Surge in Heart Infections Among Young Americans Linked to Drug Abuse

While the overall rates of a serious heart infection are declining in the United States, a concerning exception emerges among young adults, driven by a rise in injected drug abuse, according to a recent report.

In the study led by Dr. Sudarshan Balla, an associate professor of medicine at the West Virginia University Heart and Vascular Institute, findings published in the Journal of the American Heart Association on December 13 highlight the increasing rates of infective endocarditis, a potentially deadly heart infection, particularly among young adults.

Injective drug abuse is identified as a common cause contributing to the surge in infective endocarditis cases. Dr. Balla emphasizes, “Substance use was listed as a contributing cause that could explain the higher death rates in the younger age groups and also in the states in those who died due to endocarditis.”

Infective endocarditis occurs when bacteria infiltrate the heart’s lining, a heart valve, or nearby blood vessel. Traditionally, this condition is rare and is often associated with congenital heart issues or replacement heart valves. However, the misuse of injected drugs significantly raises the risk of developing infective endocarditis.

The study analyzed data from the U.S. Centers for Disease Control and Prevention spanning from 1999 to 2020. Overall, infective endocarditis-related deaths decreased from 26 per million persons in 1999 to 22 per million persons in 2020 across the general population. Notably, the decline in deaths was most significant in individuals aged 55 and older.

Contrastingly, deaths among people aged 25 to 44 saw a sharp increase, with a 2% annual rise in the 25 to 34 age group and a 5% annual rise in the 35 to 44 age group.

The researchers underscore that substance abuse poses a broader health threat to individuals aged 25 to 44, linking it to a two-fold to seven-fold rise in many common causes of death. Dr. Balla attributes this acceleration to the opioid crisis, particularly impacting younger adults.

States severely affected by drug-linked infective endocarditis, such as Kentucky, Tennessee, and West Virginia, are urged to take action. Dr. Balla emphasizes the need for “comprehensive care plans for those treated for infective endocarditis [to] also include screening and treatment for substance use disorder.”

The use of contaminated needles in drug misuse introduces bacteria into the bloodstream, increasing the risk of infective endocarditis and other infectious diseases. To address this issue, some states are implementing harm reduction programs, including clean needle exchanges, although the effectiveness of these initiatives is yet to be determined.

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