General Critical Care

Can I Safely Discharge a Patient with a Substance Use Disorder Home with a Peripherally Inserted Central Catheter? | NEJM Evidence

The rising incidence of serious injection-related infections, such as endocarditis and skin infections, among people who use drugs (PWUD) presents a clinical challenge, particularly regarding the safe discharge of these patients with peripherally inserted central catheters (PICCs) for prolonged outpatient parenteral antibiotic therapy (OPAT). This review evaluates the complications associated with PICC use in PWUD, explores combined infection and substance use disorder treatment models, and discusses risk assessment tools to guide clinical decisions. Despite limited high-quality evidence, data suggest that some PWUD can safely complete OPAT with a PICC, highlighting the importance of patient-centered care and shared decision-making to mitigate stigma and ensure the provision of gold-standard treatment.