The growing opioid crisis, notably injectable drug addiction, appears to be a substantial driver of the rising death rate of infective endocarditis among young people in the United States.

Overdose deaths from infective endocarditis have been on the rise in the United States, and the current opioid epidemic, particularly injectable drug usage, looks to be a strong reason.

A bacterial infection of the heart or blood arteries known as infective endocarditis (IE) affects 40,000–50,000 individuals annually in the US and has an average 1-year death rate of 30%.

People who inject drugs are typically younger and have a greater risk for invasive infections due to the introduction of bacteria into the bloodstream.

In fact, IE cases have grown among younger patients with PWID, most likely as a result of the current opioid addiction.

A new study in the Journal of Internal Medicine shows that the risk of death from infectious endocarditis (IE) among young people in the US (15–44 years old) has doubled in the last 20 years.

Additionally, PWID among young persons who pass away from IE has increased to about 20%.

Researchers looked at data from the US Centers for Disease Control and Prevention that was based on death certificates. They found the following (with rates per 100,000 people adjusted for age):

• IE death rates for the overall US population fell from 2.1 in 1999 to 1.8 in 2020, but young US citizens’ mortality rates more than doubled during that period, rising from 0.3 in 1999 to 0.6 in 2020.
• Mortality rates rose from 0.1 to 0.3 among adults aged 15 to 34.
• In 2020, 10% of all IE deaths were among young people. This was up from 6.8% in 1999.
• The percentage of PWID among all patients who died from IE grew from 1.1% in 1999 to 3.0% in 2020; the percentage among young people also increased, from 10.2% in 1999 to 19.5% in 2020.
• Compared to 77% in 1999, nearly 90% of the young US PWID who died of IE in 2020 were white Americans.

According to corresponding author Polydoros Kampaktsis, MD, PhD, of the Columbia University Irving Medical Center, “the number of young people in the US who die of infective endocarditis is increasing, and the ongoing opioid epidemic, specifically injectable drug abuse, appears to be a significant cause.”

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