A new study by London researchers suggests those who inject drugs are more likely to develop a serious bacterial heart infection when using a slow-release form of hydromorphone.
The study, conducted by Lawson Health Research Institute, Western University, and the Institute for Clinical Evaluative Sciences, analyzed the admission data of injection drug users who were admitted to Ontario hospitals between 2006 and 2015. Of 60,529 admissions, 733 patients were ultimately diagnosed with a heart infection called endocarditis.
The findings showed that regions with high hydromorphone prescription rates had more than double the cases of infective endocarditis when compared to regions with low prescription rates. As well, those using "controlled-release" hydromorphone were three times more likely to develop endocarditis when compared to those using any other opioid.
"Controlled-release" hydromorphone prevents the drug from being rapidly absorbed by the body with slow-release capsules that helps to spread pain relief over a longer period of time.
“There’s been a global increase in infectious diseases among persons who inject drugs and our research suggests that controlled-release prescription opioids may be a major culprit,” said Dr. Michael Silverman, an associate scientist at Lawson and associate professor at Schulich Medicine & Dentistry. “We now have evidence that suggests the injection of controlled-release hydromorphone is increasing the spread of HIV, hepatitis C and endocarditis in Canada.”
The team found that HIV and a dangerous bacterium called Staphylococcus aureus are more likely to survive in equipment used to prepare controlled-release hydromorphone since added chemicals that make the drug slow-release promote survival of bacteria and viruses.
The researchers' findings were published on Wednesday in The Lancet Infectious Diseases medical journal.