recreational/street drugs

[Sutro]

This came up separately, I was suprised to see that it came up separately in a dialoge between Zipper & Allodowick in the thread on pain meds & coumadin:

I was recently asked what recreational drugs are no more dangerous for a Coumadin patient than anyone else i.e. no significant risk of a dangerous drug interaction or the drug having a very nasty effect on heart or valve. (I'm in the drug & alcohol rehab business.)

Question is not whether the drug is safe in and of itself (nobody - not even folks in favor of legalization - contends that any recreational drug is entirely safe), but whether it has increased danger for a Coumadin/heart valve patient. Question relates only to physiological complications specific to coumadin/valve patients, not, for example, increased risk of pot heads double-dosing because of short-term memory losss, complications associated with mode of injestion (e.g. endocarditis from unsterile injections), or hazards that are no greater for a Coumadin/valve patient than for the general population.

I responded/speculated that...

- Alcohol in quantities sufficient for use as a recreational drug was specifically dangerous due to elevated INR

- cannabis/marijuana/hashish would likely be safe

- hallucinogens (LSD, psilosybin mushrooms, etc.) would likely be safe in moderate doses [large doses can cause increased heart rate]

- amphetamine-based hallucinogens such as Ecstacy would be dangerous due to increased heart rate & blood pressure

- stimulants like Cocaine and amphetamine would be dangerous due to increased heart rate & blood pressure

- heroin and other opiods would likely be safe

- don't have a clue whether PCP would be more dangerous to a Coumadin/valve patient than for other folks or not.

Clearly this is, and necessarily must remain, speculation based upon general pharmacological info. For example, no study will ever be conducted randomly assigning one group of Coumadin patients to use heroin and another not to. But my experience with pain killers has been that opiods/opiates do not significantly interact with Coumadin, and would think that the slowing of heart rate and decreased blood pressure from heroin wouldn't incur any heart or valve damage.

I'm assuming that drugs that greatly increase your heart rate, or increase your blood pressure, are dangerous for valve patients. Anyone know if that's true?

Anybody got relevant info, opinions, etc.?

 

[McCln]

Any kind of drug that make the heart rate race to the moon is dangerous. Street drug are dangerous, honey, no matter how the husslers make it all sound so safe and good for you. It will kill you. So stay away from street drugs. They are illegal for a reason that not all agree. Be careful.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve

 

[Sutro]

No argument that street drugs, in general, are dangerous. Although an argument can be made that dangerousness in drugs is relative - e.g. more folks die each year from the effects of alcohol and tobacco on the body than from all the street drugs combined, and we're still waiting for a single fatality from marijuana or LSD's effect on the body. Another case can be made that much of the dangerousness (especially from adulterants and unknown dosage) is the product of criminalizing them and is not inherent to the drug [can't think of any product that wouldn't be made more dangerous by turning manufacture and distribution over to the criminal element]. But...

Question was which drugs are even more dangerous for a Coumadin or valve patient than they already are for folks in general. I agree with you, seems that anything that results in a greatly increased heart rate would be dangerous. Which leads me to wonder: Any evidence that the dangers of caffeine are increased for Coumadin/valve patients?

This also got me to wondering about herbal supplements. For example, I suspect ephedra [Mormon tea] may be be harmful due to increased heart rate and blood pressure.

Also agree with you that one must be careful with street drugs. In fact, I think one must be careful with drugs in general whether they're street drugs or legal drugs and we can't rely on legal status of a drug to determine whether it's safe (e.g. cigarettes are exceptionally dangerous but legal). I'm in the drug/alcohol treatment industry, and see an awful lot of folks who have trashed their lives with drugs - especially alcohol, amphetamines, and cocaine.

 

[Guest]

Ephedra can be quite dangerous. I've seen 2 or 3 (1 wouldn't admit it but refused to look at me for the rest of the 20 minute visit after I asked) women in their 20s who had strokes from taking ephedra in Metabolife or a similar product. I think they also took a caffeine containing product for water retention around the time of their periods. The combination of ephedra and caffeine seems to be particularly risky.
Another pharmacist I know had a patient who lost several feet of intestine to an arterial clot after taking a few doses of ephedra. Another young man got a blood clot in his leg while running on a treadmill. He had taken ephedra for a "natural high" before running. Since a blood clot in the leg is usually a stagnation phenomenon the odds of this happening are tremendously against it happening.

 

[Zipper]

Good discussion!

Good discussion!

Sutro,

Thanks for starting this and encouraging this type of information to be shared. People of all ages and life styles are on coumadin, so I feel it valuable to discuss all interactions. Street drug info is not so readily available as the legal drug (alcohol, etc) interactions.

Salud,

Zipper *~*

 

[Guest]

Someone wrote to me through my website the other day and had another opinion about what I had posted there, so I obtained permission and published it.

Go to www.warfarinfo.com/marijuana.htm and the new stuff is under reader #2