Bates MC, et al. - In this retrospective analysis, researchers analyzed the trend of substance abuse associated infective endocarditis (IE) admissions in Southern West Virginia, as well as the economic impact of it. All admissions registered over the last decade in the largest tertiary care center for Southern West Virginia—with concomitant drug abuse (cocaine, amphetamine, sedative and other/mixed drug abuse) and IE—were analyzed with regard to cost, incidence, and geographic patterns. The impact of drug use on the incidence of IE was determined using a time series model. Findings revealed a dramatic increase in the number of patients hospitalized with IE over the last decade; this increase mirrored the increase in mixed drug use. Payments were made for only 22% of the hospital charges because the majority of payers were from underfunded state programs or private pay; this showed a hospital deficit of over $13 million during the study period.