How Certain Drugs and Alcohol Can Cause Strokes

Drug use is a significant risk factor for strokes, and it is often associated with strokes in young people who do not have the usual health problems that contribute to a stroke. But not all drugs have the same impact on the overall risk for stroke, and different drugs affect the body differently.

Sally Anscombe / Getty Images

Some drugs can cause a stroke by directly harming blood vessels in the brain while others directly cause a stroke by impairing other organs in the body—such as the heart, the kidneys, or the liver. Common drugs of abuse that are known to increase the risk of strokes include alcohol, cocaine, amphetamines, and heroin.

Alcohol

Although red wine in moderate amounts may protect you from having a stroke, heavy alcohol intake can increase your risk of having a stroke.

Long-term excessive alcohol use can increase the risk of strokes. The most notable effect of heavy alcohol use is the sharply raised risk of hemorrhagic stroke, which is a particularly dangerous type of stroke characterized by bleeding in the brain.

The elevated risk of strokes associated with excessive alcohol intake appears to be due to a combination of high blood pressure and impaired blood-clotting abilities of the body. One of the ways that alcohol interferes with blood clotting is by damaging the liver. The liver makes proteins that are necessary to prevent spontaneous bleeding. When the liver cannot adequately make these important proteins, excessive bleeding can occur anywhere in the body, including the brain.

Cocaine

There is an association between cocaine use and strokes. Cocaine can cause a sudden stroke during or shortly after use. Additionally, long-term repeated use of cocaine can also cause cerebrovascular disease over time, significantly increasing the risk of stroke, even in otherwise healthy young people who do not have other risk factors of stroke. The most important ways by which cocaine use increases the risk of strokes are as follows:

  • by dramatically and quickly increasing blood pressure and causing bleeding in the brain;
  • by causing a sudden or gradual narrowing or spasm of blood vessels in the brain; or
  • if used in its intravenous form known as crack cocaine, it increases the risk of serious infections in the heart valves. This type of heart infection, called endocarditis, is among the many heart conditions that can lead to stroke.

Heroin

Heroin is an addictive drug that is commonly abused. 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 clumps of these bacteria, known as septic emboli, may leave the heart, travel to the brain and block a blood vessel in the brain, causing 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.

Heroin overdose can cause inadequate respiration, preventing enough oxygen from reaching the body. During a period of extremely low oxygen, a person can suffer from irreversible oxygen deprivation in the brain, even if he or she is revived and survives the overdose.

Amphetamines

There have been many reports documenting amphetamine use in the hours before a major stroke, even among young healthy individuals without stroke risk factors.

Amphetamines, such as methamphetamine, have a powerful ability to produce sudden and extremely high blood pressure. As high blood pressure is the No. 1 risk factor for strokes, it is not surprising that amphetamine use can increase a person’s risk for strokes. As with cocaine, long-term use of methamphetamine increases stroke risk by causing abnormal functioning in the blood vessels of the brain, while harming the rest of the body. Short-term use of methamphetamine may result in a sudden stroke during or after use, largely as a result of sudden changes in blood pressure and heart function induced by methamphetamine in the body.

Other Drugs Which Have Been Linked to Strokes

  • Phencyclidine (PCP): this drug is also known as angel dust
  • Lysergic acid diethylamide (LSD)
  • Herbal viagra
  • Marijuana
  • Cigarettes
  • Some energy drinks (if consumed in very high amounts)

A Word From Verywell

A stroke is generally caused by long-term health problems that build up over time, damaging the blood vessels and increasing the chances of having a blood clot or a bleed in the brain. Recreational drugs of abuse can produce sudden and dramatic effects on the body, causing a variety of serious health consequences. A stroke is one of these consequences.

Recovering from a stroke caused by drug use is similar to the process of recovering from a stroke caused by any other disease—this includes rehabilitation and reducing stroke risk factors. When a stroke is caused by drug use, reducing the risk factor is focused on eliminating drug use and addiction recovery, which is more successful and longer-lasting in a professional setting. Young people are more likely to experience a stroke associated with drug use, and recovery can be quite good because of the overall good health of most young stroke survivors.


— Update: 17-02-2023 — cohaitungchi.com found an additional article Stroke associated with drug abuse … from the website www.medlink.com for the keyword impact of drug use on stroke.

Overview

Drugs of abuse are frequently associated with stroke, especially in the young. In this article, the author reviews the clinical features and pathophysiology of stroke related to drug abuse.

Key points

• Drugs of abuse increase the risk of both ischemic stroke and intracerebral hemorrhage.

• Stimulants such as amphetamines, cocaine, and phencyclidine cause a sympathetic surge with elevated blood pressure and vasospasm.

• Heroin-associated strokes are most often attributed to infectious complications such as endocarditis or ruptured mycotic aneurysm.

• Cannabis use may be associated with an increased risk of ischemic stroke, although data are limited.

Historical note and terminology

Although often considered a peculiarly modern problem, the use of drugs for their psychoactive effects dates back thousands of years. Drugs derived from the ingestion of plants have the longest history of abuse. Abuse of synthetic and semi-synthetic drugs date to the pharmaceutical development of these substances in the early 20th century. The major classes of drugs of abuse include opiates, stimulants (cocaine, amphetamine and related agents), hallucinogens (LSD, phencyclidine, etc.), marijuana, barbiturates and other sedatives, and inhalants. Alcohol and tobacco, the 2 most widespread drugs of abuse, will not be discussed in this article. This certainly should not be taken as minimizing their addictive potential or clear impact on stroke risk. Each of the broad classes of drugs of abuse produces a distinct clinical intoxication and is associated with a limited spectrum of cerebrovascular disease. Familiarity with these patterns is important to the evaluation and treatment of patients with stroke. Several difficulties arise in any discussion about drugs of abuse. First, a variety of common street names exist to describe various drugs. As no standard definitions of these terms exist, they may at times mean different things to different people. Second, given the illicit nature of most drugs of abuse, patients’ perception of the drug ingested must be considered of limited reliability. Tainted and substituted compounds are common, and only toxicological confirmation or direct testing of the substance itself can confirm the true identity of the ingested drug. Finally, a variety of different means of administration of individual drugs exist, and the effects of the drug, both desired and undesired, vary considerably based on this fact.

Read more  Atrial Fibrillation and Mechanisms of Stroke: Time for a New Model

Table 1. Street Names and Methods of Administration for Drugs of Abuse

Agent

Administration

Common name(s)

Methamphetamine

Orally, intravenously, intranasally

Meth, speed, dexies, crystal, ice

Amphetamine derivatives

Orally, intranasally

MDMA, Ecstasy, X, molly, bath salts, plant food, jewelry cleaner, ivory wave, purple wave, zoom, cloud nine

Cocaine hydrochloride

Intranasally

Blow, nose candy, snow, dust, coke

Cocaine, alkaloidal

Inhaled or smoked; intravenously

Crack, rock, base, white pipe

Phencyclidine

Orally

PCP, angel dust, trank, DOA

Heroin

Intravenously, inhaled, or smoked

Smack, junk, skag, black tar

Cannabis

Inhaled, smoked, or ingested

Marijuana, hashish, pot, grass, weed

Synthetic cannabis

Inhaled, smoked, or ingested

Spice, K2, black mamba, Bombay blue, bliss, blaze

Amphetamines are synthetic sympathomimetics whose anorectic action led to their initial use as diet pills. They have also been used as mental stimulants by long-distance drivers, students, and others trying to preserve cognitive performance in the face of sleep deprivation. Athletes have used them to enhance physical performance. The euphoriant effect of higher doses has broadened their abuse potential. Methamphetamine is typically taken orally, although it can be smoked and injected. Intravenous users crush tablets of “speed,” dissolve them in a liquid, filter them through cotton, and then inject them. Cerebrovascular complications arise from the more rapid onset of sympathomimetic action, and from foreign body reactions to “diluents” or filler substances like talc or cornstarch.

Amphetamine derivatives encompass a broad range of drugs with sympathomimetic action. Methylenedioxymethamphetamine or “ecstasy” is used both for its stimulant and euphoric properties. Other synthetic amphetamine-like substances, such as mephedrone, pyrovalerone, and methylenedioxypyrovalerone, are gaining popularity as well. These drugs can be purchased online or in drug paraphernalia stores. They are variably labeled as “bath salts,” or “plant food,” and there has been a dramatic increase in calls to United States poison control centers related to these substances (36). Ephedrine is used for the treatment of asthma and nasal decongestion (29) and is contained in the form of ephedra in the Chinese herbal preparation , frequently sold as an herbal stimulant. Over-the-counter sympathomimetics, such as phenylpropanolamine and pseudoephedrine, have been used to treat nasal congestion or facilitate weight loss (08; 29). The abuse potential and link to cerebrovascular disease associated with these drugs has been recognized since the 1980s (74; 08). Phenylpropanolamine was voluntarily withdrawn from the market in 2000 after the FDA reviewed a number of reports of hemorrhagic stroke associated with its therapeutic use (42). Amphetamines and methylphenidate are increasingly used to treat hyperactivity and attention deficit disorder in children and adults.

Cocaine is derived from the leaves of the shrub , which grows in the Peruvian and Bolivian Andes. For many centuries, the leaves of this plant were chewed or sucked by inhabitants to decrease hunger, increase endurance, and generate a sense of well-being. Addiction was not described until more concentrated forms of cocaine became available. Alkaloidal cocaine was first purified in 1860 by Niemann. Sigmund Freud and Hans Koller explored the physiological actions of cocaine. Freud first successfully employed the euphoriant effects of cocaine to wean a patient addicted to morphine. The unforeseen result was to create the first person addicted to cocaine (29).

Phencyclidine was popular in the 1980s as a stimulant that heightened sensory perception. Strokes were reported in several users (04; 08). The risk of psychosis and violent behavior with higher doses or chronic use decreased its popularity.

Opium is derived from the unripe seed capsules of the poppy plant, . Opium addiction is recorded as early as the third century BC, and during the early part of the 20th century it was estimated that 1 out of every 400 Americans was addicted to opium or related agents. Heroin (diacetylmorphine) is a semisynthetic derivative of morphine, which is 1 of the substances contained in opium. Heroin abuse did not develop until the advent of hypodermic needles (29). Although it is frequently injected intravenously, increases in purity have allowed for intranasal use. The increase of prescribing opioid medications has contributed to increased abuse of both prescription opioids and heroin.

Cannabis, from the plant , is the most widely used recreational drug in the world. It is most often prepared as marijuana or hashish, which are subsequently smoked, inhaled, or ingested. Cannabis has been legalized in a number of states in the U.S. and in Canada. The psychoactive ingredient in cannabis is delta-9-tetrahydrocannabinol (THC). Potency can vary widely across preparations based on the THC content, which is generally higher in hashish than in marijuana (80). Synthetic drugs that bind to the same cannabinoid receptors as THC have been developed. These drugs are sold as synthetic cannabis under brand names such as spice or K2. Similar to synthetic amphetamines, synthetic cannabis can be purchased online or in drug paraphernalia stores (09).


— Update: 17-02-2023 — cohaitungchi.com found an additional article Can Drugs Cause a Stroke to Occur? from the website www.newdirectionsforwomen.org for the keyword impact of drug use on stroke.

Impact of drug use on stroke It’s been a stressful week at work, and you binge drink to ward off the restlessness…alone. Something is off. Drug-induced stroke symptoms leave your face slumped and you’ve lost the ability to speak. Experiencing a stroke can leave you in a devastating state. 

If you have a stroke, you must receive immediate care. These factors can influence the likelihood of stroke:

  • Your age
  • Your ethnicity
  • Your sex
  • Smoking/alcohol
  • Lack of exercise


According to the Centers for Disease Control and Prevention, stroke kills nearly 150,000 of the 860,000 Americans who die of cardiovascular disease each year — that’s 1 in every 19 deaths from all causes. A disturbing fact about strokes is that about 80% of strokes are preventable. Strokes can affect anyone at any age. Experiencing one stroke increases the risk of experiencing another one.

What Is A Stroke?

A stroke can be characterized as a disease that affects the arteries leading into the brain. In fact, strokes are the No. 5 leading cause of death and the leading cause of disability in the United States. A stroke can occur when a blood vessel carrying oxygen and nutrients into the brain either ruptures or is blocked by a clot. When oxygen doesn’t reach the brain, that’s when cells begin to die. 

There are two types of strokes:

  • Ischemic stroke – clot obstructing the flow of blood to the brain
  • Hemorrhagic stroke – when a blood vessel ruptures and prevents blood flow to the brain
  • Transient ischemic stroke – caused by a temporary clot
  • Cryptogenic stroke – where the cause of stroke can’t be determined
  • Brain-stem stroke – can affect both sides of the brain, leaving the person in a locked-in state


A silent stroke can be described as an undetected stroke. This happens when a blood vessel blockage in the brain causes cells to die, but no warning signs or symptoms are obvious. Experts estimate that 10 silent strokes occur for every stroke with detectable symptoms.

If you’ve experienced a stroke, there are five main types of disabilities that your stroke can cause:

  • Paralysis or problems controlling movements, such as balance or swallowing
  • Sensory (ability to feel touch, pain, temperature, or position) disturbances
  • Difficulty using or understanding language
  • Issues with thinking and memory 
  • Emotional disturbances

Read more  A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse

How Are Strokes Diagnosed?

If you’ve suffered a stroke, medical professionals will check the following to determine the certainty:

  • Medical history
  • Physical and neurological examinations
  • Laboratory (blood) tests
  • CT or MRI scans
  • Other diagnostic tests that might be needed

How Can I Spot A Stroke?

Spotting a stroke requires a specific eye. Considering the intensity of a potential stroke, look for these signs to potentially save a loved one. The FAST method has been recognized as a tool to spot a stroke.

FAST Method
F. Face Drooping
A. Arm Weakness
S. Speech Difficulty
T. Time to Call 911

  • Numbness or weakness of the face, arm, or leg, especially on one side
  • Confusion or trouble speaking
  • Difficulty with sight
  • Difficulty with walking or loss of balance
  • Severe headache

Men and women experience similar symptoms of strokes, however, women can also experience:

  • General weakness
  • Disorientation and confusion or memory problems
  • Fatigue, nausea, or vomiting

Can Drugs Cause a Stroke?

Certain drugs and alcohol can increase your risk of having a stroke. Substance use disorders can present long-term health complications. Individuals in recovery often use substances to cover their physical, emotional, or mental pain. 

Polydrug use is a common element in substance abuse. Polydrug drug use, such as pairing a stimulant with a depressant, can introduce health issues. The central nervous system is responsible for communicating messages throughout the body.

Alcohol

Alcohol is a central nervous system depressant, meaning that it slows down the responses in the body. An alcohol use disorder can increase your chances of having a hemorrhagic stroke. High blood pressure and blood clotting can contribute to the risks of stroke. 

Alcohol can affect the processing of the liver, which affects blood clotting. The liver is responsible for producing proteins to prevent sudden bleeding. If the liver can’t produce these vital proteins, excessive bleeding can occur – most notably in the brain.

Nicotine

Tobacco can increase the risk of developing heart disease. It can also affect your blood pressure by increasing it. High blood pressure can lead to a hemorrhagic stroke, especially in older adults who are at an increased risk. Plus, both smoking and secondhand smoke can contribute to chronic lung issues that can cause pulmonary hypertension or high blood pressure in the lungs which can also raise the risks of having a stroke.

Cocaine

Cocaine is a central nervous system stimulant. Cocaine can cause a sudden stroke during or shortly after use. If you’ve used cocaine for the long term, your chances of developing cerebrovascular disease increase. This is dangerous for those who would be classified as young and healthy. 

Cocaine can drastically increase blood pressure and cause bleeding in the brain. Cocaine can cause a narrowing or spasm of blood vessels. Cocaine through injections can increase the risk of infections of the heart valves.

Heroin

Heroin is an opiate that acts as a central nervous system depressant. Intravenous heroin can increase the risk of endocarditis, which is a bacterial infection of the heart. The bacteria can leave the heart and travel to the brain, initiating a stroke. 

Additionally, a heroin overdose can cause you to have shallow breathing, preventing necessary oxygen from reaching the brain. If you’ve experienced low oxygen for an extended period of time, you can suffer from irreparable oxygen deprivation to the brain. 

Amphetamines

Amphetamines are a stimulant with a volatile response in the body. Amphetamines, such as methamphetamine, can cause a sudden spike in high blood pressure. Long-term use of methamphetamine increases stroke risk by causing abnormal functioning in the blood vessels of the brain while harming the rest of the body. 

Short-term use of methamphetamine could result in a sudden stroke during or after use, largely as a result of sudden changes in blood pressure and heart function induced by methamphetamine in the body.

What Are Treatment Options for Addiction to Prevent a Stroke?

Stroke caused by drugs can present a slew of bills and treatment for the challenges. The continuum of care is crafted to help those in recovery through various stages. Implementing a mixture of medications and behavioral therapies has been the staple for evidence-based care. 

There is no single cure for substance abuse, but a variety of solutions to suit your needs. Recovery is a life-long marathon. You’ll need to embrace your inner strength, met with a wonderful support system to get you to your goals. The type of care you receive is determined by the severity of your substance use disorder.There are many different types of rehab facilities, so it is important to find the one that best suits your needs. 

Counseling can support you throughout all stages of recovery. There are many different therapies to choose from based on your needs, likes, and dislikes. It can be used in conjunction with prescription medication or can be the only treatment used in moderation-based therapy programs. 

Detox

Detox for drug and alcohol addiction can cause a number of symptoms, including cravings and withdrawals. You can start your recovery process with an overnight stay or you can check into a detox center for treatment. A medically supervised program can help ease your symptoms and can boost your chances of success.

Prescription medications can be beneficial for treating specific addictions such as opioids, tobacco, alcohol, cocaine, and others. Using these treatments along with other types of counseling can improve your chance of success in recovery. For some individuals whose abuse is out of control and who experience withdrawal symptoms, detoxing alone may not be enough.

Residential Treatment

Inpatient care can be helpful to those who have been abusing substances for many years. Inpatient rehab centers employ evidence-based therapies that can help you quit drugs. Some common therapies include cognitive behavioral therapy, group and individual counseling, 12-Step programs, relapse prevention training, and extended care options such as sober living facilities. Withdrawal management is also part of the inpatient treatment program at some addiction clinics while others can handle it on a case-by-case basis. 

Partial Hospitalization Program

PHP can help those who have been abusing substances for some time, but do not need inpatient care. Partial hospitalization programs are recognized as “day programs”. Partial hospitalization programs offer a comprehensive and structured day treatment program that includes medication management, individual therapy, counseling groups and family therapy. 

Outpatient Treatment 

Outpatient treatment can be beneficial for those who have less severe addictions, who can’t take time away from work or family responsibilities or who live far from an inpatient facility. Outpatient treatment can include individual and group counseling, therapy, relapse prevention training and 12-Step programs. 

Drugs can cause a stroke to occur by damaging blood vessels in the brain or by increasing the risk of a blood clot. Some of the most common drugs that can lead to a stroke are cocaine, amphetamines and methamphetamine.

There are also certain prescription medications that can increase the risk of stroke, such as birth control pills, blood pressure medications and pain relievers such as ibuprofen and naproxen.

IOP can be beneficial to those who are unable to take time away from work or family responsibilities to attend an inpatient or PHP program. IOP can be beneficial to those who are unable to take time away from work or family. 

IOP offers group and individual counseling, relapse prevention education and 12-Step program participation three days a week for three hours each day. Drugs can cause a stroke to occur by affecting the blood flow in the brain.

Dual Diagnosis Treatment

Dual diagnosis treatment is important for those who are struggling with both a mental health disorder and addiction. Many people do not realize that drug addiction is a mental health disorder. The National Institute on Drug Abuse (NIDA) reports that addiction is a brain disease that causes compulsive drug seeking and use, despite harmful consequences.

Read more  Predicting Aspiration in Patients With Ischemic Stroke*

Some of the most common drugs that can cause a stroke are cocaine, methamphetamine and alcohol. These drugs can cause blood vessels in the brain to shrink or burst. There are also certain prescription medications that can increase the risk of stroke, such as birth control pills, blood pressure medications and pain relievers such as ibuprofen and naproxen.

Aftercare

When a person suffers a stroke, it is important that they receive appropriate medical care. This may include rehabilitative therapy to help them regain lost function or speech therapy to help them communicate.

It is also important for the person to receive support from family and friends. Stroke can be a devastating event, and the person may need help adjusting to their new life. The best way to prevent a drug-induced stroke is to avoid using drugs altogether. If you are seeking guidance after treatment, you can contact a rehabilitation center.

Support groups can be a welcoming place for people affected by stroke. The Stroke Association is a charity that can provide support to both the person who has had a stroke and their loved ones. A drug-induced stroke can be caused by many different types of drugs, including prescription medications, over-the-counter medications, and illegal drugs.

A relapse prevention plan can help you stay on track with your sobriety. If you are struggling with substance abuse, seek professional help right away. Drug-induced strokes can have a significant impact on the person’s life and can result in long-term disability and the person may need help adjusting to their new life.

New Directions Aims To Educate Those In Recovery

Substance abuse trends have been on the rise. This requires an equal effort to combat the disease of addiction. Treatment options are available to recovering individuals in California. New Directions for Women encourage a path for recovery. Your determination met with our resources can craft a new beginning for your health. Drug-induced stroke symptoms can be frightening to witness. If you or a loved one are struggling with addiction, reach out to us today.

References:

https://www.stroke.org/en/about-stroke
https://www.cdc.gov/stroke/types_of_stroke.htm
https://www.cdc.gov/stroke/facts_stroke.htm
https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/rehabilitation-for-stroke


— Update: 18-02-2023 — cohaitungchi.com found an additional article A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse from the website www.mdpi.com for the keyword impact of drug use on stroke.

1. Introduction

1.1. Stroke Definitions

According to the World Health Organization, a stroke is defined as ‘a clinical syndrome consisting of rapidly developing clinical signs of focal (or global in case of coma) disturbance of cerebral function lasting more than 24 h or leading to death with no apparent cause other than a vascular origin’. On the other hand, a transient ischemic attack (TIA) presents the signs and symptoms of a stroke, but without tissue damage and the symptoms usually resolve within 24 h [1,2]. A stroke can be defined as a rupture or blockage of an artery of the brain, which results in bleeding into the brain parenchyma or in decreased blood supply and ischemic damage to specific brain areas respectively [3].

1.2. Epidemiology of Illicit Drugs of Abuse Use and Stroke

The use of psychoactive substances has been known for thousands of years: From the ingestion of plant derivatives, such as the mushroom Psilocybe hispanica used in religious rituals performed 6000 years ago, to the abuse of synthetic drugs, such as heroin that was first synthesized in 1874 by C. R. Alder Wright, an English chemist working at St. Mary’s Hospital Medical School in London. Nowadays, substance abuse constitutes a major social and medical problem. According to the World Drug Report 2017, issued by the United Nations Office on Drugs and Crime, the number of estimated drug users worldwide has increased by 23% in 11 years, reaching 255 million individuals in 2015. At the same time, drug users with various health disorders, such as lung or heart disease, mental health diseases, infectious diseases, stroke and cancer, reached 29.5 million in 2015, with an increase of 13.5% compared to 2006. The number of deaths attributed to drug abuse has also significantly increased. Out of the total registered deaths due to drug abuse, 67.5% are attributed to amphetamine use, 49.7% to cocaine, 29.6% to opioids and the remaining 23% to other drugs [4].Stroke is the second leading cause of death in the world, responsible for 5.7 million deaths every year, which is expected to reach approximately 7.8 million by 2030 [5,6,7,8]. Moreover, stroke is the leading cause of major disability. A timely diagnosis by computed tomography (CT) and, depending on the circumstances, by CT angiography and CT perfusion is necessary to assure effective management [3,7].

1.3. Classic Concept of Stroke Pathophysiology

A stroke occurs when blood circulation of the brain is disturbed. There are two types of strokes: Ischemic stroke/transient ischemic attack (TIA) and hemorrhagic stroke. Brain tissue destruction is caused by different mechanisms with multifactorial character in the two types of strokes.Ischemic stroke represents the loss of brain function caused by a decreased blood flow and consequently reduced oxygen supply to the affected brain tissue [9].The knowledge of the latest physiopathological mechanisms in ischemic stroke is important for the development of new pharmacotherapies. Recent experimental studies in mice with transient middle cerebral artery occlusion (tMCAO) have shown the involvement of the Von Willebrandt factor (vWF) which interacts with and binds to the GPI platelet glycoprotein and the collagen receptor GP VI [10]. This vWF–GPIb axis combined with activated coagulation factor XII triggers the thrombo-inflammatory cascade in acute ischemic stroke [10,11]. In this thrombo-inflammatory process, platelets interact with T cells, which aggravate ischemia-reperfusion injury after recanalization [10,11]. However, targeting stroke-related neuroinflammation with anti-inflammatory drugs may be used with caution in order to detect any potential adverse effects to be avoided [11].Numerous other pathophysiological studies performed on patients with ischemic stroke demonstrated hemostatic abnormalities such as low serum levels of coagulation factor VII, FVII-activated antithrombin complex, tissue factor and increased serum levels of tissue factor-bearing microparticles (MPs-TF) [12,13].In hemorrhagic stroke the neuronal injury is supplemented by the compressive effect exerted by the hematoma, the systemic inflammatory response, the neuronal toxicity of the hemoglobin and the effect thrombolysis inside the intracerebral thrombus [14,15].A key role in controlling stroke mortality lies in controlling the so-called modifiable stroke risk factors [3]. There are several risk factors for stroke including age, gender, hypertension, diabetes mellitus, dyslipidemia, atheromatosis, thrombophilia, atrial fibrillation, sick sinus syndrome, patent foramen ovale or family history of cardiovascular events, hyperhomocysteinemia as well as lifestyle habits, such as low physical activity, obesity, tobacco smoking, poor diet, and alcohol consumption [3,5,6,8,16,17,18]. Controlling blood pressure and blood glucose levels, using statins for elevated blood lipid levels and reducing the use of oral contraceptives, along with lifestyle changes, can drastically reduce the risk for stroke [5].Drugs of abuse are also associated with stroke, especially in younger individuals. It has been shown that drug users, between 15 and 44 years old, were 6.5 times more likely to have a stroke compared with non-users [19]. The major classes of drugs linked to stroke are cocaine, amphetamines, heroin, morphine, cannabis, and the new synthetic cannabinoids, along with androgenic anabolic steroids, which are widely used both by professional and recreational athletes but also by the general public.This article aims to review epidemiological evidence related to drug abuse-associated stroke and elucidate the possible underlying mechanisms of stroke induced by different classes of drugs of abuse.

References

Recommended For You

About the Author: Tung Chi