Improving Outcomes for People With Injection Drug-related Endocarditis: Are Medications for Opioid Use Disorder Enough?

• Type of Material: Article
• Authors: Simeon D Kimmel, Boston Medical Center and Boston University School of Medicine; Carlos del Rio, Emory University
• Language: English
• Date: 2020-07-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 American Society of Addiction Medicine
• Final Published Version (URL): http://dx.doi.org/10.1097/ADM.0000000000000573
• Title of Journal or Parent Work: JOURNAL OF ADDICTION MEDICINE
• Volume: 14
• Issue: 4
• Start Page: 280
• End Page: 281
• Grant/Funding Information: Dr Kimmel reports support from National Institute on Drug Abuse (NIDA) (R25DA013582) and the National Institute of Allergy and Infectious Diseases (5T32AI052074). Dr Del Rio reports support from NIDA (1RO1DA037768-01).
• Keywords: HOSPITALIZED-PATIENTS; Life Sciences & Biomedicine; INFECTIVE ENDOCARDITIS; Science & Technology; Substance Abuse

Abstract

There is no doubt that medications for opioid use disorder (MOUD), methadone and buprenorphine, reduce mortality from fatal overdose, and improve other clinical and social outcomes (Larochelle et al., 2018; Medications for opioid use disorder save lives, 2019), however, more research is needed to know if MOUD improve outcomes among individuals with injection drug related infective endocarditis (IE), a serious complication of injection drug use. Previous studies show MOUD are rarely initiated in these cases and one study showed it did not improve survival (Rodger et al., 2018; Rosenthal et al., 2016). In this issue of the Journal of Addiction Medicine, Suzuki et al report the results of a retrospective study conducted at an academic, tertiary care hospital in Massachusetts between 2013 and 2015 that suggests initiation of MOUD in individuals with injection drug use related IE did not reduce long-term mortality or valve reinfection. Utilizing MOUD to manage withdrawal in the hospital is beneficial for patients in its own right, but these results are disappointing for those of us advocating and developing systems to integrate care for opioid use disorder (OUD) and infectious diseases (Springer et al., 2018). However, rather than diminishing enthusiasm for integrating MOUD into infectious disease care, we should interpret the study carefully and draw lessons that will drive future interventions.