Definition

Deaths with unintentional poisoning by and exposure to noxious substances as the underlying cause of death. '''''This includes, but is not limited to, opioids and other drugs.'''''[[br]] ICD-10 codes: X40-X49 (includes poisoning by legal and illegal drugs, alcohol, gases and vapors such as carbon monoxide and automobile exhaust, pesticides, and other chemicals and noxious substances)

Numerator

Number of deaths due to unintentional poisoning

Denominator

Total number of persons in the population

Why Is This Important?

Every day in the U.S., an average of 240 people die as a result of unintentional poisoning and 4,900 others are treated in emergency departments (2020 data).[http://www.cdc.gov/injury/wisqars/index.html ^1^] Unintentional poisoning deaths in the United States increased nearly sevenfold between 2000 and 2020.[https://wonder.cdc.gov/ucd-icd10.html ^2^]

Healthy People Objective: Prevent an increase in the rate of poisoning deaths: Unintentional or undetermined intent among all persons

U.S. Target: 11.1 deaths per 100,000 population
State Target: is not comparable because it does not include poisoning deaths of undetermined intent

Other Objectives

'''Healthy New Jersey 2020 Objective IVP-6''': Reduce the age-adjusted death rate due to unintentional poisoning to 6.8 in the total population, 8.6 among Whites and Blacks, and 3.1 among Hispanics.

How Are We Doing?

In approximately 96% of unintentional poisoning deaths nationally and 97% in New Jersey, drugs are the poison. This includes unintentional overdose, wrong drug given or taken in error, drug taken inadvertently, and mistakes in the use of drugs in medical and surgical procedures. Not included are cases where the correct drug was properly administered but had an unforeseen adverse effect such as an allergic reaction. There are a handful of alcohol poisoning and carbon monoxide poisoning deaths each year and even fewer due to exposure to other noxious substances.

How Do We Compare With the U.S.?

The unintentional poisoning death rate among New Jersey residents is 19% above that of the U.S. population as a whole.

What Is Being Done?

The [https://nj.gov/humanservices/dmhas/home/ Division of Mental Health and Addiction Services] promotes the prevention and treatment of substance disorders and supports the recovery of individuals affected by substance use disorder (SUD). The 2013 [http://www.njleg.state.nj.us/2012/Bills/PL13/46_.HTM Overdose Prevention Act] (P.L. 2013, c.46) provides immunity from liability and professional discipline to health care professionals who prescribe, dispense, or administer naloxone (or any similarly acting and approved drug) in an emergency to an individual who the person believes is experiencing an opioid overdose. The Act also contains Good Samaritan provisions, which provide immunity from arrest and prosecution for drug possession to those non-health professional individuals who call 911 for suspected overdoses, and makes naloxone available to family members who could be taught to administer the drug in case of an emergency. The Health Commissioner expanded the scope of practice for Emergency Medical Technicians in 2014 to allow for the administration of [http://www.nj.gov/health/ems/ems-toolbox/ naloxone] in cases of life threatening opioid overdoses. The same year, the Governor established a program to train and equip police officers to administer naloxone. A 2015 law expanding the scope of the NJ Prescription Monitoring Program (NJPMP) requires all physicians and pharmacists practicing in NJ to register for access and mandates physicians to check the NJPMP when patients return for refills on opioid medications. A 2017 law ([http://www.njleg.state.nj.us/2016/Bills/PL17/28_.HTM P.L. 2017, c.28]) set a five-day limit on initial prescriptions for opioids (reduced from seven days) and mandates that insurance companies accept those facing drug addiction into treatment for up to six months and without the need for prior coverage authorization. In 2016, NJDOH was awarded a CDC grant for [https://www.cdc.gov/drugoverdose/foa/ddpi.html Prescription Drug Overdose: Data-Driven Prevention Initiative] (DDPI), with funding used to advance data collection and analysis, and to evaluate state-level actions that address opioid misuse, abuse, and overdose. The [https://www.state.nj.us/health/populationhealth/opioid/ NJ Overdose Data Dashboard] was developed under this project. In 2017, the NJDOH was awarded CDC funds for [https://www.cdc.gov/drugoverdose/foa/state-opioid-mm.html Enhanced State Opioid Overdose Surveillance] (ESOOS), which leveraged the existing National Violent Death Reporting System data platform to collect additional toxicology, situation, and death scene data on fatal overdoses. In 2019, these programs were folded into CDC's [https://www.cdc.gov/drugoverdose/od2a/index.html Overdose Data to Action] (OD2A), a cooperative agreement supporting 66 state, county, and local jurisdictions to use data to track and understand the complex nature of drug overdoses, and stresses data integration in developing and implementing effective overdose prevention programs. Since 2018, the Governor's Office has focused on inter-departmental strategies that include increasing access to treatment and harm-reduction resources, enhancing recovery support systems, implementing law enforcement strategies targeting the supply of illicit drugs, and strengthening systems and data infrastructure. In addition to NJDOH, other departments involved in these efforts include Department of Human Services, Department of Children and Families, Department of Labor, Office of the Attorney General, Division of Consumer Affairs, and Department of Corrections. Information on programs and policies implemented by state agencies or signed into law under this approach is included in [https://www-doh.state.nj.us/doh-shad/indicator/other_resources/PoisoningDth.html Other Resources] or as part of the [https://www-doh.state.nj.us/doh-shad/topic/SubstanceUse.html Substance Abuse Topic].

Available Services

NJ Division of Mental Health and Addiction Services: [https://nj.gov/humanservices/dmhas/home/] Get free naloxone at these pharmacies: [https://nj.gov/humanservices/stopoverdoses/] Poison Control: [http://www.njpies.org/] or 1-800-222-1222

Health Program Information

The Center for Health Statistics is a central source for injury statistics, including unintentional poisoning. Available data include emergency department data, inpatient hospitalization data, and mortality data: [http://www.state.nj.us/health/chs/njvdrs/] NJDOH Patient Safety Reporting System: [http://www.nj.gov/health/healthcarequality/health-care-professionals/patient-safety-reporting-system/] NJDOH Environmental Public Health Tracking Program, Carbon Monoxide: [http://www.nj.gov/health/ceohs/public-health-tracking/human-exposure/#1]

Data Notes

The Healthy People 2020 objective is for poisoning deaths caused by unintentional or undetermined intent and therefore is not comparable to the HNJ2020 objective. U.S. data shown are for unintentional poisoning only. This is Healthy New Jersey 2020 (HNJ2020) Objective IVP-6.

Data Notes

This is Healthy New Jersey 2020 (HNJ2020) Objective IVP-6. Data for White, Black, and Asian do not include Hispanics. Hispanic ethnicity includes persons of any race. **Too few deaths to calculate a reliable rate.

Data Notes

Data for White, Black, and Asian do not include Hispanics. Hispanic ethnicity includes persons of any race.

Data Notes

** The number of deaths in Hunterdon County is too small to calculate a reliable rate.

References and Community Resources

1. WISQARS, 2020 fatal and non-fatal injury data: [http://www.cdc.gov/injury/wisqars/index.html] 2. CDC WONDER, 2000 and 2020 unintentional poisoning mortality: [https://wonder.cdc.gov/ucd-icd10.html] Additional information: *CDC National Center for Environmental Health: [https://www.cdc.gov/co/ Carbon Monoxide Poisoning] *CDC National Center for Injury Prevention and Control: [https://www.cdc.gov/drugoverdose/ Drug Overdose] *CDC National Center for Injury Prevention and Control [https://www.cdc.gov/drugoverdose/od2a/index.html Overdose Data to Action (OD2A)] *[https://www.nj.gov/health/populationhealth/opioid/ NJ Overdose Data Dashboard] *[https://www.njoag.gov/programs/nj-cares/ NJCARES Opioid-Related Data and Information] *[https://www.njoag.gov/programs/nj-cares/operation-helping-hand/ NJ Operation Helping Hand] *[https://gcada.nj.gov/home/ NJ Governor's Council on Alcoholism and Drug Abuse] *[http://www.nj.gov/health/ems/ems-toolbox/ NJDOH Naloxone (Narcan) Program] *[https://www.state.nj.us/health/ems/trauma-informed_care/patient_focused_tic/ NJDOH Five Minutes to Help] *[https://www.state.nj.us/humanservices/dmahs/home/Comprehensive_Demonstration_Implementation_Protocol_OUD-SUD_Program.pdf NJDHS SUD Waiver Program] allows federal matching funds to be used for expanding substance use disorder treatment services *[https://www.nj.gov/health/integratedhealth/home/naloxone.shtml NJDOH Standing Order Program - Naloxone] *[https://www.nj.gov/labor/career-services/special-services/opioid-impacted/ NJDOL Pathways to Recovery] program *[https://www.njconsumeraffairs.gov/meddrop/Pages/default.aspx NJOAG/Division of Consumer Affairs Project Medicine Drop] In 2022, the Governor announced that New Jersey is set to receive $641 million from settlements with an opioid manufacturer and the country's 3 largest pharmaceutical distributors. Paid through 2038, the funds will support state and local programs focused on treatment, prevention, and other strategies to address the opioid issue in New Jersey. [https://www.nj.gov/governor/news/news/562022/20220311a.shtml] *[https://pub.njleg.gov/bills/2004/PL04/9_.pdf NJ Patient Safety Act (P.L. 2004, c. 9)] *[https://pub.njleg.gov/bills/2012/PL13/46_.pdf NJ Overdose Prevention Act (P.L. 2013, c. 46)] *[https://pub.njleg.gov/bills/2016/PL17/28_.pdf NJ Substance Abuse Disorder Law (P.L. 2017, c. 28)] *[https://pub.njleg.state.nj.us/Bills/2020/PL21/54_.PDF NJ Senate Bill No. 2323 (P.L. 2021, c.54)] : Prescribers required to co-prescribe naloxone or another opioid antidote for patients receiving high doses of opioids or certain drug combinations *[https://pub.njleg.state.nj.us/Bills/2020/PL21/152_.PDF NJ Senate Bill No. 3491 (P.L. 2021, c.152)]: Allow paramedics to carry and administer buprenorphine to treat acute opioid withdrawal symptoms after naloxone reversal *[https://pub.njleg.state.nj.us/Bills/2020/PL21/157_.PDF NJ Assembly Bill No. 5703 (P.L. 2021, c.157)]: Waiver of prior authorization requirements for medication-assisted treatment (MAT) *[https://pub.njleg.state.nj.us/Bills/2020/PL21/396_.PDF NJ Sente Bill No. 3009 (P.L. 2021, c.396)]: Expansion of Harm Reduction services to provide sterile syringes and additional support services to persons who use drugs intravenously *[https://pub.njleg.state.nj.us/Bills/2020/PL21/430_.PDF NJ Assembly Bill No. 798 (P.L. 2021, c.430)]: Establishes County and Local Overdose Fatality Review Teams (OFRTs)