At the Cusp — Reimagining Infective Endocarditis Care amid the Opioid Epidemic

This perspective explores how the opioid epidemic has reshaped the epidemiology and care of infective endocarditis, particularly among people who inject drugs. The author recounts the story of Ms. A., a patient with opioid use disorder (OUD) and endocarditis, whose fragmented discharge plan led to delays in essential follow-up and treatment. Her recovery was only possible through a multidisciplinary team integrating addiction medicine, primary care, cardiothoracic surgery, case management, and social support. The article critiques conventional endocarditis guidelines that focus narrowly on inpatient care, arguing for expanded models that address substance use disorder, housing instability, and social determinants of health. It also warns against stigma-based policies, such as requiring abstinence before surgical interventions and advocates for team-based frameworks that reduce barriers and promote continuity of care. The piece calls for systemic transformation and compassionate, coordinated treatment models to prevent avoidable deaths and support long-term recovery.

This perspective explores how the opioid epidemic has reshaped the epidemiology and care of infective endocarditis, particularly among people who inject drugs. The author recounts the story of Ms. A., a patient with opioid use disorder (OUD) and endocarditis, whose fragmented discharge plan led to delays in essential follow-up and treatment. Her recovery was only possible through a multidisciplinary team integrating addiction medicine, primary care, cardiothoracic surgery, case management, and social support. The article critiques conventional endocarditis guidelines that focus narrowly on inpatient care, arguing for expanded models that address substance use disorder, housing instability, and social determinants of health. It also warns against stigma-based policies, such as requiring abstinence before surgical interventions and advocates for team-based frameworks that reduce barriers and promote continuity of care. The piece calls for systemic transformation and compassionate, coordinated treatment models to prevent avoidable deaths and support long-term recovery.