Key takeaways:
Many different drugs can lead to heart damage. They each do this in different ways.
Cocaine and methamphetamines are some of the riskiest drugs for your heart. They put you at risk for heart attacks, heart failure, and heart rhythm problems.
Cannabis use can cause heart disease and strokes, too.
Signs of heart damage from drugs include chest pain, shortness of breath, a racing heartbeat, and swelling in the legs.
More than 1 in 10 people who are hospitalized with serious heart conditions have illicit drugs in their systems. Drugs can affect your heart in different ways. Some drugs — like cocaine — are more dangerous than others and can lead to heart attacks or drug-induced heart failure.
But many people are not aware how substances like cannabis (marijuana) and alcohol can also lead to heart disease. So, if you or someone you know uses substances, it’s helpful to know the signs of heart damage.
What are the signs of heart damage from drug use?
Symptoms of heart damage can sometimes be hard to tell apart from symptoms of a cough, cold, or fatigue. That’s why it’s important to talk with your primary care provider if you have any of the symptoms listed below.
It can be scary to talk with a healthcare professional about new symptoms and substance use. But remember, they are there to help you, no matter what the cause. And many heart problems from drug use can be treated and cured before they become a bigger problem.
Symptoms that may be signs of heart damage include:
Chest pain
Shortness of breath
Coughing
Inability to lie flat
Heart palpitations
Fevers or chills
Headache
Swelling in the abdomen, feet, or legs
Unusual fatigue
It’s especially important to get care if the symptoms happen frequently or don’t go away within a few minutes. And if your symptoms feel severe, don’t wait for a regular office visit. Call 911 or go to the nearest ER.
Which drugs can cause heart damage?
Below, we cover illicit drugs that are used recreationally, and/or have the potential for abuse. This list doesn’t cover over-the-counter (OTC) or prescription medications. Some of the following drugs are recommended under medical supervision — like cannabis and opioids. In this article, we refer specifically to recreational use of these drugs, which often translates to higher doses and frequency.
Cocaine and amphetamines
Cocaine and methamphetamines (meth) are some of the most dangerous drugs when it comes to your heart. This is because they have a direct effect on your heart and blood vessels. These drugs work by stimulating your sympathetic nervous system. That means they can:
Raise your heart rate
Increase your blood pressure
Increase the risk for heart rhythm problems like atrial fibrillation (AFib)
Cause the arteries in your heart to go into spasm
THC and your heart: Learn how cannabis use can increase your risk of heart attack, stroke, high blood pressure, and heart rhythm problems.
Can you have a heart attack and not know it? Heart attacks don’t always cause chest pain. But there are some other signs and clues it’s time to get help.
Meds that can worsen heart failure: Some prescription and over-the-counter medications can also be harmful if you have heart failure.
When your arteries go into spasm, it can block blood flow (and oxygen) to your heart muscle. These spasms can also injure the lining of the arteries. And over time, that repeated damage can also lead to heart attacks and drug-induced heart failure.
Overall, cocaine more than doubles your risk of a heart attack. That is especially true if you are under the age of 40. Meth triples the risk. And if you use more substances — like tobacco, alcohol, or cannabis — your risk may be as high as nine times normal.
But it’s not just your heart. These drugs may also affect other blood vessels in your body. That includes your aorta — the large artery that takes blood from your heart to the rest of the body. Damage to the aorta puts you at risk for an aortic dissection. This is often fatal.
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It’s also important to note that the arteries that feed your brain can also be damaged by cocaine and meth. As a result, you are more likely to have a stroke.
IV (intravenous) drugs
People who inject drugs (of any kind) into their veins are at higher risk for a condition called endocarditis. Endocarditis is the medical term for an infection inside the heart. This can lead to permanent heart damage. From the heart, the infection can also spread to the brain and other organs.
Endocarditis happens because the needle or the injected substance isn’t sterile. That means that bacteria can be injected along with the drug. The heart is a common place for the infection to settle. From there, it can grow and destroy the heart valves and other heart structures.
Endocarditis is a medical emergency. It almost always requires hospitalization and strong antibiotics. And some people may need surgery to replace the infected valve.
If you do use injectable drugs, using sterile needles can cut your risk of endocarditis.
Opioids
Opioid overdoses are the leading cause of death for adults in the U.S. ages 25 through 64 years. At high doses, opioids might slow the heart rate and lower the blood pressure. But the main way that they cause harm is by slowing or stopping your breathing. This means the heart, brain, and other organs will not get enough oxygen. This can lead to permanent heart or brain damage.
This is why naloxone (Narcan) can be lifesaving. It quickly reverses the effect of opioids, so someone starts breathing normally again. This can restore oxygen to the body and prevent serious complications or death.
It’s also important to know that methadone can cause heart problems. Methadone is a lab-made opioid that can help people recover from opioid use disorder. But in high doses, it can cause heart rhythm problems. These conditions are called ventricular tachycardia and ventricular fibrillation. When you combine methadone with medications like benzodiazepines and other drugs, it can raise the risk for these problems. That’s why it’s important to take methadone under medical supervision.
Cannabis
About 1 in 5 people in the U.S. have used cannabis in recent years. And research estimates about a third of them have cannabis use disorder. But many people don’t know that cannabis can impact your heart health.
When you use cannabis, it can lead to:
A 34% higher risk for coronary artery disease
Higher blood pressure and heart rate, especially right after using it
Increased risk for atrial fibrillation
Dangerously low blood pressure with standing, known as orthostatic hypotension
A recent study in over 400,000 adults in the U.S. found that using cannabis daily increased the risk of heart attack and stroke by 25% and 42%, respectively. This increased risk was present even in people who had never smoked tobacco.
Keep in mind that cannabis is legal in some states for adult and/or medicinal use, but not in others. Cannabis is still illegal under federal law. Before you use cannabis products, find out the laws in your state.
Alcohol
Many people enjoy alcohol in moderation. Most people can enjoy one drink or fewer per day without any impact on the heart. But if you drink more than that, you may raise your risk for:
High blood pressure
Fortunately, the heart will often recover when you stop drinking alcohol.
Can your heart recover from drug use?
Some heart damage from drug use can be permanent. For example, if your heart muscle becomes weak from cocaine use, you may have permanent heart failure. Other conditions — like atrial fibrillation from alcohol — may go away when you stop drinking.
But no matter what type of heart condition you have, it’s treatable. In most cases, there’s something your medical team can do to make you feel better. And, when you stop using drugs or drinking alcohol, your heart can begin to recover. So, asking for help with drug use is the first step that can make a big difference down the line.
Frequently asked questions
The treatment for heart damage from drugs depends on the type of drug and the type of heart damage. In the case of drug-induced heart failure, this always starts with stopping the offending drug, which can often require medication and mental health support. Sometimes, this is enough to reverse the heart damage. For permanent or long-term damage, treatment looks very similar to treatment for heart failure from other causes.
Common signs of a heart attack include:
Pressure or heaviness in the chest
Squeezing-like chest pain that travels to the arms, neck, or jaw
Shortness of breath
Sweating
Nausea
A burning sensation that may feel like indigestion
Fatigue, weakness, or dizziness
Keep in mind that many people will not have any chest pain or obvious symptoms with a heart attack.
The treatment for heart damage from drugs depends on the type of drug and the type of heart damage. In the case of drug-induced heart failure, this always starts with stopping the offending drug, which can often require medication and mental health support. Sometimes, this is enough to reverse the heart damage. For permanent or long-term damage, treatment looks very similar to treatment for heart failure from other causes.
Common signs of a heart attack include:
Pressure or heaviness in the chest
Squeezing-like chest pain that travels to the arms, neck, or jaw
Shortness of breath
Sweating
Nausea
A burning sensation that may feel like indigestion
Fatigue, weakness, or dizziness
Keep in mind that many people will not have any chest pain or obvious symptoms with a heart attack.
The bottom line
Drugs like cocaine, amphetamines, and opioids can damage your heart. So can cannabis and alcohol. They put you at risk for heart attacks, heart failure, heart rhythm problems, and high blood pressure. So, if you’re experiencing symptoms like chest pain, shortness of breath, or palpitations, check with a primary care provider. Don’t be afraid to be honest about your situation. This is the best way for them to help you. And know that you are not alone. Most people with these conditions can recover.
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.
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References
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