Opioid injection could lead to substantial rise in bacterial heart infections

Hydromorphone may be playing a role in the increasing risk of infective endocarditis.


An investigation of individuals who infuse drugs found a critical increment in the risk of infective endocarditis, a genuine disease of the covering of the heart, potentially connected to expanding utilization of the opioid hydromorphone.

First author Dr. Matthew Weir, associate scientist at Lawson Health Research Institute said, “We observed a substantial increase in the risk of infective endocarditis among people who inject drugs, which is associated with hydromorphone’s increasing share of the prescription opioid market.”

Scientists observed at Ontario data on drug users from linked health administrative databases at ICES between April 2006 and September 2015. There were 60 529 admissions to hospital of people who inject drugs and, of these, 733 had infective endocarditis linked to injecting drugs.

Despite the fact that affirmation rates for individuals who infuse drugs were steady over the examination time frame, the danger of infective endocarditis expanded from 13.4 confirmations like clockwork (final quarter 2011) to 35.1 admissions at regular intervals in the period afterward.

Though the level of opioid prescriptions ascribed to controlled-discharge oxycodone declined quickly when it was expelled from the market by its maker in the final quarter of 2011, hydromorphone medicines expanded from 16% toward the beginning of the investigation to 53% by the end.

The analysts expected that an expansion in danger of infective endocarditis would happen when controlled-discharge oxycodone was expelled from the Canadian market; in any case, they found that the ascent started before removal.

Coauthor Dr. Michael Silverman, associate scientist at Lawson and associate professor at Schulich School of Medicine & Dentistry said, “Although our observations do not support our hypothesis that the loss of controlled-release oxycodone increased the use of hydromorphone, they do support our suspicion that hydromorphone may be playing a role in the increasing risk of infective endocarditis.”

“The increase in the risk of infective endocarditis is consistent with the findings of other studies, but the observed timing of the increase was novel.”

“Both the rise in this severe complication of injection drug use and the possible association with hydromorphone require further study.”

The findings are published in the Canadian Medical Association Journal.

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