Cardiac Surgery Peer Support Recovery

Patients admitted with active IE secondary to IV drug use require a myriad of services and
will remain hospitalized for a minimum of six weeks. During their hospitalization, infectious
disease service assists in developing a treatment plan for the active infection, neurosurgery
service evaluates and develops a plan to treat any sequelae of endocarditis, toxicology
service develops a treatment plan to manage the detoxification, and cardiac surgery service
develops a treatment plan for the infected valve. In spite of all these services, there is no
dedicated service to address the patient's substance use disorder (SUD). This missed
opportunity to begin addressing the substance use disorder potentially impairs the patient's
ability to engage in the first steps towards sobriety. Ideally, a recovery support model of
care would be available to assist these patients during their hospitalization to transition
from active addiction into the early phases of recovery from addiction.

This is a single center/single unit (7-3600) exploratory study to examine the efficacy of
three interventions on a subject's SOCRATES 8D score at time of discharge, at three months,
and at six months. A convenience sample of all patients admitted to 7-3600 who meet the
inclusion criteria for this study will be approached and provided information related to this
study. Once entered into the study, the subjects will continue in the study through their
hospitalizations and up to 90 days post hospitalization.

Inclusion Criteria:

All patients considered for this program must meet the following criteria:

1. Must be at least 18 years of age and able to provide consent

2. Must speak/read/understand English

3. Currently hospitalized and physically located on 7-3600 unit

4. Followed by or on the Cardiac Surgery service

5. Have a diagnosis of Endocarditis associated with recent or remote intravenous drug use
(IVDU)

6. Alert and oriented to person, place, time, and events leading up to hospitalization

7. Able to carry on a coherent conversation

8. Clinical Opiate Withdrawal (COW) score of less than or equal to 5 with no adjunctive
(opioids) medication use within past 24 hours a. If COW score is greater than five or
adjunctive medications have been used within the previous 24 hours, the patient will
be re-evaluate every 24 hours until score is less than or equal to five and no
adjunctive medications used within the previous 24 hours

Exclusion Criteria:

1. Under the age of 18 years old

2. Unable to speak/read/understand English

3. Hospitalized but not on 7-3600

4. Does not have a diagnosis of endocarditis associated with IVDU

5. Not followed by or on the Cardiac Surgery service

6. Not Alert or oriented or unable to carry on a coherent conversation

7. COW score that is greater than five or adjunctive medications have been used within
the previous 24 hours (see inclusion criteria)