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hello Im Joseph Alpert and the editor-in-chief of the of Medicine and Im here today to call your attention to a very interesting article that we published in this months issue concerning patients with heart failure who also used street drugs guess what its a bad idea patients who had heart failure as a diagnosis and they used street drugs had much higher morbidity and mortality and this was all street drugs of course some are worse than others particularly the sympathomimetic slike meth and cocaine those drugs of course even can cause a myocardial infarct so you can imagine putting that on top of heart failure would be a very bad idea so again Im sure all the docs out there are telling their street drug patients is a bad idea but if they have a heart failure diagnosis its a doubly bad idea please stay in touch with us from our blog and our various social media Facebook and Twitter and so forth and look forward to talking with you next month you