Berkeley County combats surging opioid overdose death rate
When one pictures a heroin addict, the image that typically comes to mind is one of a sketchy person in a dark alley or broken-down apartment using a needle to inject the drug into their body.
This stereotypical picture of what an addict looks like can be attributed to popular media, explained Jason Sandoval, the Drug Enforcement Agency Agent in Charge for the Charleston area, but this is no longer the case.
“It really affects almost everyone today and Charleston and the Lowcountry are not immune,” said Sandoval. “I went to the County Coroner of Charleston in June of 2016 and I asked her if she could help me quantify heroin and opioid overdose deaths. I did the same thing indirectly in Berkeley and Dorchester. When I got the numbers, it shocked me to my core just how acute the problem was here.”
In 2016, Sandoval continued, Charleston County was 50 to 70 percent higher than the national average of opioid overdose deaths per 100,000 and Berkeley County - a shocking 200 percent higher.
“For historical perspective, in the mid-70s, we had in the U.S. an opioid crisis,” he said. “…The opioid crisis in the 70s barely crested 1.5 deaths per 100,000 and the crack cocaine epidemic barely crested 3 per 100,000. In 2016, the opioid and heroin epidemic that we’re currently experiencing was approximately 11 deaths per 100,000.”
In Berkeley County alone, the Sheriff’s Office was dispatched to 203 overdose calls in 2016, according to Sheriff Duane Lewis. Between the Sheriff’s Office and Berkeley County EMS, there were 448 total overdose calls in the county.
“People get on pain medicine and then they’re not able to control it or get relief from it, so they need more pain relief, so they end up going to heroin,” said Lewis. “It’s cheaper and easier to get…That’s why we tell people it touches all aspects of society.”
As for why the overdose death rate in Berkeley is so high, Sandoval believes the situation is likely symptomatic of the larger national epidemic.
“Communities that traditionally would have never expected to have a drug problem, like a largely rural low population density county such as Berkeley, never had a need to analyze metrics related to the drug use and abuse,” he said. “When they did, it was a wakeup call as has occurred in many regions across the country.”
To address the local opioid crisis, the BCSO is actively working with the DEA on enforcement efforts and now has a deputy assigned to the DEA task force.
“We’re targeting not just the dealers but the users as well in hopes that they can try to get some type of medical help for their addiction,” said Lewis. “I’d like to see that. The Sheriff’s Office Narcotics Unit is targeting these heroin dealers.”
The heroin and opioid epidemic, explained Sandoval, can be directly linked to prescribing practices that began in the 1990s and continue today.
“We created a fifth vital sign, which was a patient’s subjective analysis of his or her own pain,” said Sandoval. “Because of that, we had prescription drugs prescribed like they never have been prescribed before. Anytime someone is dealing with prescription drugs, whether it’s for a legitimate pain or an ailment of some sort, there’s a calculus probably in everybody’s mind that says the pharmaceutical industry produced it, the doctor prescribed it, the pharmacist dispensed it, so it must be safe. They think they have circumvented the rules and can party and get high and it’s safe because it’s sitting in a medicine bottle and not coming from a mean drug dealer in a dark corner.”
To aid in combatting this deadly problem, county law enforcement and the local DEA are working together, explained Sandoval. Just this past October, the DEA, in partnership with local law enforcement, arrested 57 individuals involved in heroin and opioid distribution in the area.
“It was a nine-month undercover operation,” said Sandoval. “We had undercover agents and informants all over the tri-county, from local narcotics departments to the DEA office to some other federal agencies. We went out and identified high-volume, local retail dealers and some wholesalers.”
Even more shocking, continued Sandoval, is what the undercover agents discovered during this operation: Pure heroin is nearly impossible to find anymore. Instead, dealers are selling the extremely dangerous and potent substance fentanyl.
“Every time we went in and bought heroin or tried to buy heroin, it would come back from the lab laced with fentanyl, carfentanil or ‘Pink,’” said Sandoval. “A couple of occasions during these undercover operations, the dealer actually said, ‘I don’t have any heroin, but I have fentanyl.’ It’s actually hard to find pure heroin anymore. It’s all laced with or actually fentanyl.”
According to Lewis, the use of this dangerous and cheaper alternative can be directly linked to the high number of overdose deaths, both nationally and locally.
“What we’re seeing is the heroin is being laced by fentanyl to make it more potent, which is really why we’re seeing the deaths occurring,” said Lewis. “Drug overdoses caused more deaths in 2016 than firearms and vehicle crashes in the US.”
Tackling this epidemic is going to take much more than just efforts made by law enforcement, added Sandoval. Creating a counter narrative about drug abuse, education and activism are all key to reducing the use and abuse of prescription opioids and heroin.
“I think the solution truly is holistic,” said Sandoval. “Law enforcement doesn’t have the whole solution. We are one voice and one actor in this play. As the head of the DEA, I’m out in public all the time talking to anybody who will listen… I try to identify other organizations or individuals who are interested in this problem and interested in helping with this problem so that we can have a broad coalition of people talking about it…I think something that is important is that we are embracing the idea of being more out in public, more out in front, and are influencing the community to create that counter narrative.”
On Monday, Dec. 18, Governor Henry McMaster declared a public health emergency in South Carolina for the opioid epidemic and announced a comprehensive, statewide response to the ongoing crisis.
Governor McMaster issued two executive orders, the first of which established an “Opioid Emergency Response Team,” led by State Law Enforcement Division (SLED) Chief Mark Keel and Department of Alcohol and Other Drug Services Interim Director Sara Goldsby. The team’s first meeting was held on Dec. 19.
“The opioid crisis is one that has invaded so many aspects of the lives of South Carolinians and of families across the country,” said McMaster, in a press release. “We are confident that if there is a group capable of combating this problem, providing treatment for those affected, and bringing about tangible results that will change lives, it’s this group of dedicated, talented individuals that we have been able to put together.”
The other executive order directs the S.C. Department of Health and Human Services to limit initial opioid prescriptions for acute and post-operative pain to a maximum of five days for state Medicaid recipients. At the governor’s request, the state Public Employee Benefit Authority (PEBA) has agreed to enact similar limits for participants in the State Health Plan, stated the release. The governor has also asked that the General Assembly pass legislation making the five-day limitation state law for all initial opioid prescriptions.