Are an important cause of morbidity and mortality

The consumption of recreational drugs has reached epidemic proportions. Forty five million European Union citizens have used cannabis at some time, with proportionately higher use among younger people.1 The consumption of harder drugs such as cocaine and heroin is rising, with an estimated 1.5 million problem users in the European Union. Drug use is commonly associated with complications, including an increased risk of premature death. 1 2 In particular, recreational drugs have profound effects on cardiovascular function. Some studies suggest that adverse cardiac events are relatively uncommon, 1 3-5 though recent data from the United States indicate that one in four myocardial infarcts in people aged 18-45 years can be linked to cocaine use, suggesting that variation in definitions may contribute to under-reporting. 1 6

Many physicians will encounter patients with cardiovascular problems related to recreational drug misuse. In addition to the problems posed by self administration, massive overdoses may occur in individuals who attempt to smuggle illegal drugs by ingesting packets which rupture in the gastrointestinal tract; and inadvertent ingestion of recreational drugs by children has been reported. …