmful to the heart and health. Fentanyl is also a drug widely used in medicine, yet in the USA the non-medical use of synthetic opioids with painkiller effects such as Fentanyl and derivatives is a real social health problem. These substances, perhaps also purchased illegally, have in fact increased mortality due to cardiorespiratory arrest (around 75,000 deaths from synthetic opioids have been estimated in 2022 in the United States) and now constitute one of the main causes of death in young people in the USA – adults.”
“The objective of the Foundation for Your Heart and of the Anmco cardiologists – recalls Gabrielli – is to carry out prevention in step with the times in consideration of the increasingly frequent use and abuse of psychoactive substances, since not only the substances taken have changed but also the profile of those who hire them. The prevention of cardiovascular problems caused by psychoactive substances deserves all our attention and justifies every effort as these diseases are not at all rare, data show that up to a quarter of heart attacks in young people are linked to drug use. And in general, drug-induced cardiac damage is decidedly more frequent than we can demonstrate.”
According to cardiologists, “drug substances are at the center of various problems in civil society: a well-known concept but there is still little knowledge, both in the health and social fields, on the ability that these substances have to cause cardiovascular problems and damage in general biological with serious repercussions on the health of those who take them and important repercussions on healthcare spending. The lack of information and above all the misinformation, linked to the channels from which the information is drawn, determine – cardiologists warn – false beliefs such as that of believing the cannabis is harmless as it is ‘therapeutic’ and therefore favors a low perception of the danger of ‘substances’, including alcohol, for the heart and human health, particularly among young people”.
“Cardiac organ damage that can remain asymptomatic for a long time, giving the false impression of being healthy, the fact that most of the time the organ damage develops slowly over time without giving particular symptoms during intakes, the underestimation of diagnosis of heart disease determined or favored by the use of psychoactive substances and the fact that there is little sensitivity and a lot of reticence in speaking, as one should, about these issues contribute to the erroneous belief that narcotic substances do not cause that much harm to the heart and to our organism – remarks Gabrielli – All the main known drugs, including cannabis, have a cardiotoxic effect and can cause or favor the onset of various types of cardiovascular pathologies, even serious or fatal ones. In fact, narcotic substances damage the coronary arteries, causing ischemia acute or chronic heart disease and directly damage the heart muscle causing inflammation (myocarditis), dilation (dilated cardiomyopathy) or thickening (hypertrophy) of the heart. These conditions, which if not diagnosed and treated promptly, can lead to heart failure. They also favor the onset of various types of arrhythmias, sometimes lethal, and alterations of blood pressure, coagulation and heart valves.”
According to Francesco Ciccirillo, cardiologist and head of the Dahd (Drug Abuse Heart Diseases) clinic of the UOC Cardiology-Vito Fazzi hospital unit-ASL of Lecce, “it should lead us to consider psychoactive substances as an independent and additional cardiovascular risk factor and to consider their favorable role on the symptoms and cardiovascular diseases found in clinical practice as well as carrying out adequate prevention programs aimed at avoiding the first intake and even recreational use of psychoactive substances. In fact – Ciccirillo specifies – cardiovascular damage can occur not only in habitual consumer (who still remains at higher risk) but also in the occasional one, sometimes regardless of the quantity of substance taken, especially if there is a particular genetic predisposition (not always known) or other contingent factors”.
“It is difficult to quantify and predict the risk of cardiac damage from drugs in the individual – continues Ciccirillo – as the effect of the substances can vary from subject to subject and even in the same subject, based on dose, modality, timing, duration of intake, type, purity, quantity of the substance and presence or absence of other predisposing factors”.
For adequate prevention of heart disease caused by psychoactive substances, “it is also important to know and learn not to underestimate the symptoms associated with the use of substances in order to seek prompt medical help. For example, it is essential not to neglect the symptom of chest pain as it can be an expression of serious acute cardiorespiratory pathologies. From 0.7% to 6% of subjects who come to the emergency room for chest pain after using cocaine have a cardiac infarction secondary to this substance. It is equally essential to report to the doctor if they have been taken ‘substances’ to avoid dangerous pharmacological interactions”, concludes Ciccirillo.
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