According to the World Health Organization, stroke was the third leading cause of death and disability globally in 2021, and a quarter of adults are predicted to experience a stroke within their lifetime. The major risk factor of stroke is hypertension, and illicit drug use is known to negatively impact blood pressure. Multiple observational studies have suggested that illicit drug use is a risk factor for stroke, but these studies defined their exposure and outcome variables differently and used different study designs. In research published in January 2026 in the International Journal of Stroke, Megan Ritson and colleagues conducted a meta-analysis study of 32 studies that measured the association between illicit drug use and odds of stroke to assess the validity of these studies’ findings. Cannabis, cocaine, and amphetamine use were found to have statistically significant associations with odds of stroke (increased odds of 37%, 96%, and 2.22 times, respectively).
To observe the effects of illicit drug use and odds of stroke, this study conducted a meta-analysis using electronic databases (PubMed, Embase, Scopus, and Web of Science), covering studies from the inception of the database to May 2025. Studies were included in the meta-analysis if they were English-language publications that reported the primary outcomes (ischemic stroke, haemorrhagic stroke, unspecified stroke, or cerebrovascular events). The exposure variables were defined as confirmed use of illicit substances (cannabis, cocaine, amphetamines, or opioids), either based on self-report, clinical diagnosis, or toxicology testing. From the selection process, 32 studies met the inclusion criteria, which comprised 14 cohort studies, ten case-control studies, and eight cross-sectional studies. The meta-analysis found that cannabis use was associated with 37% elevated odds of stroke, with ischemic stroke having a particularly higher risk at 39%. Cocaine use was associated with 96% increased odds of stroke, with haemorrhagic stroke having 2.05 times higher odds. Amphetamine use was associated with 2.22 times higher odds of stroke, with haemorrhagic stroke having 2.83 times higher odds. Opioid use was found to have no significant association with the odds of developing stroke.
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This study by Ritson and colleagues provides evidence that cannabis use, cocaine use, and amphetamine use increase the risk of stroke, validating the findings of previous observational studies and emphasising the harm these drugs have on cardiovascular health. This also highlights these drug users, especially amphetamine users, as a group vulnerable to strokes, which can help inform public health interventions that help reduce illicit drug use and, in turn, reduce stroke incidence. GlobalData epidemiologists forecast that in the 16 major markets (16MM: US, France, Germany, Italy, Spain, UK, Japan, China, Australia, Brazil, Canada, India, Mexico, Russia, South Africa, and South Korea), incident cases of acute ischemic stroke in men and women aged 18 years and older will increase from 5.5 million cases in 2026 to 5.8 million cases in 2027. Additionally, GlobalData epidemiologists forecast that in the 16MM, diagnosed incident cases of subarachnoid haemorrhage, a subtype of haemorrhagic stroke, will increase from 1.7 million cases in 2026 to 1.8 million cases in 2032.
