What you need to know about opioids + heart health

Learn about the long-term effects of opioid use disorder (OUD) on heart health. Find answers and treatment options to put your cardiovascular health first.

Ophelia team
Opioids in various forms (fentanyl, syringe, and pills) and anatomical heart
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Arthur Robin Williams, MD

As the opioid epidemic continues and more people feel its effects, doctors are learning about the long-term effects of opioid use disorder (OUD). For a long time, many physicians were concerned with OUD’s most obvious effects: addiction, overdose, and withdrawal, all of which can be deadly in their own way.

But other serious side effects are becoming more prevalent. Many doctors are now asking questions about opioids’ effects on heart health. Can opioid use lead to heart problems? And if so, does that extend to Suboxone®, which is used to treat OUD? Can a drug overdose cause cardiovascular failure? What other heart conditions are exacerbated by the opioid epidemic? This guide seeks to answer some of these questions based on the most current scientific understanding.

What heart problems can opioid use cause?

Cardiopulmonary depression

The recreational use of opioids, like heroin and oxycodone, reduces or depresses both heart and lung function. This is what makes overdose so dangerous. At certain doses, cardiopulmonary function can quickly drop to critical levels, causing the person to stop breathing or experience heart failure. 

Atrial fibrillation

Atrial fibrillation is the medical term for a rapid and/or irregular heartbeat. This happens when the electrical impulses telling the heart how to beat are disrupted or fractionated—and it leads to a highly increased risk of stroke and heart attack. Those who frequently use opioids are much more likely to experience atrial fibrillation without warning. 


Infectious endocarditis is the result of an infection reaching the tissues of the heart, causing them to become inflamed. Historically, the condition has been uncommon except in older patients with underlying heart valve disease. However, incidences of endocarditis among opioid users have spiked in recent years. This is due to the increased risk of infection when using intravenous or injected opioids, like heroin

The onset of the COVID-19 pandemic saw reduced access to clean needles and disposal sites for used needles, and this has led to the dangerous reuse of needles for injection. Infections that are introduced intravenously can quickly spread to the heart without medical intervention, so they’re extremely concerning.

Mortality rates of those who contract an infection through intravenous drug use are on the rise, especially among younger populations. Many hospitals and clinics are unequipped to properly treat infectious endocarditis and opioid withdrawal simultaneously, meaning many patients are unable to receive proper help, even when they notice a problem and seek treatment.

Do opioids worsen pre-existing heart conditions?

Because opioids cause cardiopulmonary depression, it is also likely that they can exacerbate pre-existing heart conditions. People who had low blood pressure before using opioids may find that the drugs make it worse. This can lead to dizziness, fainting, and lethargy, making everyday tasks dangerous and putting them at risk of serious injury.

Anyone with a history of heart problems is automatically at a higher risk for serious consequences and side effects when using opioids, and the development of infectious endocarditis only makes matters more problematic. This infection can cause permanent organ damage if not properly and thoroughly treated.

Is Suboxone safe if you have heart problems?

Suboxone, a combination of buprenorphine and naloxone, is one of the most common drugs used to treat OUD. If a patient with heart problems is seeking treatment for OUD, they’ll want to know if this medication is safe for use or if it will put them at higher risk of further cardiac issues. While the drug does come with a number of expected—though minor—adverse reactions, heart problems are not among them.

When overseen by trained medical staff, Suboxone treatment is incredibly safe, and patients are unlikely to experience worsening heart conditions as a result. However, misusing Suboxone could lead to dangerous cardiopulmonary complications, so it should always be used as directed.

Additionally, patients undergoing medication-assisted treatment (MAT) with Suboxone are much less likely to misuse other opioids. This means they’ll generally be in a safer environment and less likely to use dangerous needles. These patients are also much less likely to experience fatal overdoses. Even if a patient does have a heart condition that needs to be monitored, they will be much safer while undergoing Suboxone treatment than if they let their OUD go untreated. When the option is available, treatment is always the best option for the patient’s health and safety.

Treatment that puts your needs first

Every Ophelia patient starts with a brief welcome call so we can get to know you. We’ll determine your treatment needs, including a prescription Suboxone or other buprenorphine-naloxone combination if you’re eligible, and connect you with a clinical care team for ongoing support. The goal is to make sure you’re stable throughout the course of your treatment, so you can focus on what’s most important in your life.


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