More than one in 10 patients admitted to cardiac intensive care have taken recreational drugs, research has found.
Researchers in France tested the urine samples of all patients admitted to cardiac intensive care in 39 French hospitals during a fortnight in April 2021. They found 11% had taken drugs such as marijuana, ecstasy and cocaine.
The study, published online in the journal Heart, found that those who had taken drugs were nearly nine times as likely to die or require emergency intervention as other heart patients while in hospital, and 12 times as likely to do so if they used more than one drug.
Taking drugs increases the risk of heart problems, such as a heart attack or abnormal heart rhythm (atrial fibrillation), because they can increase blood pressure, heart rate, temperature and consequently the heart’s need for oxygen.
An estimated 275 million people around the world took drugs in 2022, a 22% increase on the figure for 2010.
Although the study was not designed to prove a causal relationship, the authors conclude there is a “potential value” of testing urine samples of patients admitted to cardiac intensive care for drugs.
In a linked editorial, doctors from London’s St Bartholomew’s hospital and Queen Mary’s University of London agreed that knowing that a patient had used recreational drugs may shed light on the cause of their condition and inform how it could be managed.
“A positive test result would provide an opportunity for counselling about the adverse medical, psychological, and social effects of drugs, and for the implementation of interventions aimed at the cessation of drug use,” they wrote.
But in addition to cost, screening raises issues of patient confidentiality and the potential for discrimination in how targeted screening might be applied, they said. “There is a considerable way to go, however, before screening for recreational drug use can be recommended.”
Responding to the findings, Daniele Bryden, the dean of the Faculty of Intensive Care Medicine, said there was an important wider public health element in research like this, “which illustrates that misuse of alcohol and drugs are not without consequences for an individual patient’s condition and outcome, the number of people requiring admission to intensive care and wider healthcare resource use related to people’s lifestyle”.