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Recreational Drugs, Alcohol, and Stroke


Updated June 09, 2014

Man enjoying a drink at the bar
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Recreational Drugs, Alcohol, and Stroke

Years of research now show that drugs are significant risk factors for stroke. Some drugs can cause stroke by directly affecting blood vessels in the brain while others do it indirectly by affecting other organs in the body such as the heart or the liver. Common substances known to increase the risk of strokes include:

Alcohol: Although alcohol in moderate amounts can protect you from having a stroke, excessive intake can increase your risk of having one. Specifically, chronic excessive alcohol intake can precipitate hemorrhagic stroke. This is in many cases the result of harmful effects of alcohol on the liver, as this organ makes proteins which are necessary to prevent spontaneous bleeding. However, most of the risk of stroke with excess alcohol intake appears to be due to a combination of high blood pressure, and impaired blood clotting mechanisms.

Cocaine: There is a clear association between cocaine use and stroke. The most important ways by which cocaine use increases the risk of stroke include:

  • By increasing blood pressure and causing bleeding in the brain
  • By causing narrowing of blood vessels in the brain
  • If used in its intravenous form known as crack cocaine increases the risk of infections in the heart valves, or endocarditis, a condition that can lead to embolic stroke

Heroin: Heroin is a commonly abused drug in the United States. Similar to intravenous cocaine, intravenous heroin also increases the risk of endocarditis, a condition in which bacteria enter the blood and grow over the valves of the heart. Small pellets of these bacteria, known as septic emboli, may leave the heart, head towards the brain and cause a stroke. Because heroin is injected, its use also increases the risk of diseases transmittable by the sharing of needles such as HIV and hepatitis C.

Amphetamines: There have been many reports of amphetamine use in the hours before suffering a major stroke. Amphetamines appear have a powerful ability to cause high blood pressure. As high blood pressure is the number one risk factor for stroke, it is not surprising that amphetamine use can increase a person's risk for stroke.

Other substances which have been linked to hypertensive strokes include:

J. P. Mohr, Dennis W. Choi, James C. Grotta, Bryce Weir, Phillip A. Wolf Stroke: Pathophysiology, Diagnosis, and Management Churchill Livingstone; 4th edition (2004).
Treadwell SD, Robinson TG Cocaine use and stroke Postgrad Med J. Jun; 83:389-94 2007.
Hiroyasu Iso, MD; Shunroku Baba, MD; Toshifumi Mannami, MD; Satoshi Sasaki, MD; Katsutoshi Okada, MD; Masamitsu Konishi, MD Shoichiro Tsugane, MD for the JPHC Study Group Alcohol Consumption and Risk of Stroke Among Middle-Aged Men: The JPHC Study Cohort I Stroke 2004;35:1124

Other Causes of Stroke
What Are The Symptoms of a Stroke?

How Can I Lower My Risk of Stroke?
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