Without access to harm reduction supplies, New Jerseyans who inject drugs are at risk of infection, hospitalization, and preventable death, according to a new report released today by New Jersey Harm Reduction Coalition (NJHRC).
The report, Preventable Harms: Injection Drug-Use Related Infections in New Jersey, reviews data from the Healthcare Cost and Utilization Project and finds that hospital charges for injection drug use-related infections totaled over $1.0 billion in 2019 — enough to fully fund at least two syringe service programs in every municipality in New Jersey.
“As a medical student I see far too many people who inject drugs hospitalized with debilitating illnesses that are potentially preventable,” said Michael Enich, primary report author, MD/PhD Candidate at Rutgers University, and Trustee at New Jersey Harm Reduction Coalition. “As an outreach volunteer, I hear all the time from people who don’t want to go to the hospital because of their poor experiences seeking medical care in the past. When people who inject drugs have access to new, sterile syringes for every injection and non-stigmatizing health services to treat infections early, we can help save lives. These almost 300 deaths were potentially preventable.”
According to the report, over 7,130 residents were hospitalized for injection-related bacterial or skin infections and 283 residents died from these infections in 2019. This death toll is likely an underestimate, as available data only includes residents who died while hospitalized.
“The data is unequivocal that injection drug use associated serious bacterial infections are associated with significant morbidity and mortality for people who inject drugs and significant societal costs,” said Dr. Amesika Nyaku, report author, Assistant Professor in Division of Infectious Diseases, Department of Medicine at Rutgers New Jersey Medical School, and Trustee at New Jersey Harm Reduction Coalition. “Our analysis shows that New Jersey is not exempt. This data supports the call for greater funding to ensure that there are robust syringe access programs throughout the state.”
Report findings show that Black residents were 1.5 times more likely to be hospitalized for severe bacterial infections, despite using drugs at the same rate as white residents, and people insured through Medicaid/Medicare were 5.6 times more likely to be hospitalized than residents covered through private insurance.
“It’s hard for the layperson to understand just how hard it is for people with an injection-related wound to seek medical care for a wound,” said Caitlin O’Neill, report author and Co-Founder and Director of Harm Reduction Services at New Jersey Harm Reduction Coalition. “The numbers in this report are not abstract for me. I’ve been to people’s funerals, and I’ve seen grieving families left to rationalize how their loved one could die from such a preventable cause. It is beyond time for New Jersey to invest in a robust continuum of care for people who inject drugs, from syringe access programs to hospitals that embrace the best practices in healthcare for people who use drugs, like medication for managing withdrawal symptoms. There is no such thing as a disposable human being, and our policies must reflect that.”
The report highlights that Atlantic, Camden, Cumberland, Essex, Gloucester, Mercer, Salem, and Warren Counties had the highest rates of per capita injection-related hospitalizations, with each having more than one hospitalization per 1,000 residents in 2019.
“Serious bacterial infections resulting from injection drug use are a common harm of the opioid crisis, but can be prevented through effective harm reduction practices like distribution of safe injection supplies,” said report author Peter Treitler, MSW. “This report highlights the urgent need to expand access to harm reduction services across the state of New Jersey, in order to prevent further harm to people who use drugs and reduce the burden on the health care system of providing costly treatment for such infections.”
The report concludes with recommendations for New Jersey to prevent severe bacterial infections and advance drug user health, including: adding injection-related bacterial infection morbidity and mortality indicators to state reporting dashboards; fully funding and implementing accessible syringe service programs; supporting harm reduction programs that include safer snorting and smoking supplies as risk reduction strategies; increasing harm reduction infrastructure in emergency departments and hospitals; decriminalizing drug possession and use; and providing training to healthcare providers to reduce stigma against people who use drugs.
“Our data creates a clear picture. Failure to address treatable infections that arise from injection-related drug use cost the state of New Jersey $1 billion dollars in 2019,” said Claire Marie Kemp, report author. “We can support our loved ones, invest taxpayer dollars elsewhere, and lower the burden on hospitals by understanding and critically attending to the healthcare issues unique to people who use drugs at the first point of contact. These failures can be fixed.”