Substance use treatment and overdose patterns in high and low social vulnerability counties: a trends analysis in New...

This study investigates trends in substance use treatment admissions and overdose patterns across New Jersey counties from 2014 to 2022. Using the Social Vulnerability Index (SVI), we examined how county-level vulnerability differentiates treatment utilization and overdose outcomes.

We created a novel, longitudinal data set using data from multiple public sources. Data were obtained and analyzed for all 21 New Jersey counties. Outcome measures included substance use treatment admissions, opioid-specific treatment admissions, overdose deaths, and naloxone administration. Using the SVI, counties were categorized as either high (n = 10) or low (n = 11) social vulnerability. Data analyses were conducted using joinpoint analysis to identify trends over time and variation by social vulnerability status.

Significant trends were identified regardless of social vulnerability status for all outcome measures, appearing as upward trends in initial segments and flat or declining trends in latter segments. High vulnerability (compared to low vulnerability) counties demonstrated greater Annual Percentage Change (APC) magnitudes for all outcome measures in the initial segment, similar APCs in the latter segment, and had higher baseline rates and peak rates.

Findings demonstrate that county-level social vulnerability status is associated with substance use treatment admissions and overdose patterns. Specifically, high vulnerability counties exhibit consistently higher rates of substance use treatment admissions, naloxone administrations, and overdose deaths. This pattern highlights a need for expanded substance use services along the continuum of care for vulnerable areas and the viability of SVI status as a useful and simple tool for targeting service expansion efforts.