ENDOCARDITIS: A SERIOUS HEALTH RISK OF ADDICTION

By John Giordano, Doctor of Humane Letters, MAC, CAP

In her youth, Emily was an exceptional young woman. She was an A+ student with big goals and loads of ambition. When she wasn’t studying, you’d often find her participating in her favorite activity, sports. Even as competitive as she was, Emily never spoke a harsh word to her challengers; in fact, quite the opposite. Emily had a bubbly personality with such a positive outlook on life that people just seemed to gravitate towards her.

But there was another side to Emily that most outsiders never saw. As Emily got older, she began showing subtle signs of anxiety and depression. Nothing over the top mind you; but just enough to concern her mother. As popular as Emily was, she didn’t develop any close relationships with her friends. She all but stopped going to school functions and other social interactions with other kids her age in favor of staying home and studying.

Emily’s mother became so concerned at the beginning of her senior year that she took her to their general practitioner seeking his professional opinion. After speaking with both of them, their doctor told Emily’s mother that this very well could be a phase she was going through caused by the stress of school and getting accepted at a good college. He told her to keep an eye on it and if her behavior got worse in the next few months to contact him. This was a relief for Emily’s mom who started to think she might be a tad over protective of her daughter.

Life went on pretty normally for their middle-class household until the fall when Emily was off to college. Dorm life forced her into a social setting she wasn’t accustomed to. A new friend from her floor offered her a pill to help ‘take the edge off.’ Emily’s life changed the split second she swallowed the opioid painkiller. It masked her anxiety and depression while taking away her inhibitions. She found herself seeking out bigger dosages and began shooting up heroin by midterms. Emily dropped out in her second semester.

Emily abused drugs for nearly ten years before she found recovery. Unfortunately her story is way too common today. Bright kids with a terrific future and no drug or alcohol abuse history lose everything in no time at all to addiction. Yet for all the trials and tribulations these addicts go through to get to recovery, many find their greatest challenges lie ahead.

By the way, Emily is a composite character made up of several women I’ve treated over the years. I chose this style so that I could show you the depths of addiction.

It’s no secret that drug addiction wreaks havoc on the human body. The deadly toxins inherent in drugs damage nearly all our organs and systems. They impair enzymes that are critical to a countless number of bodily functions, can inhibit or mimic hormones and compromise the immune system. The human body is an incredible machine in that it has the ability to detox itself. However, if someone is heavily toxic, for example a drug addict, the body’s ability to detoxify itself becomes compromised from the overload; requiring treatment.

Drug addiction also robs the body of life sustaining nutrients. By far, most addicts’ diet consists of heavily processed foods when they eat at all. This lifestyle combined with the toxic nature of drugs causes damage in the gut so that it can’t absorb the nutrients in food the way it’s intended. Fortunately, a good vitamin routine can help alleviate many of these issues.

In addition to these life-threatening conditions resulting from drug addiction, addicts face an even greater peril than once thought. Independent studies have shown an increase in virulent viral infections that, from all outward appearances, seems to be a direct correlation to the steady increase in drug abuse.

HIV, STDs, hepatitis, endocarditis and other viral infections are becoming way too common among addicts. These potentially deadly viruses are spread mainly through unprotected sex and/or shared dirty needles. I saw a global statistic not long ago that was very revealing. On average, one in ten new HIV infections are caused by the sharing of needles.

Most of these infectious diseases are on peoples’ radar with the exception of endocarditis. I think it is safe to assume addicts and their loved ones are aware of the stress drugs put on the heart. However, endocarditis can be the more deadly disease.

There was a study published last spring and reviewed by Dicardiology dot com in the May 14, 2018 issue that revealed a staggering static. The number of patients with endocarditis that were hospitalized dramatically trended upward over the last ten years. As you might have already suspected, the upward trend on a graph looks remarkably similar to that of the increase in mixed drug use.

Make no mistake about it; endocarditis is a life-threatening and hard to treat condition. The bacteria can destroy heart valves and spread to other parts of the body. The Centers for Disease Control (CDC) is on the record stating that addicts with endocarditis who inject drugs have a disproportional chance of recovery. Their research shows addicts are 10 times more likely to die or require a second surgery within months after initially leaving the hospital when compared to other patients.

There are two types of endocarditis, acute and subacute. Depending on which type, the damage to heart valves can be swift and severe or slower and less dramatic.

Acute endocarditis is the result of aggressive skin bacteria, commonly staphylococcus, entering the bloodstream. It immediately multiplies while attacking heart valves. This type of endocarditis can be fatal in less than six weeks.

Conversely, subacute endocarditis can remain undetected in the system for months, all the while attacking heart valves. Subacute is caused by bacteria commonly found in the mouth and throat (streptococci, streptococcus sanguis, mutans, mitis or milleri). The symptoms are non-specific and hard to detect. They can persist for weeks and even months.

That being said, all of these viral infections and other associated addiction related health issues make a strong argument for public safe injection sites, also known as supervised injection sites, for heroin and other drugs. Domestically it is considered a bold idea, yet several countries and cities in Canada, Australia, and Europe have gone this route and with great success. New York City, Philadelphia, San Francisco, Seattle, Denver, Ithaca, New York, and other cities across the US are strongly considering the program.

At this juncture, I feel compelled to share with you that I am a firm advocate for abstinence. However, I’m also a realist. It has been my experience in the last nearly forty-years that if an addict is not ready for change, a team of wild horses can’t drag him or her into treatment. It’s just will not work. So taking that into consideration, supervised safe injection sites looks like a viable harm reduction option.

The concept is amazingly simple, yet it has the potential to deliver big results. The sites that I’ve seen and ones being considered are nothing fancy, but they are clean and provide sterile injection equipment. They’re also staffed around the clock with addiction trained professionals who can administer naloxone if anything goes awry. The staff is also available to discuss addiction treatment options if asked.

The challenge American cities face is the Department of Justice has already taken a stand on the subject stating the harm reduction approach is illegal. This seems consistent with the ‘War On Drugs’ ethos of jail over treatment. However, we’re in the throes of the worst drug epidemic the world has ever known and desperately need a new perspective to guide a new approach. It’s painfully obvious to even the casual observer that the ‘War On Drugs’ is an abject failure and not worth pursuing any longer.

Will public safe injection sites reduce drug overdose deaths and viral infections? The municipalities already on the harm reduction program claim a dramatic drop in both overdose deaths and viral infections. According to NPR: ‘a study published in Lancet, and included in the most recent review of evidence by criminologists, Milloy and other researchers found that the fatal overdose rate sharply decreased in and around the immediate area of the site.’ The study also stated that there was no evidence of the “honey pot effect,” meaning it didn’t increase or encourage drug use.

The time has long past for us to reevaluate our approach to this deadly drug epidemic.

John Giordano is the founder of ‘Life Enhancement Aftercare & Chronic Relapse Recovery Center,’ an Addiction Treatment Consultant, President and Founder of the National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Beach Chamber of Commerce. He is on the editorial board of the highly respected scientific Journal of Reward Deficiency Syndrome (JRDS) and has contributed to over 69 papers published in peer-reviewed scientific and medical journals. For the latest development in cutting-edge addiction treatment, check out his websites: www.PreventAddictionRelapse.com www.HolisticAddictionInfo.com