Injecting Opioids Increases Risk of Bacterial Heart Infection

Injecting Opioids May Increase Risk of Bacterial Heart Infection

Author -  Dr. Lakshmi Venkataraman, MD
Article Reviewed by 
The Medindia Medical Review Team on January 28, 2019 at 6:07 PM
  • Intravenous injection of hydromorphone, an opioid drug may be linked to increased incidence of infective endocarditis, a potentially fatal heart infection
  • A substantial increase in the prescription of hydromorphone coinciding with the time period during which there was an increase in the rates of infective endocarditis
  • Intravenous drug use has been on the rise since 2000 in North America; further studies are needed to characterize the effects of intravenous drug use and associated serious complications such as infective endocarditis

An increasing use of hydromorphone may be associated with the rise in infective endocarditis in intravenous drug users according to a recent retrospective study in Canada.

"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," write the authors, including first author Dr. Matthew Weir, associate scientist at Lawson Health Research Institute and assistant professor at Schulich School of Medicine & Dentistry, Western University, London, Ontario.

Listen to this article

The findings of the study titled 'The risk of infective endocarditis among people who inject drugs: a retrospective, population-based time series analysis' appear in CMAJ (Canadian Medical Association Journal).

Intravenous Hydromorphone Use and Risk of Infective Endocarditis

  • The team analyzed Ontario data on drug users from administrative databases at the Institute for Clinical Evaluative Sciences (ICES) from April 2006 to September 2015
  • During this period, there were 60529 hospital admissions of intravenous drug users and among them, 733 persons were found to have infective endocarditis associated with IV drug injections
  • Despite admission rates of IV drug users remaining relatively stable over the study period, the rates of infective endocarditis rose from 13.4 admissions every three months (fourth quarter 2011) to 35.1 admissions every three months thereafter until the end of the study period
  • Interestingly, the proportion of opioid prescriptions of controlled-release oxycodone declined rapidly as it was removed from the market by its manufacturer in the fourth quarter of 2011; concurrently hydromorphone prescriptions rose from 16 percent at the start of the study to 53 percent at the end of the study period
The findings of the study suggest that the rise in infective endocarditis cases in IV drug users might be linked to increased use of the opioid hydromorphone.
  • However, the rise in infective endocarditis cases did begin to increase slightly even before controlled release oxycodone was removed from the market. The rise in infective endocarditis cases associated with IV drug use is consistent with similar studies but the noted time of increase was something unexpected
"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," says co-author Dr. Michael Silverman, associate scientist at Lawson and associate professor at Schulich School of Medicine & Dentistry.

What is Infective Endocarditis?

Infective endocarditis is a serious infection affecting the innermost layer of the heart including the heart valves. It is usually caused by bacteria and is termed bacterial endocarditis but occasionally fungal and other infections can also cause endocarditis.

The symptoms of endocarditis may be similar to other infections with symptoms of fever, chills, fatigue, nausea and vomiting, and can be easily missed. Fortunately, it is rare in persons with healthy hearts.

However, certain persons are at risk of developing infective endocarditis including persons with previously diseased hearts, congenital heart disease and IV drug use. Persons at risk especially should immediately see a doctor if they develop any of these symptoms.

It is a potentially life-threatening infection and needs prompt treatment with antibiotics and other supportive measures.

Scope of Study

The increased incidence of infective endocarditis in IV drug users and possible association with hydromorphone warrant further studies.


Increased risk of infective endocarditis in IV drug users may be associated with increased use of intravenous hydromorphone, an opioid drug and needs to be further studied and validated.

Reference :
  1. The risk of infective endocarditis among people who inject drugs: a retrospective, population-based time series analysis - (

Source: Medindia
Font : A-A+

Cite this Article   close



Recommended Readings

Latest Health In Focus

The Eggstraordinary Superfood: Health Secrets of Eggs
Unraveling the nutritional might of eggs! Dive deep into the science-backed benefits of this superfood and its role in holistic well-being.
Favipiravir in Kids With COVID Causes Eye Color Change as a Side Effect
A recent report, highlighted a rare side-effect of COVID medication in children. Read more to find out.
Katalin Karikó and Drew Weissman Receive the Nobel Prize in Physiology or Medicine
Karikó and Weissman's mRNA breakthroughs spark a vaccine revolution, saving millions in the COVID-19 crisis.
Sugar Tax: An Innovative Health Initiative To Curb Diabetes
Is tax on sugar containing beverages an effective initiative to fight Diabetes? Read more to find out.
TB Drug Shortage in India: Can India Achieve Its Goal of Eradicating TB by 2025
Explore the dire TB drug shortage crisis in India, its consequences, and the urgent need for solutions to save lives.
View All
This site uses cookies to deliver our services.By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use  Ok, Got it. Close

Injecting Opioids May Increase Risk of Bacterial Heart Infection Personalised Printable Document (PDF)

Please complete this form and we'll send you a personalised information that is requested

You may use this for your own reference or forward it to your friends.

Please use the information prudently. If you are not a medical doctor please remember to consult your healthcare provider as this information is not a substitute for professional advice.

Name *

Email Address *

Country *

Areas of Interests