LAUSR

To the Editor—The COVID-19 pandemic has exacerbated the opioid epidemic in North Carolina, evidenced by a 22% increase in opioid overdoses in 2021 [1]. This epidemic within a pandemic respects no boundaries regarding education, socioeconomic status, gender, race, or ethnicity. The toll is staggering, with increased fatal overdoses associated with intravenous drug use (IVDU) plus increased transmission of infectious diseases like HIV and hepatitis C virus (HCV) from sharing/reusing injection equipment. Drug use associated (DUA) endocarditis (infection of a heart valve) is also on the rise, placing an economic strain on our health care system; the median cost of hospitalization for DUA endocarditis that requires heart valve replacement exceeds $250,000 [2]. To combat these human and economic costs, North Carolina must rely on scientific evidence and expand the continuum of care for people who use drugs.