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Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
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Updated: Feb 17, 2026

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Association Between Recreational Drug Use and Cardiovascular Events Post-Hospitalization in France.

Raphael Mirailles1,2,3, Clément Delmas4, Solenn Toupin1,2

  • 1Université Paris-Cité, Service de Cardiologie, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, France (R.M., S.T., J.-G.D., P.H., T.P.).

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Recreational drug use significantly elevates the risk of major adverse cardiovascular and cerebrovascular events (MACCE) in intensive cardiac care unit (ICCU) patients within one year. This highlights the critical need for targeted interventions for this high-risk population.

Keywords:
cardiovascular diseasesdrug usershumansincidenceintensive care unitsprognosisrecreational drug use

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Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • Recreational drug use is linked to in-hospital outcomes in intensive cardiac care units (ICCU).
  • Cardiovascular consequences of recreational drug use post-acute cardiac events require further investigation.

Purpose of the Study:

  • To assess the 1-year prognostic impact of recreational drug use on major adverse cardiovascular and cerebrovascular events (MACCE).
  • To evaluate the association between recreational drug use and MACCE in ICCU patients.

Main Methods:

  • Prospective, multicenter ADDICT-ICCU study involving 1392 ICCU patients.
  • Systematic urinary drug testing upon admission; 1-year follow-up for MACCE (cardiovascular death, myocardial infarction, stroke).
  • Multivariable Cox regression analysis adjusted for traditional prognostic factors.

Main Results:

  • 11.3% of patients tested positive for recreational drugs (cannabis, opioids, cocaine, etc.).
  • 1-year MACCE incidence was higher in drug users (12.7%) vs. non-users (6.0%).
  • Recreational drug use, particularly cannabis and opioids, independently predicted MACCE (HR 2.91).

Conclusions:

  • Recreational drug use substantially increases the risk of adverse cardiovascular outcomes within 1 year post-ICCU admission.
  • Targeted interventions are essential for ICCU patients with a history of recreational drug use.