Opioid Crisis Hits Hardest in New Jersey’s Most Vulnerable Communities

The opioid epidemic continues to reshape the public health landscape of New Jersey, but its impact is far from uniform. According to a new study led by Dr. Jamey Lister and his team at the Rutgers School of Social Work, the crisis is hitting the state’s most vulnerable communities with disproportionate intensity, revealing deep-seated inequities in healthcare access and support systems. The research, featured by the Rutgers Brain Health Institute (BHI), provides a data-driven look at how socioeconomic status and geographic location correlate with overdose rates.

What researchers found

Researchers tracked substance use treatment admissions, overdose deaths, and naloxone use across all 21 New Jersey counties from 2014 to 2022. Using the CDC’s Social Vulnerability Index, which accounts for factors like poverty rates, access to transportation, and housing stability, they found that communities with higher social vulnerability consistently experienced worse outcomes on every measure studied.

The study used joinpoint regression analysis to identify trends over time and revealed that while the opioid crisis affected all counties, its impact was distinctly more severe and sustained in socially vulnerable communities.

Key findings at a glance

High vulnerability counties

• Opioid treatment admissions increased sharply between 2014 and 2018
• Overdose death rates peaked higher and continued to rise slightly after 2017
• Naloxone administrations by first responders remained elevated throughout the study period
• Overall rates of treatment need and overdose deaths stayed consistently higher

Low vulnerability counties

• Treatment admissions and naloxone use peaked in 2017–2018, then declined
• Overdose death plateaued after 2017
• Overall burden remained lower throughout the entire period
• Showed statistically significant decreases in later years

The persistent gap

New Jersey has made some progress in addressing the opioid crisis evident by some measures showing declining trends from their peaks around 2017–2019. However, this progress has not been evenly distributed. The counties that had the highest need in 2014 still carried the highest burden in 2022. On several measures, the disparity between high- and low-vulnerability counties remained substantial or even widened.

Why this matters: Simply expanding services statewide isn’t enough. Communities facing greater social challenges need targeted support and resources. Previous research has shown that disadvantaged areas often have less access to treatment services, creating a troubling cycle where the places hit hardest by the crisis have the fewest resources to fight it.

Moving forward: Priorities for addressing disparities

These findings point to several priorities for reducing the unequal impact of the opioid crisis across New Jersey’s communities:

1. Expand treatment access in high-vulnerability counties, particularly medications for opioid use disorder such as buprenorphine and methadone – best practices that have demonstrated superior comparative effectiveness (vs. behavioral treatments and abstinence-based approaches) for preventing opioid-related mortality.
2. Increase naloxone distribution through overdose education and naloxone distribution (OEND) programs, including alternative methods like vending machines and mobile outreach in underserved areas.
3. Integrate addiction services into existing healthcare settings like community health centers to lower barriers to care in communities with limited infrastructure.
4. Use vulnerability data such as Social Vulnerability Index as a planning tool for guiding where new programs and funding should be directed.

Study reference

Cooper, S.E., Fougnies, L.V., Juntilla, A.M., Lister, H.H., Hilton, K., & Lister, J.J. (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, 23, 100653.

Support and treatment resources

If you or someone you care about is struggling with opioid use, help is available

• Find a treatment
• Learn about Narcan
• Crisis hotline: -1-800-662-HELP