How do Opioids affect the Heart?

Learn about how opioid use disorder affects the heart and cardiovascular health  

Many harmful effects of opioids have become evident through the everlasting opioid crisis. However, the public and medical fields have limited awareness of certain risks. Some of these factors include the way opioids can impact cardiovascular health in patients or people who take opioid medication long-term for chronic pain. 

How Opioid Use Affects the Heart

Thankfully, with proper screening and prevention steps, those with opioid use disorder can still benefit from medication-assisted treatment if they’ve experienced heart health concerns.  

Conditions that affect the heart most associated with opioid use include: 

Atrial fibrillation and opioids is a condition that causes rapid and irregular heartbeat. A disrupted and fractioned electrical signal in the atria causes this condition, commonly known as the upper cardiac chambers of the heart. People who use opioids more frequently exhibit this condition, which can increase the risk of stroke and potentially heart attacks.

Bradycardia in opioid users is commonly seen in those with a slower heart rate. This is caused by a slowing of the sinus node. It has also been observed in individuals with sick sinus syndrome. Bradycardia caused by opioids doesn’t often present itself while the patient is at rest, but it leads to poor cardio endurance, making exercise and physical activity difficult. 

Opioids and cardiovascular death or a fatal heart-related medical event unrelated to overdose is not uncommon among opioid users. Patients are more likely to suffer from undiagnosed heart conditions or events such as heart arrhythmias and heart attacks, causing sudden death. Many experts link this to chronic opioid use and its depressive effect on breathing, leading to sleep disorders such as sleep apnea, which significantly strains the heart. 

Opioids and heart failure can erode vital cardiovascular mechanisms. Opioids, when used alone, don’t do much to prevent the heart muscle from contracting to pump blood, but when mixed with other substances, such as benzodiazepines, it can lead to eventual heart failure.  

Infective endocarditis risk is a life-threatening infection that affects the heart’s structures, including valves that control blood flow. While this condition was previously not common and more often found in elderly patients with heart valve disease, it’s emerging among young people who use opioids like heroin and fentanyl intravenously. This illness carries a high mortality rate, and survivors are left with life-long cardiac disease. 

Cardiac arrhythmia is a disruption to the heart’s natural pumping rhythm, which is also sometimes called palpitations. An irregular heartbeat can sometimes feel like the heart is beating too hard, too fast, or skipping a beat. Arrhythmia can lead to stroke, heart failure and sometimes death.  

Vasodilation and opioid-induced hypotension is a condition that causes the dilation of blood vessels caused by opioid use. This can lead to hypotension (low blood pressure), causing people to feel faint when standing up quickly. It can also cause orthostatic hypotension, leading to severe lightheadedness when upright or syncope or frequent fainting. 

MAT Drugs Heart Conditions 

Regular opioid use is likely to exacerbate symptoms for individuals with pre-existing, especially undetected, heart issues. Those with low blood pressure will notice that the effects of opioids exacerbate this condition, sometimes causing dizziness, fainting and lethargy. 

With intravenous use of illicit opioids, the risk of infectious endocarditis is dramatically high. If not treated correctly, individuals with heart problems who contract the virus are likely to experience permanent organ damage.

Medication-assisted Treatment and Heart Health 

MAT drugs are life-saving for those with opioid use disorder, but they are still classified as opioids. Those with heart problems seeking treatment for OUD are often concerned that these medications could potentially worsen their conditions. Fortunately, drugs like Suboxone do not list heart problems among their side effects. 

Specialized medical professionals monitor patients taking MAT drugs and conduct routine check-ups to screen for any changes in heart function. Along with improved overall health through treatment and less exposure to intravenous illicit opioid use, patients are unlikely to experience any new heart-related diagnosis.  

Those who have experienced heart-related issues and infections can still enroll in MAT. Heart conditions can be treated alongside opioid use disorder. The use of a controlled opioid maintenance medication will always be safer than the alternative, which is no treatment at all.  

Heart Disease Risk Factors and Prevention 

Everyone should work towards improving their heart health, especially those with a history of substance misuse. Apart from medical intervention, individuals can take small daily steps to decrease the risk of future heart disease. 

Avoiding tobacco use and smoking 
30-60 minutes of exercise daily 
Limiting and avoiding alcohol 
Eating a heart-healthy diet  
Maintaining a healthy weight 
Taking multi-vitamins 
Quality sleep and sleep hygiene 
Stress management 
Regular screening of heart function  
Keeping cholesterol in check 
Regulating and monitoring blood pressure 

Some factors can increase the risk of heart disease that people can’t change, however. Being aware of these issues can help improve prevention measures. 

Family history and heart disease: People with a family history of heart disease should be particularly aware of their habits, as some diseases can be hereditary.  
Gender-specific heart risks: Men and women face different heart-related risks. While estrogen helps protect women from heart disease, the increased chances of diabetes raise the risk more than in men.  
Age-related heart disease risks: After the age of 45, the risk of heart disease in men increases. For women, this risk increases after the age of 55.  
Ethnic groups and heart disease: Certain racial and ethnic groups are at higher risk of heart disease, such as African Americans, South Asians and Hispanic Americans.  

The medical providers at Middlesex Recovery’s outpatient, office-based facilities are compassionate professionals who treat every patient as a whole. With medication-assisted treatment, each patient receives care for substance use disorder but will also receive regular health screenings to ensure the heart and rest of the body are functioning properly. Middlesex Recovery dedicates itself to providing all patients with the highest quality of care, supported by substance use counselors. Give us a call today to learn more about our treatment programs.