New 'Wave' Of Heroin Epidemic Hits New Jersey Suburbs



A "second wave" of heroin abuse's effects has hit New Jersey, impacting young suburban users, according to a report.

A newly released Centers for Disease Control and Prevention (CDC) report says two out of every five suburban heroin users in New Jersey are likely to be infected with hepatitis C - a virus, or infection, that causes liver disease and inflammation of the liver.

"Hepatitis C virus (HCV) infection is a major public health issue," according to the report, entitled "Linkage to Care for Suburban Heroin Users with Hepatitis C Virus Infection, New Jersey, USA."

"Although persons born during 1946– 1964 represent most of the population with chronic HCV infection, young persons, those 17–35 years of age, who inject heroin now make up the second wave of HCV infection," according to the report.

The study derived its results from the Princeton House, a psychiatric facility in suburban New Jersey with an active opioid detoxification program that instituted a new HCV screening program from Oct. 1, 2014 through June 9, 2015.

As part of the standard of care, patients admitted for heroin detoxification were tested for HIV, HCV, and hepatitis B virus infections, according to the report.

"We identified a 41.4 percent prevalence of hepatitis C virus, absence of HIV, and unexpectedly high frequency of hepatitis C virus genotype 3 among suburban New Jersey heroin users 17–35 years of age during 2014–2015," according to the report.

"Despite two clinicians prepared to engage these users, few were successfully linked to care and treated," according to the report.

The Princeton House study was conducted after the incidence of acute HCV infections increased significantly among young people in non-urban areas of the United States between 2006 and 2012, according to the report.

Among those, a 13 percent annual increase of acute HCV infection was reported in non-urban counties, a 170 percent increase over the course of 6 years, according to the report.

Young suburban heroin users have been described as the "second wave" of HCV infection in several U.S. states, including Massachusetts and New York. New Jersey was not part of those initial reports.

"Our objective was to characterize HCV infection among young suburban heroin users in New Jersey and to evaluate linkage to care among this population," according to the report.

At the Princeton House, a total of 861 patients from 10 of 21 New Jersey counties were tested for the HCV antibody. Here were the results:

  • 374 (43.4 percent) tested positive.
  • Most (573 [66.6 percent]) patients were 17–35 years of age.
  • Of those, 237 (41.4 percent) were HCV antibody positive.
  • From this population, 187 patients were further evaluated; 50 patients refused evaluation or were discharged before evaluation.
  • Women constituted 52.4 percent.
  • Races and ethnicities were 173 non-Hispanic white, 2 non-Hispanic black, 4 Hispanic, and 8 "other."

"That most patients were women (52.4 percent) and non-Hispanic white (92.5 percent) probably reflects the demographic of persons seeking detoxification from heroin and coincides with demographics of other reports of young non-urban (drug users) in the United Sates," according to the report.

To achieve success similar to that of HIV treatment with drug users, the report says, a coordinated program that includes committed case management services to help drug users is likely to be needed.

"Further study to explore this and the ability to successfully treat this population is crucial to address the national HCV infection epidemic," according to the report.