We read with interest the article by Nishimura et al titled “The Impact of Substance Abuse on Heart Failure Hospitalizations” and published in The American Journal of Medicine.1 In this article, the authors aimed to characterize substance abuse among patients with heart failure and to describe the prevalence of substance abuse and its outcomes. The authors demonstrated that disorders such as methamphetamine, opioid, and alcohol abuses were associated with a greater number of hospital encounters for heart failure.