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Increase in Cardiac Events Due To Opioid Use

Medically reviewed by Nassir Azimi, MD, Susan Kerrigan, MD and Marianne Madsen on January 16, 2023

Although deaths and hospitalizations from COVID-19 get most of the attention nowadays, millions of people who never got the virus have also suffered. During 2020’s lockdowns, for example, both opioid abusers and those in recovery faced enormous challenges. Many were isolated. Most were unable to access traditional in-person treatments. In response, some relapsed. Others increased their abuse. Meanwhile, counterfeit opioids laced with deadly fentanyl flooded the market.


The sad results were demonstrated by a report from the Centers for Disease Control and Prevention’s National Center for Health Statistics in July of 2021. It showed that drug overdoses had increased by nearly one-third –– a record-setting pace that left over 93,000 dead. Most were opioid-related; many were linked to fentanyl. Besides the risk of overdose, opioid users with cardiovascular issues also face a higher heart attack risk. If you or a loved one are taking opioids, what should you know about this?


Fentanyl Risks 


Today, most illegal fentanyl comes from China –– although a growing percentage has come from Mexico as well. Some have called it China’s most dangerous import.” While it was developed in the United States for pain management, its rock bottom price has made it a favorite of street-level drug dealers who aren’t interested in repeat business. That’s because as fentanyl has been added to cocaine and meth along with opioids, it has increased the number of fatal drug overdoses. Although increased production in Columbia was also cited, fentanyl was the main reason there were 2½ times more cocaine-related deaths in 2018 than in 2014.


The practice of cutting opioids with fentanyl has become so widespread that they were even implicated in the death of music legend Prince. Facing chronic pain following decades of high-energy live shows, the singer took Vicodin. Unfortunately, someone who worked for him purchased it illegally and the counterfeit Vicodin led to the fatal overdose. 


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Opioid Addiction

Opioid Addiction

Heart Attack Risk 


For people with cardiovascular issues, even legal opiates can be dangerous. For one thing, when morphine is administered via an IV, it can reduce the effectiveness of medications designed to prevent clotting. Opioids can affect low-density lipoproteins and free triglycerides. High levels of lipoproteins and the metabolites of dietary fats in the body are associated with greater risks of atherosclerosis, stroke, and heart attacks. One study showed that patients who abused opioids and needed coronary artery bypass surgeries had low-density lipoprotein and triglyceride concentrations that were much higher than non substance abusers. Due to the factors mentioned above, researchers concluded that there was a direct correlation between opioid abuse and worsening lipid profile, hypercholesterolemia, and coronary artery disease. When needles are shared (a common practice for many who use heroin), it can lead to a serious infection of the heart’s valves. 


However, the most dramatic consequence of opioid use or abuse are cardiac arrests. These events often occur with younger people and, unlike other heart attacks, oxygen deficiency occurs while the heart is still beating. This means brain damage can happen very quickly. Unfortunately, many opioid addicts are alone when this happens. However, if you witness someone having an opioid-induced heart attack, it’s important to know its specific signs. The person is more likely to be unconscious and may not have a history of cardiovascular problems. Administering CPR can help, although giving the victim naloxone, which can reverse respiratory depression, is ideal. 


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Opioid Crisis

Opioid Crisis

Risk of Other Heart Issues 


Not only are opioids a factor in acute heart issues such as a heart attack, the evidence is growing that use of opioids may increase the risk of chronic heart conditions. A review study published in the Journal of the American Heart Association pulled together several studies related to nonacute opioid use (NOU) and cardiovascular outcomes. 


Though more research is needed in this area, this systematic review showed that using opioids not only increases the risk of heart attacks and cardiopulmonary arrests, but also increases the risk for cardiac disorders associated with infections, such as infective endocarditis, often brought on by reusing needles. NOU also increases the risk of chronic cardiovascular issues such as arrhythmias.




Increasingly, doctors are recommending that patients with heart issues avoid opioids and NSAIDS and take acetaminophen or aspirin. The risks from opioids are just too great.


Written by John Bankston

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