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The American Heart Association published a study in its official journal on September 18 which shows that the opioid epidemic has correlated to an increase in heart infections throughout the United States. The researchers arrived at that conclusion by analyzing the National Inpatient Sample Registry, a database of hospitalizations across the country. From 2002 to 2016, the number of Americans who went to the hospital for infective endocarditis who also abused drugs doubled from 8% to 16%.
This phenomenon was most severe in the Midwest, the region of the country which consists of the states of Illinois, Indiana. Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. In this region, the number of heart infections involving illegal drugs increased by about 5% every year. Additionally, the researchers determined that most of the victims of this phenomenon were white, low-income men. In comparison to infective endocarditis patients who did not abuse drugs, these patients were more likely to struggle with alcoholism and suffer from HIV and hepatitis. However, since they also tended to be younger, they were less likely to die from the infection.
According to Dr. Serge G. Harb, the lead researcher for the study, “infective endocarditis related to drug abuse is a nationwide epidemic.” Infective endocarditis is a bacterial injection of the valves or lining of the inner chambers of the heart. The infection results from bacteria entering the bloodstream through the mouth, respiratory system, stomach, skin, or urinary tract. The symptoms of infective endocarditis include chest pain, fever, chills, fatigue, nausea, and pain in the joints and muscles. Antibiotics can cure the infection, but without treatment it may cause organ damage, heart failure, and fatal strokes. About 34,000 people contract infective endocarditis every year, and about 20% of them die as a result.
Infective endocarditis most often afflicts people who already have heart disease, although drug abuse is also a major risk factor. In particular, heroin needles can carry the bacteria that causes the infection. The researchers believe that heroin and other opioids are the drugs responsible for many infective endocarditis cases.
The substantial rise in drug abuse associated with infective endocarditis further highlights the devastating effects the opioid epidemic has had in the United States, and why intensive efforts are needed to further address this serious public health issue.
The Midwest, the region where the incidence of drug-related heart infections increased most dramatically, is also one part of the country where the opioid crisis has been most devastating.
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To address this tragic problem, Dr. Harb says that treatment for opioid addiction is necessary for preventing more cases of drug-related infective endocarditis. “Appropriately treating the infection is only one part of the management plan,” he says. “Helping these patients address their addictive behaviors, providing social support, and getting them to effective rehabilitation programs are key aspects in their optimal care and to prevent relapses.”
Unfortunately, patients who survive opioid-induced heart infections may never receive treatment for their substance use disorders. Consequently, they might develop infections again. In fact, these patients are ten times more likely to develop infective endocarditis a second time compared to patients who abstain from drugs, according to the study. Therefore, the researchers recommend that infective endocarditis treatment also involve treatment for addiction, especially for demographics most at risk.
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