heart disease patients at higher risk for stimulant drug toxicity death: study highlights importance of stigma and screening
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the study found people who had diagnosed heart failure or ischemic heart disease were about two times more likely to have a stimulant toxicity death compared to an opioid toxicity death.
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while addiction and death from opioid is a concern, new research from the bc centre for disease control british columbia reveals that people with heart disease are at greater risk of dying from stimulant drug toxicity than from opioid drug poisoning.
the findings highlight the need for clinicians to talk to patients about illicit substance use and screen those for illicit drugs who may be at risk.
the study, published in biomed central (bmc) medicine and conducted by substance use and epidemiology experts, physicians and people with lived experience of substance use, investigated bc coroners service records for 3,788 people who died from drug toxicity between january 2015 and december 2019. the aim was to better understand differences in health conditions and health service visits between people who died from stimulant toxicity, those who died from opioid toxicity and those who died from both.
“in this study, we found that about one in three people who died of drug toxicity were in contact with health professionals for chronic disease care in the month before they died,” lead author dr. heather palis said in a news release. she is a senior scientist for harm reduction and substance use services at the bc centre for disease control at the university of british columbia and assistant professor at the school of population and public health. “this suggests there is an opportunity for services and support to be offered to people at risk of overdose across the health system.”
illicit drugs like cocaine and methamphetamine (commonly known as crystal meth) are stimulants that can have a number of negative effects on your cardiovascular system, including the cardiac rhythm. overuse and chronic use of these street drugs can change the structural and electrical characteristics of the heart, leading to an abnormal heartbeat where it’s beating too slowly, too fast or irregularly. your heart may not be pumping enough blood to your body which can be fatal.
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the study found people who had diagnosed heart failure or ischemic heart disease were about two times more likely to have a stimulant toxicity death compared to an opioid toxicity death. people who died of stimulant toxicity also visited healthcare more frequently for cardiovascular disease compared to people who died of opioid toxicity.
“people using stimulants appear to have more cardiovascular disease, and healthcare providers should be screening them for such conditions,” study co-author dr. frank scheuermeyer, an emergency room physician at st. paul’s hospital and program head for emergency medicine at the centre for advancing health outcomes, said in the release.
bc centre for disease control british columbia also points out that as of september 2024, 15,602 people have died from unregulated drug poisoning in the province since the toxic drug crisis was declared a public health emergency in 2016. unregulated drug toxicity is the leading cause of death in b.c. for people aged 10 to 59.
but how can doctors determine if someone is at risk of overdose if substance use isn’t discussed?
“people who use drugs often don’t feel safe disclosing their substance use to healthcare providers,” beth haywood noted in the release. haywood is a member of a peep, a provincial peer advisory group of people with lived experience of substance use, and peer project coordinator with island health. “we need to work to destigmatize these conversations, so people can get the services they need. primary care is a place where this can start.”
having conversations about the steps people can take to reduce drug-related health risks and the harm reduction tools that are available to them can help to reduce stigma around substance use. there’s also a push from the study authors to identify more opportunities for targeted interventions to reduce drug toxicity deaths among people who use substances and who have medical comorbidities. and given the numbers of people impacted, more research into the association between chronic disease, stimulant use and the risk of death due to drug toxicity is needed.
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during the time period of the study, 60 per cent of people who died of illicit drug poisoning had both opioids and stimulants deemed relevant to their deaths, and 11 per cent had stimulants deemed relevant to their death without opioids.
“preliminary data from the bc coroners service indicate that the proportion of illicit drug poisoning deaths where a stimulant has been deemed relevant has increased in recent years,” dr. jatinder baidwan, chief coroner at bc coroners service said in the release. “in 2023, it accounted for 76 per cent of such deaths.”
learn about harm reduction efforts at the centre’s toward the heart.
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