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Although the crack epidemic drastically reduced U.S. fatalities related to drug use, evidence has shown that cocaine use has not disappeared [5]. Cocaine remains the leading cause of death due to misuse/abuse of drugs in the U.S. and most illicit drug-related deaths occur in adolescents and young adults with a history of cocaine use [6]. In fact, people who use cocaine are at an increased risk for acute cardiovascular events, such as myocardial infarction, and other illnesses like HIV/AIDS and depression which significantly increase mortality and morbidity [6].
Cocaine use is a risk factor for major irreversible cardiovascular effects such as myocardial infarction and heart failure, as well as hypertension, and apparent cocaine-induced myocardial infarction is now considered a self-limiting hypersensitivity reaction [7, 8]. Most cocaine-induced serious adverse cardiovascular effects occur within several hours of cocaine use, whereas cocaine use may be the immediate precipitant of myocardial infarction that is not associated with illicit drug use [9]. After myocardial infarction, blacks tend to exhibit more severe disease and have a shorter life expectancy [10]. A study of adipocytes found that macrophages play an important role in a cardiac myopathy characterized by increased secretion of pro-inflammatory cytokines and reduced production of adiponectin in cardiomyopathic ob/ob mice [11]. There is also evidence that subjects recruited from drug treatment programs may retain higher levels of cardiac biomarkers compared to subjects recruited from the general population which may contribute to the expected higher mortality in the general population of cocaine users [12].
In published literature, the presence of HIV/AIDS has not been studied as a predictor of cocaine-related mortality within a control population of chronic cocaine users with varying lengths of treatment. Given the evolution of cocaine use from freak stimulant to socially-accepted drug, it is important to note that methamphetamine use among a cocaine-dependent population is associated with a significantly increased risk of HIV infection and AIDS [13]. In addition to HIV infection, cocaine abuse is related to a number of important ill health outcomes such as stroke, suicide, pulmonary arterial disease, renal disease, depression, cognitive decline, addiction, and more [14]. d2c66b5586