Stroke Risk Soars with Recreational Drug Use, Even in Young Adults: New Research Reveals

Recreational drugs—including cocaine, cannabis, and amphetamines—significantly increase the risk of stroke, even among younger users, according to a comprehensive analysis of data from over 100 million people. The findings, published in the International Journal of Stroke, provide compelling evidence that these substances are causal risk factors for stroke, not merely correlated with other lifestyle factors.

Stroke: A Growing Global Health Crisis

Stroke remains a leading cause of death and disability worldwide. While modifiable risk factors like diet and exercise play a role, emerging evidence suggests that recreational drug use is a significant, and often overlooked, contributor to stroke incidence. In England and Wales, 8.8% of adults aged 16-59 reported using drugs in the past year (2024), equating to approximately 2.9 million individuals. U.S. Data indicates that over half of those aged 12 and older have experimented with drugs like cocaine, cannabis, and opioids.

Meta-Analysis Reveals Alarming Trends

Researchers at the University of Cambridge conducted a meta-analysis, pooling data from numerous studies to provide a more robust understanding of the relationship between drug use and stroke. The analysis revealed:

• Cocaine: Associated with a 96% increase in stroke risk.
• Amphetamines: Linked to a 122% increase in stroke risk.
• Cannabis: Increased stroke risk by 37%.
• Opioids: No statistically significant link to stroke risk was found.

Increased Risk in Younger Users

When the analysis focused on individuals under 55, the risks were even more pronounced:

• Amphetamines: Nearly tripled the risk of stroke (174% increase).
• Cocaine: Increased stroke risk by 97%.
• Cannabis: Increased stroke risk by 14%.

Genetic Evidence Supports Causation

To strengthen the evidence for a causal link, researchers employed Mendelian randomization, a technique that uses genetic variations to assess the relationship between risk factors and stroke. This analysis indicated:

• Cocaine Use Disorders: Strongly associated with brain hemorrhage and cardioembolic stroke (caused by blood clots traveling from the heart to the brain).
• Cannabis Use Disorders: Associated with stroke particularly large artery stroke.
• Problematic Alcohol Use: Linked to increased risk of cardioembolic stroke and large artery stroke. Alcohol addiction increased the overall risk of stroke.

Mendelian randomization could not be used to assess the association with amphetamines due to a lack of available genetic data.

How Drugs May Trigger Strokes

The researchers propose several mechanisms by which these drugs may increase stroke risk, including:

• Sudden spikes in blood pressure
• Blood vessel spasm and constriction
• Heart rhythm problems
• Increased blood clotting (particularly with cannabis)
• Inflammation or vasculitis (especially with amphetamines)

These mechanisms are known to contribute to both ischemic strokes (caused by blood clots) and hemorrhagic strokes (caused by bleeding in the brain).

Implications for Public Health

“This is the most comprehensive analysis ever conducted on recreational drug use and stroke risk and provides compelling evidence that drugs like cocaine, amphetamines, and cannabis are causal risk factors for stroke,” said Dr. Megan Ritson from the Stroke Research Group at the University of Cambridge. “These findings give us stronger evidence to guide future research and public health strategies.”

Dr. Eric Harshfield, Alzheimer’s Society Research Fellow at the Department of Clinical Neurosciences, added, “Our analysis suggests that it is these drugs themselves that increase the risk of stroke, not just other lifestyle factors among users. Taken together, our findings emphasize the importance of public health measures to reduce substance abuse as a way of helping also reduce stroke risk.”

Source: Ritson, M., et al. (2026). Does Illicit Drug Use Increase Stroke Risk? A Systematic review, Meta-Analyses and Mendelian Randomization analysis. International Journal of Stroke. DOI: 10.1177/17474930261418926