The opiate-dependent patient with endocarditis: addressing pain and substance abuse withdrawal.

Intravenous drug use is associated with infectious diseases such as endocarditis. Patients often require intensive medical and nursing management in the intensive care unit as well as simultaneous intensive pain, withdrawal, and psychosocial management for the tolerance and behavior issues commonly associated with this population. To provide comprehensive care, the advanced practice nurse needs to understand the relation between intravenous drug use and the development of infective endocarditis. Furthermore, the advanced practice nurse must have skill in making distinctions between pain and opiate withdrawal, selecting a strategy for treating these syndromes, and providing the intravenous drug-using patient with support and aftercare resources.