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National study finds decline in drug use–associated heart infections but growing share involves stimulants

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National study finds decline in drug use–associated heart infections but growing share involves stimulants

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A new national study found that hospitalizations for serious heart infections associated with drug use are declining after years of increases, driven largely by a decrease in opioid-associated cases.

Published today in Clinical Infectious Diseases, the study analyzed national hospitalization data from 2016 through 2022 to identify trends in drug use–associated infective endocarditis. Researchers identified more than 118,000 hospitalizations nationwide during the seven-year period. Hospitalizations peaked at approximately 18,700 in 2020, during the COVID-19 pandemic, before declining by 18% to about 15,300 in 2022.

Infective endocarditis is a potentially life-threatening infection that occurs when bacteria or other germs enter the bloodstream and infect the inner lining or valves of the heart. The infection, which can occur when people inject drugs, can cause permanent heart damage, require lengthy hospital stays or lead to death.

"Our goal was to provide an updated national picture of these serious infections, which often affect younger adults in their 30s," said the paper's first author, Paul Christine, M.D., Ph.D., assistant professor of medicine at the University of Colorado Anschutz. "With opioid injection historically accounting for a large share of these infections, we wanted to understand whether greater availability of addiction treatments and harm reduction services, along with changes in how people use drugs, may have influenced hospitalization trends nationwide."

The researchers hypothesized several possible factors contributing to the decline. One possible explanation is expanded access to addiction treatment and harm reduction services for opioid use, such as access to sterile syringes and education about safer drug use practices, as well as greater efforts to connect people with opioid use disorder to medications that can help them enter recovery.


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