Addiction studies have shown that treat- ment outcomes for behavioral interventions alone for opioid use disorders are dismal, with >80% of patients returning to drug use. Some data show that patients who used pharmacotherapy, such as agonist therapy (opioid substitution therapy), in addition to behavioral treatments had a 50% reduction in relapse compared with those who used behavioral therapies alone.8 10 3. Stroke in patients with IE can have several mechanisms, including hemorrhagic transfor- mation of an ischemic infarct, septic erosion of an atherosclerotic vessel without aneurysm for- mation, and rupture of a mycotic aneurysm. Up to 35% of all patients with IE develop clinically evident systemic emboli. If more sensitive tests, such as magnetic resonance imaging, are used, a much higher proportion of patients with IE have evidence of emboli. In these patients, the most common cause of stroke is septic embolus CLINICAL STATEMENTS AND GUIDELINES resulting in ischemia, often followed by hemor- rhagic transformation. Anticoagulant therapy may increase the risk of an embolic infarct converting to a hemorrhagic infarct, and this risk must be weighed against the higher risk of recurrent embolization and valve dysfunction, particularly in patients on anticoagulation for a prosthetic valve. A specialist in the field of neu- rology or neuroradiology should be added to the Heart Valve Team when stroke complicates 4. POET randomized stable patients who had left- sided endocarditis caused by streptococcus, E. faecalis, S. aureus, or coagulase-negative staphylococci to treatment arms of contin- ued intravenous treatment or a switch to oral antibiotic treatment after antibiotics had been administered intravenously for at least 10 days. Within 1 to 3 days before the completion of the assigned antibiotic treatment, TEE was per- formed to confirm that the patient had a suf- ficient response to treatment as part of this 5. 