How cocaine and dirty needles are turning 20-somethings into heart patients

He performed two life-saving, expensive surgeries successfully, but even cardiologist Dr. Sean Connors couldn't save one man from the grip of drug use.

The 30-year-old patient underwent two open heart surgeries in St. John's after a dirty needle spread infection from the injection site to his heart valve.

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"We pulled him through another heroic surgery — because these are very big surgeries — and he survived, and I remembered reading his obituary in the paper a few months after that," Connors said.

"I felt that hit home really hard and it's hard on the whole team."

Connors and other cardiac specialists have been tracking a troubling spike in the number of IV drug users requiring heart valve replacements due to infection and the number of heart attacks suffered due to cocaine use.

Broken hearts

"Over the past year, what used to be a rare occurrence began to be regular. Every month we had a young person in hospital," Connors told CBC News.

Last year, there were 20 patients — most of whom were in their twenties — undergo open heart surgery. It's a practice that would only be seen about once a year a decade before. 

Connors estimates the surgery costs hundreds of thousands of dollars. That's not counting the emotional toll it takes on those who try desperately to save a life, only to have the same patient back on the table again months later. 

"It puts a big strain on us. Although we certainly have the capacity to do heart surgery and we do it every day, but we don't do it every day on a 25-year-old," he said.

"I think emotionally having to take someone previously with a normal heart and because of an infection introduced to the body have to do open heart surgery … you know, we do that but we don't like to see that."

Cocaine hits hearts

In 2016, Connors said 25 people under the age of 40 suffered heart attacks because they used cocaine — which causes the heart to spasm. 

In both cocaine-induced heart attacks and replaced heart valves, it's not uncommon for the same patients to fall back into bad habits and subsequently return with worsening heart conditions.

"Once they're fixed, they feel well and they start back on the same bad habits that they had before and we end up having to admit them back in hospital. And let me tell you, the second time around with heart surgery and lots of times people don't get through that second operation." 

Connors said typically heart doctors see people when their addiction has already become crippling. And despite efforts made to keep patients on track and off drugs, sometimes it's not enough. 

"That's the most sad thing about all of this — we'll do everything we can to fix you. But if you go back and you relapse and you come back again and you're beyond being able to be fixed again … that's very difficult." 

Cardiologists and cardiac surgeons with Eastern Health have been combing through data from the last several years. That information will be given to people in the field, who deal with drug addicts.

"I think to really address this problem we're going to need people on the prevention side, the rehabilitation side and people with expertise different than what we have as physicians."  

Safe injection material

Tree Walsh of the Safe Works Access Program, which supplies clean injection kits, says it's startling but not surprising.

Walsh said in addition to reusing and sharing needles, reusing water and cotton can result in bacteria entering the body.

"The numbers of people who do inject drugs in this province are particularly high and there is very little access to clean using equipment," she said, and stigma still exists for those seeking clean needles.

Walsh said that she's heard some pharmacists have refused to sell injection drug users clean needles. However, the Pharmacists' Association of Newfoundland and Labrador says it believes in harm-reduction methods, like providing clean needles.  

"When people can't get clean equipment they use and reshare."

Walsh said the province needs to provide safer using equipment and increase education efforts.

Government agrees

Health Minister John Haggie agrees that access to clean using equipment is key in fighting against infection.

"We're looking at proposals from them as to what their needs may be for the coming year," Haggie told CBC News Thursday afternoon.

The province does provide funding for programs like SWAP to purchase clean injection kits.