A substance misuse epidemic has been observed in the United States leading to a dramatic increase in mortality rates. Because of poverty and accessibility to drugs, Camden County, NJ, has struggled with substance-related fatalities. In addition, it should be noted that individuals from wealthier surrounding counties travel to Camden because of increased accessibility to purchasing drugs. This could lead to an increased mortality in Camden County, independent of the county’s population. Thus, analysis of these reports in Camden and comparing it to the neighboring Gloucester County, NJ can provide detailed epidemiological variables that would aid in future management plans for individuals struggling with this disorder.
The Camden County Department of Health and Human Services provided mortality data for both Camden and Gloucester counties. Using SPSS Statistical Software, the data were analyzed between the years of 2013 to 2015, in terms of demographics, cause and manner of death, and the substances that were present at the time of death for each subject.
During this period, a total of 675 individuals died secondary to substance misuse, with a higher percentage in Camden County compared with Gloucester. Caucasian males aged 25 to 44 years were the most common demographics of the substance misuse mortalities. However, the percentage of African American fatalities steadily increased every year. In addition, substance misuse-related mortalities were significantly more common when individuals had >1 substance present in their blood. Opioids were the most commonly encountered offending agent with a total of 576 (85.3%) subjects testing positive. Heroin was the most common opioid present in 52.6% of subjects. Opioids were followed by benzodiazepines in 36.0% and stimulants in 34.7% of individuals.
A high prevalence of opioid-related mortality was detected in both counties, specifically for Camden County, between the years of 2013 and 2015. An increasing incidence of opioids, specifically heroin and oxycodone, was also detected. Although prescription opioids might contribute to the initial development of addiction, the sudden suspension of these resources, without adequate treatment, can often lead individuals to shift to heroin as cheaper and more potent resource of opioids. Physician education and changing the prescribing patterns as well as harm reduction strategies are needed. For acute pain, the recommendations to provide initial limited amount of opioids have recently been implemented. In addition, a multimodal management plan to treat those struggling from chronic pain should include a psychiatrist/addiction specialist, therapist/addiction counseling, social worker, and family physicians and/or pain specialist. Although the adolescent population was not the age group with the highest mortality during this period of time, early drug intervention is needed to prevent mortality that is being seen in individuals in the second and third decades of life.
*Cooper Medical School of Rowan University
‡Department of Psychiatry, Cooper University Hospital, Camden
†Camden County Department of Health and Human Services, Blackwood, NJ
§University of Florida, Collage of Medicine, Gainesville, FL
Presented in poster form at the 2017 Annual Meeting of the American Academy of Addiction Psychiatry.The authors declare no conflict of interest.
Reprints: Karim Sedky, MD, Department of Psychiatry, 3 Cooper Plaza, Suite 346, Camden, NJ 08103 (e-mail: firstname.lastname@example.org).