Patient Perspectives on Substance Use and Treatment After Serious Injection-Related Infections

Overview

This qualitative study explored patient experiences following hospitalization for serious injection-related infections (SIRIs), highlighting common reductions in substance use, varied views on medications for opioid use disorder (MOUD), and the role of harm reduction. Despite access to hospital-based addiction services, ambivalence and stigma around MOUD persist, underscoring the need for longitudinal support.

Background

Serious injection-related infections such as endocarditis and osteomyelitis cause significant morbidity and mortality among people who inject drugs (PWID). Treatment typically involves prolonged antibiotic therapy and increasingly includes medications for opioid use disorder (MOUD) to reduce re-hospitalizations and mortality. Hospitalization for SIRIs presents an opportunity to engage patients in integrated infectious disease and addiction care. However, MOUD remains underutilized, and many patients do not complete recommended antibiotic courses, highlighting gaps in care.

Data Highlights

Key Findings

• Hospitalization for SIRIs often led to reduced substance use and increased adoption of harm reduction practices among patients.
• Patient perspectives on MOUD were mixed, with persistent negative experiences and stigma despite hospital-based addiction services.
• SIRI hospitalizations served as critical moments for patients to reflect on their substance use and overall health.
• Only about 80% of participants completed recommended antibiotic therapy, indicating challenges in treatment adherence.
• Re-hospitalization rates remain high, emphasizing the need for improved longitudinal care and support.

Clinical Implications

Hospitalization for SIRIs represents a key opportunity to engage patients in comprehensive addiction and infectious disease care, including initiation and retention on MOUD. Addressing medication stigma and providing explicit harm reduction support are essential to improving treatment adherence and reducing re-infection. Long-term, multidisciplinary follow-up is critical to sustain benefits achieved during hospitalization.

Conclusion

SIRI hospitalizations provide a pivotal moment for intervention, but persistent ambivalence toward MOUD and treatment challenges highlight the need for enhanced, patient-centered longitudinal support integrating harm reduction and addiction services.

References

1. Authors/Boston Medical Center/2024 -- Reflections on Hospitalization: Insights from Patients Regarding Substance Use, Opioid Use Disorder Treatments, and Harm Reduction After Serious Injection-Related Infections