From American Heart Association News
HealthDay reporter
TUESDAY, April 20, 2021 (American Heart Association News) – One day at his Denver Health emergency room, Dr. Eric Lavonas another tragic trifecta.
“In one nine-hour shift, I looked after someone with chest pain from cocaine, someone with an opioid overdose who stopped breathing, and someone using methamphetamine who believed they were being followed by shape-shifters,” he said. “Unfortunately this is no longer rare.”
Lavonas, who is also a professor of emergency medicine at the University of Colorado, has a front-row seat in what appears to be a pandemic surge in addictive, illegal drugs that damage the heart and threaten life.
As of late June last year, 13% of Americans reported starting or increasing substance use to deal with coronavirus-related stress or emotions. This comes from a report by the Centers for Disease Control and Prevention.
In December, the CDC reported that substance abuse and fatal overdoses increased at the start of the pandemic, presumably because lockdowns, financial stress and uncertainties about the future increased drug use. In a preliminary CDC summary released last week, nearly 90,000 overdose deaths were counted in the twelve months to September 2020, a 29% increase from the previous period. That surpassed the more than 80,000 annual deaths reported last May. According to health officials, this was the highest number ever recorded in a 12-month period.
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Although more recent statistics are not yet available, Lavonas said, “Everyone agrees that these have increased this year. People are under more stress than ever and are more socially disconnected than ever.”
Lavonas helped produce a scientific statement for the American Heart Association last month warning of an overdose of opioids – now the leading cause of death for Americans aged 25 to 64 – and encouraged non-medical people to use naloxone learn how to counteract an overdose of opioids.
Dr. Isac Thomas, a cardiologist at the University of California at San Diego Health, echoed concerns about opioid abuse but is equally alarmed by methamphetamine, a potent, highly addictive stimulant.
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“I think not enough attention is paid to how big the problem has gotten, especially in the cardiology field,” said Thomas, who led two recent studies linking methamphetamine use to heart failure. “Lots of young people cut their lives a lot.”
The three drugs Lavonas encountered during his shift punish the heart in different ways.
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Called “the perfect heart attack drug” by Australian researchers, cocaine presented its results at a conference in 2012. The study found that regular use of the illicit stimulant can stiffen arteries, increase blood pressure and damage the heart muscle – all risk factors for heart attack and Stroke.
Similarly, Thomas said, methamphetamine “has a direct toxic effect on the heart”. It causes enlarged cardiomyopathy, he said, a weakening and enlargement of the heart muscle that ultimately leads to heart failure.
“We see a lot of young men and some young women who come in with shortness of breath, lightheadedness, and fatigue,” said Thomas. “We find that their heart is badly damaged and just doesn’t pump well. It’s a pretty serious illness and they’re at a pretty high risk of death despite their young age.”
Methamphetamine can instantly cause irrational, even psychotic, behavior. “I’ve seen people using methamphetamine die as a result of traffic,” Lavonas said.
The effects of opioids on the heart are less direct, but no less dangerous.
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“Opioids have become much more deadly when the previous epidemic of prescription drug and heroin abuse was replaced with fentanyl, which is much stronger,” Lavonas said. “People die within minutes of being injected, and often they die alone.”
They die because illegally made fentanyl can be so potent, without control or proper dosage, that users fall asleep and stop breathing.
“If oxygen doesn’t get to the brain and heart, the brain and heart die,” Lavonas said. “I have great compassion for people who can’t stop using, but they are unlucky to die every time one pentanyl injection.”
Injecting medicine, Thomas warned, can lead to endocarditis, a potentially fatal infection of the heart valves.
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Both doctors said that there are no easy answers to the fight against addiction.
“We can tell patients the treatment plans, but we can only control so much in their lives,” said Thomas. “Once they are released, they often fall straight back into their addiction pattern.”
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When faced with the opioid crisis, Lavonas has a twofold message: “Get help. There are good systems of support and treatment,” he said. “But recovery is gradual. For people not ready to take this step, at least never use it alone and always have naloxone available. As long as you’re alive, there is hope.”
For those in need, the Drug Abuse and Mental Health Authority Disaster Distress Helpline is available at 800-985-5990.
The American Heart Association News is all about heart and brain health. Not all of the views expressed in this story reflect the official position of the American Heart Association. The American Heart Association, Inc. owns the copyright or all rights reserved. All rights reserved. If you have any questions or comments about this story, please send an email [email protected]
By Michael Precker
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