Substance abuse: Can drugs cause strokes?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Drugs are a major risk factor for strokes. A 2007 JAMA Psychiatry study showed that from 2000 to 2003, the abuse of amphetamines, cannabis, and cocaine increased drastically. They found that:

Amphetamine abusers are 4 times more likely to suffer a hemorrhagic stroke and are 163% more likely to die from it.
Cocaine abusers face a 133% increased risk of hemorrhagic stroke and a 103% higher risk of ischemic stroke.

If you’re battling drug abuse, Ardu Recovery Center offers the support and expertise to help you reclaim your life. Reach out to our drug rehab center and start your journey to healing.

Understanding strokes

A stroke is a medical condition where part of the brain is damaged by blood flow disruption. It’s characterized by the sudden loss of brain function. Symptoms of strokes include:

Sudden numbness or weakness, especially on one side of the body
Confusion or trouble speaking
Difficulty understanding speech
Sudden vision problems in one or both eyes
Dizziness
Loss of balance and coordination
Severe headache
Trouble walking or difficulty with movement

There are two main types of strokes: ischemic and hemorrhagic.

Ischemic strokes are more common. They happen when a blood clot or a fatty deposit blocks a blood vessel supplying the brain. The blockage deprives brain cells of oxygen and nutrients, causing them to die within minutes.
A hemorrhagic stroke occurs when a blood vessel in the brain bursts, causing bleeding within or around the brain. This bleeding increases pressure inside the skull and damages brain tissue.

Since brain cells begin to die rapidly during a stroke, quick intervention can save brain tissue, reduce the severity of long-term damage, and increase the chances of recovery.

What causes strokes?

Strokes can strike suddenly, but they often result from underlying health issues and lifestyle choices. Here are the primary risk factors that can lead to a stroke:

High blood pressure (hypertension) is the most significant risk factor for stroke. Hypertension can damage blood vessel walls, causing blockages or ruptures.
Atrial fibrillation (irregular heartbeat) can cause blood to pool and form clots, which may travel to the brain and cause an ischemic stroke.
Cardiovascular disease increases the risk of stroke. It contributes to the formation of blood clots and the narrowing of arteries.
Blood clotting disorders or medications can clog the brain’s blood vessels.
Smoking damages blood vessels and increases blood pressure, significantly raising the risk of both ischemic and hemorrhagic strokes.
Alcohol abuse often raises blood pressure and contributes to irregular heart rhythms, increasing the likelihood of stroke.
Illegal drug use causes severe spikes in blood pressure and damages blood vessels, leading to strokes.

Drug abuse harms your brain and body, making it a major cause of strokes and other serious health issues.

What drugs can make you have a stroke?

Certain drugs drastically raise your risk of having a stroke.

Cocaine is a powerful stimulant used recreationally for its euphoric effects. It sharply increases blood pressure, leading to blood vessel damage and strokes.
Methamphetamines are stimulants often abused for their intense energy and focusing effects. Methamphetamine abuse causes severe spikes in blood pressure, damaging brain blood vessels and leading to strokes.
Amphetamines are prescription stimulants used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. When abused, they raise blood pressure and heart rate.
Heroin is an illegal drug used for its intense euphoric effects. It can cause respiratory depression and low oxygen levels that lead to brain damage and stroke.
Ecstasy (MDMA) is a synthetic drug popular in party scenes for its mood-enhancing effects. MDMA abuse can cause dehydration and dangerously high blood pressure.
Synthetic cannabinoids (spice, K2) are man-made chemicals similar to THC, used recreationally. They can cause severe cardiovascular issues, including sudden spikes in blood pressure.
Prescription stimulants (e.g., Adderall, Ritalin) used to treat ADHD have a high risk of strokes when misused. They can significantly raise blood pressure and heart rate.

If you or someone you know is struggling with drug abuse, seek professional help immediately. Ardu offers comprehensive addiction treatment and detox programs tailored to your individual needs. Our experienced team provides compassionate care and evidence-based therapies to support lasting recovery and reduce health risks associated with substance abuse.

Types of strokes caused by drugs

Drug abuse can lead to different types of strokes, each with distinct mechanisms and outcomes. The specific type of stroke is influenced by the drug used and its effects on the cardiovascular system and brain.

A comprehensive 2019 review article by Tsatsakis, et. al., titled “A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse,” linked the following types of strokes with drug abuse.

Ischemic stroke

Ischemic strokes occur when blood clots block brain arteries. They are linked to cocaine, amphetamines, heroin, cannabis, synthetic cannabinoids, and anabolic androgenic steroids. These substances can form clots in blood vessels, causing two kinds of ischemic strokes: thrombotic strokes, which form clots within brain vessels, and embolic strokes in which clots travel from elsewhere.

Hemorrhagic stroke

This type of stroke involves bleeding in or around the brain, often as a result of sudden blood pressure spikes. This is primarily a consequence of cocaine, amphetamine, and heroin abuse. These substances weaken blood vessels and promote the formation of aneurysms—balloon-like bulges in artery walls that can rupture under pressure.

Transient ischemic attack (TIA)

Often called a “mini-stroke,” TIAs are temporary blockages that last less than twenty-four hours. While symptoms resolve quickly, TIAs are serious medical emergencies and warning signs of future strokes. Stimulants are frequently associated with TIAs because of their intense and immediate effects on blood flow and pressure.

Vasospasm-induced stroke

A vasospasm-induced stroke occurs when brain blood vessels suddenly narrow (vasoconstriction). Narrow blood vessels reduce or impair blood flow. These strokes are common with cocaine and amphetamine use because the drugs cause intense vasoconstriction. Prolonged vasospasm can lead to cerebral infarctions.

Cerebral venous thrombosis

In cerebral venous thrombosis, blood clots form in the brain’s venous system, obstructing drainage. This can cause both ischemic and hemorrhagic damage. This type of stroke is associated with stimulants and dehydration from MDMA use, which increases blood viscosity.

Vasculitis-related stroke

Inflammation of blood vessels can lead to narrowing, blockage, or weakening, causing both ischemic and hemorrhagic strokes. This is often seen with cocaine, methamphetamine, and heroin use because these substances exert potent inflammatory effects on blood vessels.

Cardioembolism-induced stroke

Blood clots form in the heart and travel to the brain, blocking arteries. Cardioembolism-induced strokes are common in cocaine and amphetamine users because of drug-induced heart arrhythmias and damage. Intravenous drug use can also lead to heart infections causing emboli.

Hypoxic-ischemic brain injury

Hypoxic-ischemic brain injury results from severe oxygen deprivation, common in opioid overdoses. Excessive amounts of opioids cause respiratory depression. This type of stroke can also occur with stimulant-induced seizures or cardiac arrest.

Recovery is challenging but essential for preventing life-threatening complications such as strokes. Ardu specializes in safe, medically-supervised detoxification to manage drug withdrawal symptoms.

Our team of medical professionals is expertly trained in addressing the complex health risks associated with substance use disorder (SUD), including potential cardiovascular and cerebrovascular complications. By choosing Ardu, you’re not just overcoming addiction; you’re taking a crucial step in safeguarding your long-term health. Don’t wait until it’s too late. Contact Ardu Recovery Center today.

Can an overdose cause a stroke?

A drug overdose is a major cause of strokes, and it is extremely dangerous. When someone overdoses, especially on stimulants such as cocaine or amphetamines, it can send their body into overdrive. Their blood pressure skyrockets, putting immense stress on the blood vessels in their brain. This sudden pressure spike can cause weak spots in the arteries to burst, leading to a hemorrhagic stroke.

A heroin overdose can cause severe respiratory depression, drastically reducing oxygen to the brain and triggering an ischemic stroke. According to Andersen and Skullerud, “potential causes of stroke include hypotension and hypoxemia induced by opiate overdose; these can result in global hypoxic-ischemic injury to classically vulnerable areas of the brain.” Even if the user survives the immediate overdose, the damage from drug-induced strokes can be permanent and life-altering.

Other signs of a drug overdose include:

Slow, shallow, or irregular breathing
Rapid or irregular heartbeat
Dilated or pinpoint pupils
Blue or pale skin, especially around the lips or fingertips
Confusion or disorientation
Seizures or convulsions
Chest pain
Vomiting or gurgling sounds
Loss of consciousness

A stroke from an overdose can happen in minutes, often before emergency services can arrive.

Can drug withdrawal cause a stroke?

Drug withdrawal can also cause a stroke—though less commonly than strokes caused by active drug use. During withdrawal, the body experiences significant physiological stress as it adjusts to functioning without the drug. This can cause extreme fluctuations in blood pressure, heart rate, and body temperature. For some drugs, particularly alcohol and benzodiazepines, severe withdrawal can cause seizures, which may trigger a stroke.

The dehydration and electrolyte imbalances common during withdrawal also increase the risk of blood clots and affect blood flow to the brain.

Ardu provides specialized drug detox services to safely manage withdrawal symptoms. Our approach includes medical monitoring, hydration therapy, and targeted treatments such as CBT and mindfulness practices to ease your transition. With a focus on your comfort and safety, we tailor our detox programs to your unique needs.

Let us help you through this critical stage, so you can begin your recovery with confidence and support.

Need help overcoming addiction to drugs?

Illicit drug use often comes with significant health risks, but that doesn’t mean you can’t stop using. Recovery is challenging, but Ardu is here to guide you every step of the way. The first step in mitigating these risks is detox.

Our drug detox programs help your body safely adjust during withdrawal, which can often trigger severe cardiovascular and stroke-related complications, especially in chronic users. Our evidence-based approach includes round-the-clock care at our medical detox facility, where experienced professionals closely monitor your progress. We use FDA-approved medications to manage withdrawal symptoms and reduce the risk of adverse events such as intracranial hemorrhage.

After completing detox, you can transition to one of our inpatient or outpatient rehab programs. They cater to the specific needs of our patients with a history of substance abuse and stroke risk factors. Our therapies, including cognitive behavioral therapy (CBT) and trauma-informed care, address the underlying issues that contribute to substance abuse and reduce the likelihood of stroke and other cardiovascular events.

Our team is equipped to address both the physical and psychological aspects of addiction with treatments tailored to prevent relapse and promote recovery. We do this by combining evidence-based therapies with a holistic approach to addiction and detox services, such as:

Nutritional therapy with a focus on restoring physical health
Yoga and exercise programs to strengthen the body, enhance mental health, and provide a healthy outlet for stress management
Amino acid therapy to balance brain chemistry and reduce cravings
Vibroacoustic therapy that uses sound waves and vibrations to promote relaxation, reduce stress, and improve mental clarity
Hyperbaric oxygen therapy to increase oxygen levels in the body and accelerate healing

At Ardu Recovery Center, we provide comprehensive care to treat not only the addiction but also the serious health risks associated with drug use. Contact us to get informed and start your sobriety journey today.

Read our admissions process page for more information.

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Drugs that cause strokes FAQ

Do opiates cause strokes?

Opiates, such as heroin, morphine, and codeine, carry the risk for stroke, though they are more commonly associated with other cardiovascular accidents. Opiate abuse can reduce oxygen in the brain and lead to a condition called hypoxia. This increases the likelihood of ischemic attacks and intracerebral hemorrhages.

Chronic opiate users often experience fluctuations in blood pressure, which can damage blood vessels and lead to strokes. Opiate abuse often coincides with other risk factors, such as heart disease and prescription drug misuse, which can further elevate stroke risk.

Can codeine cause stroke?

Codeine is a prescription medication commonly used for pain relief. It is less likely to directly cause a stroke than other more potent opioids. Misuse of codeine can still increase the risk of stroke, particularly in patients with underlying heart diseases or other cardiovascular risk factors.

Codeine can lead to respiratory depression, which reduces oxygen supply to the brain. The use of codeine in combination with other prescription drugs or recreational drugs can elevate blood pressure and increase the incidence of stroke.

Can morphine cause a stroke?

Morphine abuse can indirectly increase stroke risk, especially in patients with existing cardiovascular disease. The primary concern with morphine is its potential to cause respiratory depression, leading to hypoxia, which can result in ischemic strokes or cerebrovascular disease.

Morphine use can also cause significant fluctuations in blood pressure, increasing the risk of intracranial hemorrhage. Chronic users, particularly those with a history of heart disease, are at an even higher risk for these types of strokes. While morphine itself is not a direct cause of stroke, its effects on the body can make strokes more likely.

Can drugs cause brain bleed?

Certain drugs can cause a brain bleed, also known as an intracranial hemorrhage. Illicit drugs such as cocaine and methamphetamine are particularly notorious for causing brain bleeds because of their potent effects on blood pressure and blood vessels. They can cause sudden, severe increases in blood pressure, leading to ruptures in blood vessels within the brain.

Even some prescription drugs, such as blood thinners, can increase the risk of brain bleeds if misused or not properly monitored. Chronic users of these substances, especially those with underlying cardiovascular conditions, are at an increased risk of experiencing intracranial hemorrhages and other severe cerebrovascular events.

Can opiates damage the brain?

Opiates can have devastating effects on the brain, causing many forms of damage.

Hypoxia: Respiratory depression caused by opiates leads to reduced oxygen levels in the brain, resulting in cell death and damage to brain tissue.
Increased risk of ischemic strokes: Opiates can contribute to the development of blood clots and reduced blood flow, leading to strokes that damage brain areas.
Cognitive impairment: Chronic opiate use can lead to difficulties in memory, attention, and decision-making, altering brain structure and function over time.
Emotional dysregulation: Long-term opiate use can disrupt the brain’s ability to regulate emotions, leading to mood swings, depression, and anxiety.
Altered brain structure: Prolonged use of opiates can cause changes in the brain’s physical structure, particularly in areas related to reward, motivation, and stress response.
Impaired neurotransmitter function: Opiates can disrupt the balance of neurotransmitters, leading to altered communication between brain cells and contributing to addiction and withdrawal symptoms.
Increased susceptibility to cerebrovascular events: Opiate abuse can elevate the risk of cerebrovascular events such as intracerebral hemorrhages, further damaging brain tissue.

How does withdrawal affect the brain?

Drug withdrawal can have significant effects on the brain. During withdrawal, the brain undergoes intense physiological stress as it adjusts to the absence of the drug. This stress can cause anxiety, depression, and cognitive difficulties. In severe cases, withdrawal can trigger seizures, which may lead to strokes or other serious complications.

The brain’s neurotransmitter levels, which have been altered by drug use, struggle to return to normal, causing mood swings, irritability, and even hallucinations. Chronic users of prescription drugs, opioids, or illicit substances may experience long-lasting changes in brain chemistry.

Are drugs hard on the heart?

Many drugs are tough on the heart. Stimulants such as cocaine and methamphetamines cause sudden and severe increases in heart rate and blood pressure, leading to a heightened risk of cardiovascular events, including myocardial infarction (heart attack), ischemic stroke, and intracranial hemorrhage.

Opiates, while primarily affecting the respiratory system, can also impact heart function by lowering oxygen levels in the blood, which strains the heart over time and increases the risk of heart diseases. Chronic drug use, whether prescription medications or illicit drugs, can lead to severe cardiovascular risk, including arrhythmias, heart failure, and other serious health complications.

Do opioids shorten life expectancy?

Opioids can shorten life expectancy, especially if you’re a chronic user. The primary risks associated with opioid use include respiratory depression, which can lead to fatal overdoses and an increased risk of cardiovascular events such as heart attacks and strokes. Chronic opioid use can also lead to long-term health issues, including liver damage, kidney failure, and a weakened immune system, all of which contribute to a shortened lifespan.

The risk of addiction, combined with the potential for dangerous drug interactions or infections related to intravenous drug use, further increases the risk of death among opioid users. Long-term use of prescription drugs is associated with a substantial reduction in life expectancy, especially because of the heightened risk of severe cardiovascular events and cerebrovascular incidents such as intracerebral hemorrhages and ischemic strokes.

Resources

Westover, A. N., McBride, S., & Haley, R. W. (2007). Stroke in Young Adults Who Abuse Amphetamines or Cocaine. Archives of General Psychiatry, 64(4), 495. https://doi.org/10.1001/archpsyc.64.4.495

Tsatsakis, A., Docea, A. O., Calina, D., Tsarouhas, K., Zamfira, M., Mitrut, R., Sharifi-Rad, J., Kovatsi, L., Siokas, V., Dardiotis, E., Drakoulis, N., Lazopoulos, G., Tsitsimpikou, C., Mitsias, P., & Neagu, M. (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

Andersen SN, Skullerud K. Hypoxic/ischaemic brain damage, especially pallidal lesions, in heroin addicts. Forensic Sci Int. 1999 May 31;102(1):51-9. doi: 10.1016/s0379-0738(99)00040-7. PMID: 10423852.