Cocaine and the Heart: The Underrated Physical Dangers of Stimulant Abuse

Cocaine's psychological effects are widely known, but its impact on the heart is often dangerously underestimated. This potent stimulant places immense strain on the cardiovascular system, even in young adults with no prior history of heart disease. Cocaine use can trigger heart attacks, aortic dissection, and fatal arrhythmias. 

Let’s explore how cocaine harms the heart, the science behind its toxic effects, and why cardiac screening is essential in managing substance use disorders.

How Cocaine Affects the Cardiovascular System

Cocaine is a stimulant drug. It’s derived from the coca plant and is known for producing intense feelings of energy, alertness, and euphoria. 

People use it as a recreational drug - and it acts by blocking the reuptake of norepinephrine, dopamine, and serotonin. This leads to prolonged stimulation of the sympathetic nervous system. This “fight or flight” state results in vasoconstriction, leading to high blood pressure and reduced oxygen delivery to vital organs, especially the heart. 

Excessive stimulation also increases heart rate and myocardial oxygen demand, further stressing the cardiac system. This results in a perfect storm for cardiovascular emergencies as stated below:

Vasoconstriction and Hypertension

When blood vessels constrict, the heart must work harder to pump blood through narrowed arteries. This increases blood pressure (hypertension), a known risk factor for heart failure and coronary artery disease. Unlike gradual-onset hypertension, cocaine-induced spikes are abrupt and extreme. This sudden increase in pressure can rupture blood vessels, including the aorta, causing aortic dissection, a life-threatening emergency where the inner layer of the aorta tears.

heart-drawing-medical-terminology-of-cardiovascular-system-problems-from-using-blow-coke-yay-snow-powder-white-yayo-hypertension-and-drugs-congenital-heart-disease

Case Study: Cocaine-Induced Aortic Dissection

A 48-year-old man with recent cocaine use was presented with chest pain and back pain. Further tests revealed a Type-A aortic dissection. Despite emergency surgery, he succumbed to these complications. Diagnostic imaging confirmed an acute aortic dissection. Toxicology results were positive for recent cocaine use. Notably, he had no conventional cardiovascular risk factors. 

Cocaine and Myocardial Infarction (Heart Attack)

Cocaine can cause myocardial infarction (MI), or heart attack, by inducing coronary artery vasospasm. Unlike typical MIs caused by plaque buildup, cocaine-related MIs often occur in arteries that appear otherwise normal. The intense vasospasm restricts blood flow, depriving the heart tissue of oxygen, resulting in damage or death of cardiac muscle cells.

A study summarized by the American College of Cardiology found that 25% of patients under age 30 presenting with acute coronary syndrome admitted to recent cocaine use. Alarmingly, many had no traditional cardiovascular risk factors like diabetes, smoking, or high cholesterol.

Accelerated Atherosclerosis and Long-Term Side Effects

Chronic cocaine use contributes to the buildup of plaque in the arteries (accelerated atherosclerosis). This narrows the coronary vessels, increasing the risk of coronary artery disease and heart failure over time. Additionally, cocaine-induced oxidative stress damages the endothelium (the inner lining of blood vessels), fostering inflammation and plaque formation.

shortness-of-breath-ejection-fraction-aortic-dissection-long-term-side-effects-of-drug-abuse-addiction-treatment-facilities-in-Texas

Cocaine-Induced Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle that reduces its ability to pump blood effectively. Cocaine can cause both acute and chronic cardiomyopathy. Repeated use weakens the heart muscle, lowering the ejection fraction (the percentage of blood the heart pumps with each beat). This leads to symptoms such as shortness of breath, fatigue, and fluid retention.

Case Study: Dilated Cardiomyopathy in a Young Man with Cocaine Use

A young adult male presented with symptoms of heart failure, including extreme fatigue and shortness of breath. Cardiac imaging revealed a severely reduced ejection fraction of 25%, consistent with dilated cardiomyopathy. He had no history of hypertension, diabetes, or coronary artery disease. Further evaluation confirmed recent cocaine use. With no other identifiable cause, his condition was attributed to cocaine-induced cardiomyopathy.

Arrhythmias and Sudden Cardiac Arrest

Cocaine disrupts the heart’s electrical system, increasing the risk of arrhythmias (abnormal heart rhythms). These can range from palpitations to life-threatening ventricular fibrillation, where the heart quivers instead of pumping. In some cases, this leads to sudden cardiac arrest, which is fatal if not treated immediately.

Electrolyte imbalances and increased myocardial oxygen demand from stimulant use further exacerbate these risks. Even minor lapses in rhythm can be deadly in the presence of underlying congenital heart disease or structural heart changes.

The Risk of Mixing Cocaine and Alcohol

When cocaine and alcohol are used together, the liver metabolizes both substances simultaneously. During this process, instead of breaking each down separately, the body forms cocaethylene, a unique and toxic metabolite that remains in the bloodstream much longer than cocaine. While cocaine’s effects may wear off within an hour or two, cocaethylene can persist for several hours, exerting prolonged and intensified pressure on the cardiovascular system.

Why Is Cocaethylene So Dangerous?

cocaethylene-toxicity-risk-factors-young-adults-college-students-parties-on-campus-risks-to-heart-mental-health-mixing-blow-coke-snorting-smoking-and-alcohol

Cocaethylene is more cardiotoxic than cocaine. That means it damages the heart muscle and blood vessels more aggressively. Several studies have shown that cocaethylene toxicity increases the risk of:

It also lowers the threshold for fatal arrhythmias, especially ventricular fibrillation, a condition where the heart's electrical activity becomes disorganized and ineffective, leading to cardiac arrest if not immediately reversed.

The Need for Cardiac Screening in Addiction Treatment

The effects of cocaine can be silent until a serious event occurs. Therefore, people with substance use disorders, especially those who combine cocaine and alcohol, should undergo routine cardiac evaluation as part of their recovery process.

Recommended cardiac screenings include:

Early screening, even in those who are asymptomatic, can identify heart conditions that may be reversible with early intervention and sustained abstinence. A proactive approach, especially for those with a history of stimulant use, can make the difference between recovery and a silent tragedy.

If you need help getting off of cocaine, we can help. Our team has extensive experience in cocaine use treatment and can help you regain control of your life.

888-249-2191

TikTok and Teen Drug Use: How Viral Trends Shape Perception

TikTok has exploded in popularity among young people. But along with dance memes and comedy skits, the social media platform is rife with videos depicting drug use among teens in a surprisingly casual light. Scrolling through the “For You” page, it’s easy to find clips of teens experimenting with alcoholic beverages, misusing medicines, or showing off vaping tricks.

Viral Content as the “New Normal”

TikTok’s algorithm delivers content based on user behavior. A teen who engages with videos about cannabis or alcohol might quickly find their feed full of similar posts. Repetition desensitizes in real time. Content that once seemed shocking soon feels normal, especially when portrayed as humorous or relatable.

These videos rarely show outcomes like hangovers, arrests, or overdoses. Instead, they promote a filtered, upbeat version of reality that minimizes harm, spreading misinformation about prescription drugs, alcoholic beverages, and even illegal drugs.

school-students-spreading-misinformation-real-life-consequences-vaping-electronic-cigarette-illegal-drugs-teens-young-adults-phone-addiction-social-media

Viral Trends That Normalize Substance Use

Here are a few troubling TikTok trends that have circulated widely:

The Benadryl Challenge

One of the most dangerous trends encourages teens to take excessive amounts of Benadryl to hallucinate. In 2023, a 13-year-old boy in Ohio died after attempting this challenge. The videos that inspired him made it look like a thrill, not a medical emergency.

DIY Highs

The “Nutmeg Challenge” encouraged teens to consume large amounts of the spice for a psychedelic effect. Nutmeg in high doses is toxic, leading to confusion, heart palpitations, and lasting damage. Yet the challenge gained traction, often presented as a weird experiment rather than a serious risk.

BORGs (Blackout Rage Gallons)

Popular among college students, BORGs involve mixing vodka, water, and flavor enhancers into gallon jugs. Despite claims that these drinks are “safer” because they include electrolytes, they often contain the equivalent of 16+ shots of alcohol. One TikTok-fueled BORG party led to 28 students being hospitalized for alcohol poisoning.

Vaping Videos

Teens frequently post vaping tricks and brand endorsements, portraying vaping as trendy and harmless. The health risks, addiction potential, and legal issues are rarely mentioned.

Hashtags Like #TripTok and #SniffTok

Under these tags, users share experiences and skits related to cannabis, ketamine, or even prescription drug misuse. These videos often present drug use as funny or bonding, downplaying or ignoring risks.

How Misinformation and Peer Pressure Work Online

Many teens know about the dangers of drugs. But TikTok’s content makes those dangers feel distant. When someone scrolls through dozens of upbeat videos about drinking or smoking weed, they start to see it as normal, even expected.

The problem is what’s missing. Teens aren’t seeing detox, withdrawal, or ER visits. They’re not seeing the ramifications of full-blown addiction. This selective portrayal of reality can mislead teens into thinking drugs are safe in moderation—or even that they’re a social necessity.

Negative peer pressure plays a huge role. On TikTok, popularity is measured in views and likes. When risky behavior goes viral, it sends a signal: this is what gets attention. That kind of social validation influences behavior, especially among teens who may already feel isolated, stressed, or insecure.

For teens with existing risk factors like mental health challenges or family trauma, TikTok’s messaging can be especially harmful. A funny video about getting high may reinforce the idea that substances are a solution to deeper problems.

college-students-young people-drink-alcohol-open-communication-alcohol-and-marijuana-risk-factors-negative-peer-pressure-dangerous-trends-buying-illegal-drugs-at-school-high-risk-factors

Real-World Consequences

While not every teen who sees drug-related TikTok videos will try them, these trends have had clear offline impacts:

The content teens consume online contributes to risky decisions offline—and in some cases, tragically fatal ones. Drugs like opioids are a public health crisis

How Parents Can Respond

TikTok isn’t going away. Instead of panic, parents can focus on education, dialogue, and boundaries.

1. Talk Without Judgment

Ask your teen what they’re watching and how they feel about it. Share what you’ve seen, too. Rather than lectures, aim for conversations. The goal is open communication, not control. Tell them they can talk to you about anything, especially if they’re feeling pressured or confused about what they see online.

2. Promote Critical Thinking

Help your teen understand that not everything online is true. Discuss how videos can be staged, edited, or only show part of a story. Encourage them to ask: “What’s missing here? What might have happened after this video ended?”

3. Monitor and Support Without Spying

Keep tabs on what your teen is exposed to—without invading their privacy. If you’re not already connected on TikTok, ask to see the kinds of accounts they follow. Teens with engaged, supportive parents are less likely to try alcohol and marijuana or experiment with drugs in secret. Staying aware is critical for your family safety as well as growing public health effort to reduce digital exposure to risky behaviors.

monitor-social-media-use-without-spying-on-kids-TikTok-account-feeling-pressured-prescription-drugs-mental-health-concerns-keep-kids-out-of-trouble-get-help-before-its-too-late-More-Than-Rehab-Houston-Texas

4. Address the Underlying Why

Talk about why teens might want to use substances. Boredom, social anxiety, or emotional pain are all common motivators. If your teen is dealing with mental health challenges, make sure they know there are safer ways to cope.

5. Share Real-Life Consequences

Without fearmongering, talk about the actual risks. Mention overdose deaths tied to fake pills. Bring up the students hospitalized from BORGs. Let them know that what happens online doesn’t always stay there—and that bad decisions can carry real world costs.

6. Encourage Healthier Content

Not all of TikTok is harmful. Some creators promote sobriety, mental wellness, and honest discussions about drug recovery. Help your teen find and follow accounts that reflect positive values.

A Shared Responsibility

TikTok’s influence on young adults isn’t going away. But it doesn’t have to lead to harm. With informed parenting, open communication, and strong critical thinking, teens can learn to question what they see and resist harmful trends.

The key is staying involved. Don’t assume your teen knows better. Talk to them, ask questions, watch a video together, and unpack it. That small investment of time can prevent big problems down the road.

And if your teen is already struggling—or if you suspect substance use is becoming a problem—don’t wait to get help. The risks are too high, and the stakes are too real to go it alone.

Where to Turn for Help

If your teen is already struggling with substance use or mental health challenges, don’t wait. Reach out for help. Professional support can make all the difference in preventing a temporary mistake from becoming a long-term crisis.

More Than Rehab offers evidence-based treatment and resources tailored for teens, young adults, and families facing challenges related to substance use. Visit More Than Rehab to speak with a caring team that understands the pressures today’s youth face—and how to turn things around before it’s too late.

888-249-2191

Holidays 2021: A Guide to Avoiding Relapse Triggers

The holidays are a time when most people reunite with friends and family to celebrate. It is considered a time to drink, eat, and be merry.

Unfortunately, the holidays can also be stressful for people in recovery, and the chances of addiction relapse are relatively high. Emotional relapse may make any recovering addict turn to drugs or alcohol as a coping mechanism.

Some common holiday triggers are:

Holiday triggers can easily make anyone in recovery return to drug or alcohol abuse. Luckily, we have a few tips that go a long way in preventing relapse during the holidays. These tips will help you stay sober during the holiday season.

Wake up every morning with the decision to stay sober

Every morning, make a conscious decision to stay sober. Plan how to avoid any triggers you may encounter that day and what you’ll do if you get any cravings.

avoid-relapse-triggers-holiday-season-Houston-Texas-drug-rehabilitation-addiction-treatment-resources.

Eat healthily

Ensure you eat healthy during the holidays. Staying hungry may result in low blood sugar, which may, in turn, make you more irritable. When you are irritable, you become impulsive and may end up relapsing. Be sure to have a snack with you when on the move and snack every few hours.

Avoid high-risk situations

Evaluate every situation and decide whether they are high-risk or low risk. 

If you are in early recovery, it would be best to avoid high-risk situations. If you must, try to leave early.

It would also help to know your triggers for you to avoid them. Some of the most common triggers are anger, loneliness, fatigue, and hunger.

Make a point of taking care of yourself both physically, mentally, and emotionally. Not doing so may lead to physical relapse or mental relapse, which may in turn, lead to alcohol or drug use.

Carry your own drinks to parties

Most office and family parties have non-alcoholic beverages. However, it wouldn’t hurt to bring your own non-alcoholic beverages. If the party you’re going to will serve champagne, you can carry flavored sparkling water to sip on as other people drink their champagne. Other alternatives are juices or sparkling cider.

Carrying your drinks helps you avoid the temptation of indulging in the alcoholic drinks that are often served at holiday and Christmas parties.

Bring a sober friend along

friends-and-family-holidays-2021-addiction-relapse-prevention-triggers-how-to-avoid-drugs-alcohol-Houston-TX

If you’re lucky enough to have a friend staying sober during the holidays, keep them close. A sober friend can keep you in check. If you feel the need to drink or get high, your friend will talk you out of it. Additionally, you’re less likely to feel the pressure to indulge when both of you are drinking non-alcoholic beverages.

Have a schedule

You may notice that over the holidays, most therapists cancel their sessions during the holidays since they either want to go on vacation or be with their friends and family. When this happens, you may not have sessions as often as you are used to. 

Try making a schedule of fun things you can do in your free time to keep yourself busy.

Learn to say "no" (politely)

Sometimes, you may not be ready to share details of your recovery journey with friends or family. Therefore, you need to learn how to politely decline their offers without giving out too many details. Practice your responses in advance so that you’re ready when they question you. For instance, if someone offers you drinks, you can decline by saying that you are the designated driver.

Volunteer

Volunteering during the holidays is an excellent pastime for people in recovery. You can choose to volunteer at a local shelter, food bank, or senior living community. Other than keeping you busy, volunteering can help remind you of how lucky you are.

Don’t isolate yourself

Although avoiding holiday parties and people seems like a good idea, it isn’t necessarily. Don’t isolate yourself by staying indoors. Spending too much time in isolation may lead to a relapse.

Try to choose events you can comfortably attend and make time for your friends and family. Show up for office parties and family events, but ensure you don’t relapse.

Have a support system

As mentioned earlier, the holiday celebrations and stressors can be relapse triggers. Having a strong support system can keep you busy and accountable throughout the holiday season. Support system can be your loved ones or peers in groups like Alcoholic Anonymous or Narcotics Anonymous. 

According to the National Institute on Drug Abuse, these groups complement and extend the effects of professional treatment. If you don’t have a support group or if you have travelled to a different city or state for the holidays, check this site for organizations and support groups in your area.

When the craving kicks in, move past it

Cravings will likely kick in during the holidays. The trick is to stay strong and not give in since the urge will pass after a few minutes. Talk yourself out of it, move to a different venue, meditate, or even just take deep breaths. Do whatever you have to do to move past your cravings. You’ll realize that the more you beat your cravings, the easier it becomes in the long run.

Approximately 21 million Americans struggle with substance use disorders, and during the holidays it could be especially tempting. Due to holiday triggers, the relapse rate for people in recovery is typically much higher.

If you’re having a hard time staying sober during the holidays, know that you are not alone. It would help to reach out for extra support during this season. Try booking extra therapy sessions, going for extra meetings, or even starting a new course of therapy. This way, instead of relapsing, you’ll end the year on a sober note.

If you or anyone you know is struggling with substance abuse or experiencing a relapse, contact us for safe and secure addiction treatment. You can also call us at: 1-888-249-2191. We are open 24/7 and have several treatment programs approved by the National Institute on Drug Abuse to help you get back on your feet. Our supportive and caring staff will walk with you, every step of the way.

You can also look at resources on the American Society of Addiction Medicine website.