Opioid Vulnerability Varies by County in New Jersey

Opioids, particularly fentanyl, pose a significant public health threat, and new research from Rutgers University highlights how geographic location plays a crucial role in opioid-related risks. A study of New Jersey counties reveals a persistent gap in opioid-related treatment needs and overdose rates, with those in areas with higher social vulnerability consistently facing greater challenges.

Social Vulnerability and Opioid Risk

Researchers analyzed data from 2014 to 2022 and found a strong correlation between social vulnerability – factors like socioeconomic status, access to transportation, and disease burden – and adverse opioid outcomes. Counties identified as “high” vulnerability exhibited consistently higher rates of substance utilize disorder treatment admissions, opioid-specific treatment admissions, overdose deaths, and naloxone administrations compared to “low” vulnerability counties.

A Persistent Gap

The disparity in opioid risk between high and low vulnerability counties has remained stagnant for over a decade, and in some cases, has widened. While New Jersey saw a surge in opioid overdose fatalities in the mid-2010s – increasing from 14.71 deaths per 100,000 residents in 2014 to a peak of 34.01 deaths per 100,000 in 2019 – interventions like expanded access to overdose reversal medications (naloxone) and evidence-based treatments (buprenorphine and methadone) helped to stabilize the situation. The rate decreased to 31.34 deaths per 100,000 in 2022, but this improvement wasn’t universal.

County-Level Disparities

In 2023, drug-related overdose deaths ranged dramatically across New Jersey counties, from 9.2 per 100,000 in Somerset County to 58.1 per 100,000 in Atlantic County, according to the National Center for Health Statistics.

Methodology

The Rutgers research team, collaborating with the Rutgers Center for Integrated Care, utilized the Social Vulnerability Index (SVI) developed by the U.S. Centers for Disease Control and Prevention to categorize counties. They then compiled public data from 2014-2022 from the New Jersey Division of Mental Health and Addiction Services, the N.J. Office of the Attorney General, and the U.S. Census Bureau, focusing on substance use treatment admissions, overdose deaths, and naloxone administrations.

Key Findings

• High vulnerability counties consistently showed higher rates of adverse opioid-related outcomes.
• The gap between high and low vulnerability communities remained consistent or widened throughout the study period.
• Opioid-specific treatment admissions and naloxone administrations decreased in low SVI counties after 2017, while rates in high SVI counties plateaued or increased.
• Overdose death rates continued to marginally increase in high SVI counties after peaking in 2017, while rates plateaued in low SVI counties.

Implications and Future Research

The study underscores the need for targeted substance use services in vulnerable areas. Researchers emphasize the importance of understanding the factors linking social vulnerability to poor opioid outcomes and suggest that counties with greater disadvantages may have fewer addiction services. Further research is needed to inform policies that prioritize resources for communities most at risk.

“Initiatives designed to tackle the ongoing health crisis must consider this disparity of need,” said Sarah Cooper, a doctoral student at Rutgers University School of Social Work and first author of the study.

Source

Cooper, S. E., et al. (2026). Substance use treatment and overdose patterns in high and low social vulnerability counties: a trends analysis in New Jersey from 2014–2022. Addictive Behaviors Reports. https://doi.org/10.1016/j.abrep.2025.100653