Which recreational drugs raise stroke risk most?

Clear differences in risk across substances

A large medical-data analysis linking hundreds of millions of records found marked differences in stroke risk associated with recreational drug use. The strongest associations were with stimulants: people recorded as using amphetamines showed the highest relative increase in stroke risk, while cocaine and cannabis were associated with smaller but still elevated risks.

Key findings

• Amphetamines were associated with roughly a doubling of stroke risk compared with non-users.
• Cocaine use was linked to a near doubling of risk as well, though slightly lower than amphetamines.
• Cannabis use showed a more modest increase in risk, substantially smaller than for stimulants but still measurable.

What this means for patients and clinicians

Clinicians should recognize that recreational drug exposure is a significant, and in some cases large, contributor to stroke risk, especially in younger adults who otherwise may lack traditional vascular risk factors. Public-health messaging and substance-use interventions that target stimulant use could have a meaningful impact on reducing preventable strokes. For researchers, the findings underscore the value of large-scale medical datasets to quantify harms and to guide prevention and screening strategies.

Gaps and uncertainties

The study design identifies associations, not definitive causation, and it can be difficult to separate effects of polysubstance use, pre-existing health conditions, and patterns of use (frequency, dose, routes). Still, the size and consistency of the signals make a compelling case that certain recreational drugs — particularly stimulants — substantially raise stroke risk.