For individuals who choose to drink alcohol, con- sumption of 2 drinks per day for men and 1 drink per day for nonpregnant women might be reason- (Class IIb; Level of Evidence B). Drug Abuse Drug addiction is often a chronic, relapsing condition asso- ciated with societal and health-related problems.706 Drugs of abuse, including khat, cocaine, amphetamines, 3,4-methyl- enedioxy-N-methylamphetamine (also known as MDMA or ecstasy), and heroin, are associated with an increased risk Use of these drugs can produce acute severe BP elevations, cerebral vasospasm, vasculitis, embolization resulting from infective endocarditis, endothelial dysfunc- tion, hemostatic and hematological abnormalities resulting in increased blood viscosity and platelet aggregation, and In a recent Middle Eastern cohort study of patients with acute coronary syndrome,717 khat chewing was preva- lent and was associated with an increased risk of stroke and death. Cathinone, the major ingredient of the khat plant, has sympathomimetic and central nervous system stimulating effects. The literature also includes case series of stroke asso- ciated with cannabis use; however, the mechanism remains In a prospective study of 48 young patients with ischemic stroke, 21% had multifocal intracranial stenosis associated with cannabis use.720 Information about stroke-related drug abuse is limited mainly to epidemiological studies of urban populations. There is an increase in the risk of both ischemic and hem- In a cross-sectional study of hospital- amphetamine abuse was associated with ICH (adjusted OR, 4.95; 95% CI, 3.24 7.55) but not with ischemic stroke; cocaine abuse was associated with ICH (OR, 2.33; 95% CI, 1.74 3.11) and ischemic stroke (OR, 2.03; 95% CI, 1.48 2.79). Amphetamine abuse was associated with a higher risk of fatal ICH (OR, 2.63; 95% CI, 1.07 6.50). 