Cardiovascular Toxicity as a Result of Recreational Drugs

A bewildering range of recreational drugs exists and the majority have cardiovascular effects. In the United Kingdom almost a fifth of young people used illegal drugs between 2011 and 2012. As a group, recreational drugs account for a leading cause of mortality and morbidity among the young, and this is frequently via cardiovascular complications. This chapter profiles the cardiovascular properties of major recreational drugs in use at present, including cocaine, amphetamine-like compounds (e.g., MDMA), heroin, cannabis, LSD, inhaled volatile substances, and the scant information that exists on newer “designer drugs” and “legal highs.” Treatment for cardiovascular complications is also covered with up-to-date guidance. Cocaine’s cardiovascular risk profile is perhaps the most studied and its propensity to precipitate myocardial infarction in young, healthy adults is well known. However, it exerts its effects via a complex interplay of systems, an understanding of which is vital to guide management of the patient presenting with a cocaine-induced cardiovascular emergency. The risks of “body packing” and polydrug abuse are also covered.