Hospitalizations For Heart Infection Related To Injection Drug Use On The Rise

By Paul Gaita 09/07/16

A new study found a major increase in the number of young white American injection drug users being hospitalized for infective endocarditis.  

Hospitalizations For Heart Infection Related To Injection Drug Use On The Rise

A new study has found that a potentially lethal heart infection is on the rise among young Americans due to injection drug use.

Infective endocarditis (IE) is an infection of the heart valves that occurs among individuals with congenital heart valve defects, but it is also common among injection drug users who use dirty syringes, introducing harmful bacteria to the bloodstream and the heart.

Researchers at Tufts Medical Center in Boston recently examined rates of IE in the United States and found that the infection is on the rise among IV drug users, due largely to skyrocketing opioid abuse.

Using data from the years 2000 to 2013 which cover 35 million inpatient hospital stays per year, the study authors found that 12% of all hospitalizations for IE was due to injection drug use-related infective endocarditis (IDU-IE).

While that percentage may seem minor, it represents a 5% increase from the number of hospitalizations for IDU-IE in 2000—an estimated growth from 3,578 cases to 8,530. Of the IDU-IE cases in 2013, the study authors found that 42% were young adults ages 15 to 34—53% of that group was female, and 80% of them were white.

According to the United Nations Office on Drugs and Crime, the number of individuals using injection drugs worldwide in 2013 was 12.19 million.

“We have observed a major increase in young people with opioid addiction cycling in and out of the healthcare system, and many end up with devastating complications of injection drug use like infective endocarditis,” said the study’s first author, Dr. Alysse Wurcel, an infectious diseases physician and assistant professor at Tufts University School of Medicine. “Our study confirms that this trend is increasing across the U.S. and represents yet another indicator of the challenges we face with the national opioid epidemic.”

The increase in cases of IDU-IE poses a significant problem for both patients and healthcare facilities. The infection can result in a host of complications, from pneumonia to infected clots in the lungs called septic emboli, both of which may require ICU care or ventilatory assistance as well as lengthy periods of antibiotic treatment. Some patients may also require surgery to replace the damaged heart valves, but these operations are often considered high-risk. Patients with IDU-IE have mortality rates between 11% and 26% while in hospital and 12% to 50% mortality rates within five years of infection.

As the study noted, most IDU-IE patients are either unemployed or underemployed and use publicly-funded medical insurance, which incurs huge financial burdens for families, healthcare facilities and insurance companies alike.

“We're seeing a shift toward youth, white youth, and women, and it's likely that we'll continue to see even higher increases,” said senior study author Dr. Thomas Stopka, assistant professor of public health and community medicine at Tufts. “We need to identify these different subgroups and better understand how they are affected by the opioid epidemic and associated complications, so that we can try to design a more comprehensive approach to prevention, intervention, and care."

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.