Austin Draper once worked in Michelin-starred restaurants and lived on organic farms in Northern California. Now, at 35, he has survived six cases of endocarditis, three open-heart surgeries and the amputation of nine toes, yet heart infections from drug addiction continue to threaten his life.
His medical bills exceed $1 million. The true cost, however, is measured in lost potential and a relentless cycle he cannot break.
“To think that I did something to myself to require all of this is scary,” Austin said during his most recent six-week hospital stay in June.
From stability to crisis
Austin’s comfortable Santa Monica upbringing crumbled during the Great Recession when his family lost their home. Both he and his parents fell into drug addiction. His mother, hooked on OxyContin before transitioning to heroin and fentanyl, once revived him from his first overdose with Narcan.
Despite his heroin habit, Austin pursued his passions for years, working on farms and serving in upscale restaurants whilst train-hopping across the country between jobs. By his late twenties, however, fentanyl had taken over.
In 2021, Austin felt so weak he could barely move. Doctors diagnosed his first case of endocarditis, replacing his heart valve and installing a pacemaker. He was 30 years old.
Drug addiction heart infections strike repeatedly
Endocarditis, a life-threatening inflammation of the heart’s lining, increasingly strikes people who inject drugs as bacteria from dirty needles enters the bloodstream. Cardiac doctors at San Francisco’s Zuckerberg General Hospital treated 425 cases over five years.
Nationally, heart infections from drug addiction amongst opioid users soared between 2011 and 2022, with 40,000 to 50,000 annual diagnoses in the United States.
Austin continued injecting fentanyl after his first infection. Within months, he developed another. Shortly after his second hospital stay, both parents and his grandmother died within weeks, sending him into depression and fuelling more drug use.
His third infection left his toes gangrenous from poor circulation. His fourth, fifth and sixth infections followed, each requiring weeks of antibiotics.
Hope and relapse
Despite permanent housing, monthly Sublocade injections to reduce cravings, regular therapy and a dedicated primary care provider who rushed him to hospital during his sixth infection, Austin struggles to stay sober.
During his June hospital stay, he spent six weeks sewing clothing designs, reading and journaling. He spoke earnestly about starting a clothing line, securing a job and replacing drugs with gardening. In his journal, he wrote: “The next step is to stop this abuse.”
Less than an hour after discharge, a reporter found Austin unconscious on his apartment floor. He had discovered leftover fentanyl and ketamine whilst tidying up.
“In my head, (sobriety) sounds easy, but when it actually comes down to it, it’s just incredibly difficult,” he said.
Healthcare faces ethical dilemmas
Each open-heart surgery costs approximately $200,000, plus $100,000 for six-week antibiotic treatments. Some doctors question operating on repeat cases, whilst cardiac surgeon Dr Glenn Egrie blames systemic failures.
“If there’s no support for a patient and we don’t address the underlying cause, then are we surprised when a person comes back?” he said.
Stanford psychiatrist Dr Anna Lembke emphasises that severe addiction requires intensive residential treatment away from environments where drugs remain accessible. “It’s not a moral failing,” she said. “We’re all products of our environments.”
Austin knows the risks but continues to inject fentanyl, describing his addiction as “the perfect relationship” that makes him feel safe from the outside world.
“I’m just not ready to die,” he said.
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