Illicit drugs and stroke
- Recent research in Scotland (2006 ISD) reports one in three Scots have taken illicit drugs at some point in their lives. The figure – 37% – represents a huge increase on the 24% identified in a previous survey in 2004.
- Abuse of illicit drugs is a significant risk factor for stroke and abuse of illicit drugs should be considered in any young patient with stroke even when other risk factors are present and the patient denies the use of drugs.
- The actual number of patients who sustain a stroke from illicit drug use is unknown for various reasons, including difficulty in obtaining an accurate case history regarding illicit drug use due to stigma, and death certificates being recorded as “drug overdose” rather than more specific details of secondary complications.
- The increasing numbers of people abusing these drugs and the the increase in stroke in younger people (15-44 year olds) appears to be linked. In a study by Kaku and Lowenstein 1990, illicit drug abuse was the most commonly identified potential predisposing risk factor for stroke in patients less than 35 years old.
- In order of frequency, cocaine, heroin, phencyclidine, amphetamines, MDMA and marijuana have all been reported in association with stroke. Both ishaemic and haemorrhagic strokes are directly associated with these drugs.