Overdose Deaths Rise as Pandemic Continues

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COURT HOUSE – New Jersey Health Commissioner Judith Persichilli expressed concern June 22 that the long battle with the COVID-19 pandemic may be worsening, what she called, the overdose epidemic. Persichilli said that state overdose deaths were 20% higher this year than at a similar period in 2019.
“We do not want to see this trend continue,” Persichilli said, as she announced a grant program for local health departments to “study patterns of overdose in their communities.”
Persichilli said the state saw 1,339 suspected overdose deaths so far this year, and that contributing factors in the rise may be the “social isolation, grief and job loss” that accompanied the restrictions on social interaction imposed to fight the novel coronavirus.  
Sen. Michael Testa (R-1st) took Persichilli’s remarks, as reported in the media, to be further evidence that “the supposed ‘shutdown for the common good’ has resulted in overwhelming negative consequences for local economies and the mental health of individuals.” Testa’s remarks signal that the rise in overdose deaths may become part of the political contention surrounding the speed and nature of the reopening strategy.
What Happened?
Nationally, reports show that public health restrictions stressing social distancing and self-quarantine are much more than inconveniences to those fighting addictions. Uncertainty, isolation, and economic distress heighten anxiety and depression. For those addicted to drugs and alcohol, the pressures to turn to their habits for relief can be overwhelming.
The Recovery Centers of America reported a spike in individuals seeking help to avoid painful withdrawals during lockdown periods.
Health officials pointed out that tolerance changes can produce devastating results when individuals return to strong drugs for temporary relief.
New Jersey Attorney General Gurbir Grewal issued an administrative order that required prescribers must co-prescribe naloxone to any patient continuously receiving opioids for chronic pain management. The lack of a buddy system often used by addicts was noted as another negative factor in overdose complications when no one is around to administer the naloxone or call for help.  
The New Jersey Health Department Opioid Dashboard, at www.NJCares.gov, shows that 2020 is witnessing a growth in suspected overdose deaths. By the end of May 2019, the state experienced 1,115 overdose fatalities. The 1,339 this year represents the 20% increase Persichilli noted.
Looking at the data by month supports the argument that pandemic restrictions are probably taking a toll on the mental health of those fighting addictions. The largest increase, over 2019, occurred in the months of lockdown, with May 2020 accounting for a 25% increase over May 2019.
Cape May County
In Cape May County, the data suggests a slightly different picture. At the end of May 2020, the county experienced 23 overdose deaths. By the same point in time, in 2019, the total was 11 overdose deaths, and in 2018, the total was 12. A doubling in the overdose deaths from January to May in 2020 is troubling.
Yet, the deaths appear to have been on their way to significant growth before the pandemic restrictions were imposed. In the county, by the end of March, overdose deaths were at 11, the number that was not reached until the end of May 2019.
While the biggest increase in year-to-year overdose deaths, in the state, came in May, in Cape May County, the highest single-month increase was in February, before the first COVID-19 case appeared in the state.
A look at historical data shows the county problem has long roots. Suspected overdose deaths jumped from 32, in 2016, to 59, in 2017, and have not been below 47 a year since then.
When looking at the overdose deaths in proportion to the population, the picture becomes even more disturbing. In 2016, the county experienced one overdose death per 2,927 members of the population. By 2018, that number dropped below 2,000 to 1,969, meaning where the proportion for 6,000 in the population used to account for two overdose deaths, it now accounts for three.
NJ Cares doesn’t provide the population statistics for each county past 2018, but the case, in Cape May County, can’t be better. The population shrinks each year in census estimates, and the number of overdose deaths increased in 2019 over 2018.
When one looks at proportional population for every overdose death across all 21 counties for 2018, all seven of the counties that traditionally make up South Jersey were below the state average. Four of those counties were below 2,000 people per death and Cape May County was one of the four.
It is not news that the county continues to have a problem with drug addiction and overdose deaths. A look at Naloxone administrations as a proxy for overdose incidents, which do not necessarily result in death, shows that 2019 had an increase over 2018.
This year, the overdose deaths, from Jan. 1 to May 31, total 23, and the Naloxone administration total is 93. Neither of those numbers projected on a straight line would represent an increase over 2019 at year end, but a straight-line projection would probably be incorrect since monthly comparison of the numbers shows that the overdose deaths are at double the level they were for the same period in 2019.
State Grants
A great deal of evidence from mental health professionals and recovery centers strongly suggests that the type of restrictions used to combat the virus likely had a negative impact on those addicted to drugs and alcohol. Yet, the county data also suggests that a spike in overdose deaths may have been underway in the county before the restrictions were imposed.
This possibility speaks to the thrust of Persichilli’s remarks concerning the health department grants. She noted, “The department recognizes the importance of local solutions to bring about a sustainable change that is needed to address the overdose crisis.”
According to a spokesman, the Cape May County Department of Health submitted an application for one of the $100,000 state grants. The funding, if obtained, allows for the establishment of multidisciplinary overdose fatality review teams with public involvement. The countywide teams will “analyze data, identify regional trends, and evaluate strategies to reduce opioid deaths.”
Persichilli said local health officials are best equipped to “effectively direct policies, practices, and partnerships to prevent future overdoses.”
To contact Vince Conti, email vconti@cmcherald.com.