Naloxone Incidents Increased 10% in ’19

TRENTON – New Jersey Department of Health data shows that Naloxone, also known as Narcan, incidents increased in 2019 over 2018. Cape May County was one of four counties in the state to see a year-to-year increase. 
This increase compares complete 2018 numbers to the first three quarters of 2019 (January-September), making the year-to-year rise even more troubling.
Counties that saw an increase were Bergen, Hunterdon and Passaic, along with Cape May County. The other 17 counties, including Camden, witnessed a drop in such incidents, at least until fourth-quarter data is added. 
For those who equate Naloxone incidents with the number of opioid overdoses, the news that the county saw an increase last year is not comforting. Experts debate how reliable Naloxone incidents are as a proxy, but there is some evidence buttressing the tendency to do so.
A 2013 peer-reviewed study, published in the Prehospital Emergency Care Journal, supported the use of such incidents as proxy indicators.
What Do the Numbers Say?
For Cape May County, the number of Naloxone incidents, where Naloxone was administered for suspected opioid overdose, rose 10% in 2019, while, statewide, the number declined by 15%.
Could one contributing factor to the increase be a more widespread distribution of Naloxone, and thus a higher number of times that it could be used to save a life? It’s possible that such a factor could be positively contributing to the increase in use, yet state health data also shows that confirmed drug-related deaths are also increasing in the county. 
Data is available through 2017 and shows that confirmed drug-related deaths were significantly higher than in any of the previous six years. For 2017, the principle drugs listed as involved in the deaths were heroin and fentanyl.
While state numbers for drug-related deaths were also up in 2017, the incidence per 100,000 of the population was far lower in the state, as a whole, than in Cape May County.
Part of what drives such a number is the influx of visitors, some of whom are not here just to enjoy the beaches and attractions.
Uniform Crime Reporting (UCR) data show, for the same period, an uptick in arrests for possession, as well as for sale and/or manufacturing (http://bit.ly/36xRluQ). The data also shows that crime, like most other things in the county’s seasonal economy, is cyclical.
While the county has a low crime rate per 100,000 of the population in the first quarter of the year – when there’s barely 100,000 people in the county – that rate shoots up to one of the highest in the state in the quarter that encompasses July, August and September. 
Although UCR numbers do not provide quarterly drug possession arrests, there is no reason not to think that drug possession arrests follow the same seasonal pattern.
Drug use is a problem in the county, and that is not news to residents. Crime statistics indicate that crimes against property are often linked to drug use.
Data on substance abuse admissions to medical facilities tells a similar story. In Cape May County, heroin is, by far, the primary drug involved in substance abuse admissions or drug-related hospital visits.
In 2017, the data shows that out of 193 drug-related hospital visits, heroin was involved in over 60%. It also shows that the patients were predominantly male, white, over half were employed and the vast majority were seen as emergency-room outpatients.
Once more, the rates for the county are higher than counties with higher populations, probably again reflecting the influx of visitors to the county during summer.
One statistic where it is harder to assign cause to the visiting population is the higher rate of neonatal abstinence syndrome, a term representing a group of conditions caused when a baby goes through withdrawal from drugs the baby was exposed to in the womb.
For the state, the incidences of neonatal abstinence syndrome have risen during the period from 2008 to 2017, moving from 3.3 per 1,000 births to 7.1 per 1,000 births. 
In the county, that same set of statistics is 10 per 1,000 births in 2008 to 34.9 in 2017, almost five times the state number.
Perhaps, the increase in Naloxone incidents is a proxy for the county’s battle against opioid and other drug-related dependencies that still, for all its progress, has a long way to go. 
To contact Vince Conti, email vconti@cmcherald.com.