More safe syringe sites needed to reduce infections from injecting drugs, study says

A new study finds that skin and soft tissue infections from drug injections resulted in thousands of hospitalizations, killed hundreds of people, and cost more than $1 billion in hospital charges in New Jersey in 2019.

Researchers with the New Jersey Harm Reduction Coalition said their findings show why it’s important for the state to expand safe syringe sites statewide. There are only seven around the state now.

“We should be fully funding and implementing accessible syringe programs in every corner of the Garden State,” said Michael Enich, the report’s primary author and a coalition trustee.

State officials should also report injection-related infection data, which is as important a measure of public health as the data on overdose fatalities, substance use treatment, viral hepatitis, and Narcan administrations the Department of Health now publicly reports, Enich added.

A state Department of Health spokeswoman did not respond to a request for comment.

The study finds:

• 283 people died from severe bacterial infections associated with injecting drugs in 2019, while hospitals reported 1,967 emergency room visits and 7,310 hospitalizations of people with such infections.
• Such infections cost more than $1 billion in hospital charges, with a median charge of $74,406 per hospitalization. That’s enough to fund at least two safe syringe programs in every New Jersey municipality, coalition members said.
• Atlantic, Camden, Cumberland, Mercer, and Salem counties reported the highest rates of these hospitalizations. Most of those hospitalized were men and people ages 30 to 49, with Black and low-income people disproportionately impacted.
• Bacteremia/sepsis was the most common infection resulting in a hospital stay, but endocarditis was the costliest.

Dr. Amesika Nyaku, one of the report’s authors, is an assistant professor of infectious diseases at Rutgers New Jersey Medical School.

“It is crucial for us to not only have transparency as we’re looking at the numbers and trends moving forward in New Jersey, but also have a keen eye to closing these disparities, because there should not be these differential outcomes according to people’s income, according to their race and ethnicity, according to gender, or according to their age,” Nyaku said.

Jenna Mellor, the coalition’s executive director, applauded measures now before legislators that would expand harm reduction services. Those include a bill that would allocate $15 million to expand access to safe needle programs, another that would decriminalize syringe possession, and another that would require pharmacies to sell syringes to adult customers without a prescription.

But she and other coalition members also called on policymakers to decriminalize drug possession and use, because people are less likely to seek treatment when addiction is treated as a crime rather than a chronic health condition.

Health care providers — especially first responders and emergency providers — should get more training to reduce the stigma associated with drug use, which also dissuades users from seeking help, coalition members said. They recommended that hospitals offer medication-assisted addiction treatment and connect patients with safe syringe services.

Because getting rid of needles altogether would eliminate the threat of infections from injecting drugs, the coalition also urged policymakers to provide funding for harm reduction programs to provide supplies to drug users who smoke or snort drugs, supplies like straws for one-time use, sterile razors, alcohol prep pads, and new pipes and filters.

“These infections are preventable, and by thinking meaningfully about how we can ensure a safe supply of sterile syringes, we can make sure that no other New Jerseyan dies of a severe bacterial infection,” Enich said.