The bad cardiovascular news on a whole swathe of drugs continues.
A recent meta-analysis in the International Journal of Stroke found that recreational drugs increase the risk of stroke, with amphetamines increasing the risk by 122%, cocaine increasing the risk by 96%, and marijuana increasing the risk by 37%. The authors, based at the University of Cambridge, concluded that the results “emphasize the importance of assessing substance misuse when evaluating stroke risk and the importance of public health measures to reduce substance abuse in reducing stroke risk.”
Dr. Eric Harshfield, the study’s senior author, said that “our analysis suggests that it is these drugs themselves that increase the risk of stroke, not just other lifestyle factors among users.”
The authors posited a few explanations for why drug use often increases stroke risk. Regarding marijuana, for example, the study explained that “mechanisms suggested to link cannabis with stroke include cerebral vasoconstriction, impaired cerebral vasomotor function, and fluctuations in blood pressure.” They said that cocaine has been “reported to result in cerebral vasospasm, perhaps due to its sympathomimetic effect and an increase in circulating endothelin.” In plain English, this means that marijuana can tighten and interfere with blood vessels in the brain and that cocaine can cause spasms in these blood vessels, in turn increasing the risk of stroke.
This study builds on prior findings that have linked drug use to a range of adverse health outcomes. A 2025 systematic review in the journal Heart found that people who used marijuana had a 29% higher risk for sudden heart attacks or angina, a 20% higher risk for stroke, and twice the risk of death due to cardiovascular disease compared to non-users. A 2026 study in JAMA Health Forum found that 13–17-year-olds who used marijuana in the past year faced a 2.19x risk of developing a psychotic disorder and a 2.01x risk of developing a bipolar disorder by age 26.
Dr. Harshfield added, “taken together, our findings emphasise the importance of public health measures to reduce substance abuse as a way of helping also reduce stroke risk.” In practice, this means that policymakers in the United States should further invest in prevention, treatment, and recovery services. These interventions will help prevent non-users from initiating drug use and help current users quit, thereby averting further harm and promoting population health.
People who use marijuana or cocaine on the weekend may not know that it can increase their risk of a stroke or quickly spiral into a corresponding substance use disorder. As more Americans use and misuse drugs––with approximately 74 million using illicit drugs and 28 million having a drug use disorder in 2024––they must know that drug use is not a harmless or risk-free activity.