Cocaine-Induced Cardiovascular and Immune Dysfunction: Emerging Mechanisms.

Substance use and its associated comorbidities are a global public health crisis affecting millions of people, involving both legal and illicit substances, including cocaine, opioids, methamphetamine, fentanyl, alcohol, and marijuana. Currently, most of the research in drug abuse has been focused on the drug-mediated dysregulation of the monoaminergic and glutamatergic brain pathways because of their role in addiction, tolerance, dependence, withdrawal, and relapse. In addition, individuals using cocaine (acute and chronic) also exhibit signs of peripheral compromise, affecting the cardiovascular system, immune function, and multiple aging processes. However, the underlying mechanisms remain incompletely understood. Recently, emerging mechanisms of drug action, independent of neurotransmitter dysregulation, have been described in nonneuronal cells, helping to explain the significant burden of cardiovascular disease, immune compromise, and sudden death in the drug user population.