By Terry Gotham
Since we’re not getting any younger, cardiovascular issues will continue affect the Burner population in increasing numbers. Considering Burners also party like rockstars, in one of the harshest climates on earth, I wanted to take this time to go over some of the research associated with drugs & your heart. As a disclaimer, once again, many popular recreational drugs are specifically contra-indicated for people with anywhere from mild to major heart issues, but if you listened to your doctor, you probably wouldn’t be going to Burning Man with your minor CV distresses. As 30% of this country has High Blood pressure, and quadruple & quintuple bypass are now commonplace, these issues aren’t esoteric, so let’s meet them head on.
While the standard “drugs increase heart rate & blood pressure” trope is trotted out every summer, that’s not entirely the case, depending on the drugs that you choose to do. This journal article from the American Journal of Medicine documents a number of ways that drugs can drive hypertension or blood pressure. Some recreational drugs can even interfere with anti-hypertensive prescriptions. This finding emphasizes the need to not only understand the effects of the recreational drugs that you’re planning on taking on playa, but to also do your research to confirm that any prescription medications you’re taking don’t interact with your fun drugs. The connection between alcohol & heart disease, cardiomyopathy, heart disease & hypertension is extensive and a discussion of that is beyond the scope of this article, so please check the American Heart Association & Medscape resources on the matter.
The effects of MDMA on the heart & heart tissue haven’t been studied super extensively, but this article from the NMR Biomed journal documented a couple of anxiety inducing physical effects on the rat heart. Obviously, it’s difficult to extrapolate out what the effects are on humans from an animal model. However, a study from 2003 in Molecular Pharmacology did show that MDMA can have effects on the heart similar to FenPhen (remember FenPhen?!). This can include valvular disease and pulmonary hypertension. Again, this wasn’t a finding for most patients, but a small group of them, but it’s important to present all the evidence to let you decide.
Cocaine is much more dangerous to your heart than MDMA, and that’s not something the jury is still out on. In doing research for this piece, I happened to connect with a friend who is a heart surgeon, who had just dealt with a cocaine related emergency surgery a week or so ago. The patient had done so much cocaine they gave themselves an Aortic Dissection. For everyone who didn’t go to medical school and doesn’t know what that means, the dude did so much blow he managed to tear a rip in his aorta. For more, albeit totally gross details of this life-threatening cardiac event, here’s a quick round up from the Mayo Clinic.
If you’re lucky enough to not be so coked out your cardiovascular system starts a fight with itself, cocaine can still do damage to your heart over time. Dr. Varun Kumar confirms that cocaine forces an abnormal level of blood flow through the heart’s smallest blood vessels, as they’ve been dilated by the drug. This explains why, even if you don’t have any outward signs of cardiovascular trauma, if your vessels stiffen because of the cocaine, or clot because of cocaine itself (theory not confirmed by evidence yet), that can contribute to heart damage. This was corroborated by a study carried out in the Australian hospital system. While the sample size was small (only 20 people) the imaging done on even casual cocaine users showed poorer ventricular function and greater systolic BP. If you’ve had a heart attack, your doctor’s probably informed you those are risk factors for cardiovascular events. If you haven’t and you put things up your nose, start taking notes.
To be clear, while there are lots of drugs that cause cardiovascular events, cocaine is a huge part of that conversation. Cocaine is responsible for 31% of emergency room visits, as documented by this massive review published in the journal Circulation, by the American Heart Association. With 1.6 million in this country meeting the criteria for cocaine dependence, it’s much more likely you’re going to run into someone pushing a rolled up dollar past a salt & pepper goatee than an older gentleman asking for NBOMe on playa.
This doesn’t mean psychedelics & other drugs are totally safe. Here’s a report of someone from Poland on mushrooms who had a myocardial infarction & arrythmia after presenting at the ER with Psilocybe intoxication.We’ve all seen people who pushed the psychedelic envelope a little too far and had a pounding heart, tension & severe anxiety. In these cases, one of the simplest ways to ease stress on the heart is to ease the mind. The Zendo Project & Green Dot rangers on playa is the best resource to connect individuals having spiritual emergencies with. They can not only handle the psychedelic issues, but in the worst cases connect with physical health emergency workers who can take it from there.
Don’t forget, just because you’re not taking illegal drugs, doesn’t mean the stuff you’re consuming is 100% safe. Even pre/post-workout supplements have resulted in ER visits. For anyone who still thinks that’s an urban legend, here’s a case of a 25 year old with no prior health issues or cardiovascular diagnoses that was brought to the ER with palpitations & atrial fibrillation (common form of irregular heartbeat). All you guys looking to get swole before you hit the playa this august? Be careful and don’t just go nuts with the workout powder without doing your research.
Lastly, inhalants & cannabis. Cannabis doesn’t seem like something that would interact with your cardiovascular system badly, but that’s not 100% correct. This report to cardiologists from 2000 in Heart, notes that if you have ischemic heart disease, pot can increase the frequency of angina-like symptoms when engaged in low-level exercise. This goes without saying, but definitely clear exercise & drug use with your doctor if you have a heart condition. If you do inhalants, firstly, I’m sorry your life is that awful. But more importantly, over the long term, inhalant usage can lead to cardiomyopathy, so you may want to eventually get some help for that sniffing habit you keep from everyone else.
Obviously, on playa, all of these risks are amplified, and complicated with the need for water & the rigor of trekking around in the 95 degree weather and arid landscape. Unless you’re one of those lunatics that run the Burning Man 5K on 1 hour of sleep because you regularly book 6-10 miles around Brooklyn or the Bay, make sure you confirm how your heart will handle both drug use & drug use on the playa. It’s a lot more than just pissing clear for some of us.
Stay safe & out of the ER. Doctors can kill the vibe.