CASES OF COCAINE-INDUCED strokes are on the rise as the prevalence of the drug continues to increase, the clinical lead of the Irish National Audit of Stroke has warned.
Dr Joe Harbison, a stroke doctor at St James’ Hospital Dublin and associate professor at Trinity College, told The Journal that the public is largely unaware of how much drug usage can increase the risk of a stroke.
Cocaine can cause sudden surges in blood pressure leading to a stroke in hours or even minutes, he said.
“It’s particularly a problem in younger people. Someone could come in after having a stroke on cocaine and we’ll tell them that was probably the cause and they’ll be surprised.
“The baggies don’t have a little warning on them that tell you how dangerous it is,” he continued.
Harbison said that as a yearly average he encounters around 10 cocaine-induced strokes – or ‘coke-strokes’ as some doctors call them – in his hospital alone but that the problem is spreading and becoming more common.
“This year was the most I’ve ever seen, we had four cases in just one month,” he said.
Of the 12,000 cases that entered drug treatment last year, cocaine was the most common drug involved, accounting for 34.0% of all cases according to the Health Research Board.
This was a 25% increase from 2021.
The HRB also found cocaine was the most common main drug used by new cases, accounting to 41% of drug treatment admissions.
“I’m in an inner city hospital so we probably see more coke-strokes than other hospitals. But they are probably under-reported because doctors in other parts of the country wouldn’t know how to spot one as accurately,” Harbison told The Journal.
“We see people get lifelong brain injuries as a result of the strokes cocaine is causing them. In other cases, people will recover very well.”
“But if you’re using cocaine regularly at 25, you’ll probably still be fine at 26 but at 60 or 65 maybe you’ll struggle to find your car keys.”
Harbison added that he was worried that the popularity of cocaine showed no sign of slowing down and that hospitals in other parts of the country would need to get used to dealing with coke-strokes.
In 2011, cocaine was the main chemical involved in 24 drug deaths.
By 2018, this figure had more than tripled to 78 and had reached 130 deaths in 2020.
Other drugs can also increase the risk, as well as polydrug use, when two or more drugs are consumed during the same time period.
Heroin and methamphetamine can also cause strokes, but that hasn’t occurred as frequently as those brought on by cocaine, Harbison said.
“You’re definitely increasing your risk if you’re inhaling or snorting an ill-defined amount of cocaine that’s cut with something dangerous. The cocaine you get may be cut with various dangerous things.
“You don’t know how much you’re taking and there’s an argument to legalise drugs in order to standardise them. I’d be more in favour of looking at medicalisation than legalisation but I think the war on drugs has almost certainly failed.”
Long-term alcohol use as well as smoking cigarettes are the cause of more than one-third of strokes and they can be consumed legally, he noted.
Drug prohibition has “done more damage than it has prevented”, Harbison added.
“That’s my own personal view. And it may be time for a different approach.”
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