Injection Opioid Use Increases Risk for Bacterial Heart Infections
As the opioid epidemic continues to increase in the United States, new research suggests injection opioid use may be associated with yet another concerning health complication: infective endocarditis.
This finding emerged from a population-based time series analysis of Canadian health administrative data, which was performed in light of increasing trends in infective endocarditis among injection drug users in the United States, Australia, and Sweden.
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Specifically, the researchers analyzed the risk of admissions for infective endocarditis associated with injection drug use and any changes in opioid prescription rates in each quarter from 2006 to 2015. The researchers noted that the fourth quarter of 2011 served as the intervention point, when traditional controlled-release oxycodone was removed from the market in Canada.
Results of the study indicated that the risk of admissions for infective endocarditis associated with injection drug use had increased from 2006 to 2015. Although mean admissions rose from 13.4 per quarter before the intervention to 35.1 per quarter after the intervention, the researchers observed no significant change in infective endocarditis risk at the intervention point.
However, infectious endocarditis risk had increased earlier and in conjunction with the increase in hydromorphone prescriptions. Hydromorphone accounted for 16% of all opioid prescriptions upon the start of the study and 53% by the study’s end.
“The risk of infective endocarditis related to injection drug use is increasing and is temporally associated with increasing prescriptions for hydromorphone,” the researchers concluded. “This relation warrants further exploration.”
—Christina Vogt
Reference:
Weir MA, Slater J, Jandoc R, Koivu S, Garg AX, Silverman M. The risk of infective endocarditis among people who inject drugs: a retrospective, population-based time series analysis. CMAJ. 2019;191(4):E93-E99. https://doi.org/10.1503/cmaj.180694.