The Other Pandemic

With nationwide deaths now exceeding 350,000 as of Jan. 1, the coronavirus (COVID-19) has eclipsed our country’s other pandemic – drug overdose fatalities. 

 

In 2019, a record number of 70,980 individuals died from drug overdoses, a 4.8% increase from 2018. By comparison, approximately 58,000 soldiers died during the entire Vietnam War. The number also beats yearly records for nationwide fatalities caused by car accidents, gun violence, and the HIV/AIDS epidemic. It also exceeded deaths caused by both prostate and breast cancer in 2019.       

 

Recently, the South Carolina Department of Health and Environmental Control (DHEC) published its annual report detailing the number of overdose deaths that occurred in the state of South Carolina during 2019. The report shows that South Carolina experienced approximately 1,131 total overdose deaths from all drugs, a 2.5% increase from the 1,103 in 2018.  

 

While the number of total overdose deaths from all drugs rose 2.5% in 2019, the number represents an improvement from the jump that occurred between 2017 and 2018, which went from 1,001 to 1,103, or 10.2%. Since 2015, South Carolina has seen a 43.3% increase in total overdose deaths, jumping from 789 to 1,131. Deaths due to certain type drugs still remain, or have emerged, as being problematic. 

 

As illustrated in the DHEC report, an overdose fatality often involves multiple types of drugs, and each was reflected separately in the data corresponding to an individual death. Of the 1,131 total overdose deaths in 2019, DHEC reported that 923 involved prescription drugs, 876 involved opioids, 537 involved fentanyl, 196 involved heroin, 230 involved cocaine, and 338 involved psychostimulants. This last group includes such drugs as methamphetamine, amphetamine, methylphenidate (Ritalin), and 3,4-

methylenedioxymethamphetamine (MDMA, a.k.a., ecstasy).

 

While at a slightly slower pace than reported for 2018, overdose deaths involving opioids continue to rise in South Carolina. In 2019, opioid involved overdose deaths jumped from 816 to 876, an increase of 7.3% from the preceding year. 

 

The number of opioid involved deaths was highest in the following counties of South Carolina: Horry (131); Charleston (107); Greenville (102); Spartanburg (55); and Richland (52). Horry County observed a 54% increase in opioid involved deaths, the highest in the

state, going from 85 in 2018 to 131 in 2019.

 

In 2019 there were 6,989 naloxone administrations by EMS, an approximate 11.2% increase from the 6,285 administered doses in 2018. Naloxone (sold under the brand name Narcan among others) is an antidote medicine used to reverse and counter the effects of opioids in an overdose event. Since 2015, there has been an approximate 41.6% increase in naloxone administrations, jumping from 4,933 to 6,989. These naloxone administration numbers do not reflect private third-party administrations not made by EMS or law enforcement. 

 

While reporting for the 2020 overdose fatalities will not be available until sometime later this year (usually summertime), the number of naloxone administrations by first responders for the year were up drastically, believed to be associated with a host of negative impacts caused by COVID-19. For instance, in May 2020, EMS responded to an estimated 915 suspected opioid overdoses in South Carolina, the highest monthly number in the state’s history, and nearly twice that reported for May 2019. Anecdotal evidence suggests that this unfortunate trend is directly related to the negative impacts of COVID-19, including greater unemployment levels, isolation from others, and reduction of in-person treatment and recovery options, all of which is believed to be resulting in greater

drug use by those suffering from substance use disorder.      

 

Particularly problematic were overdose deaths involving psychostimulants and fentanyl. For instance, overdose deaths in 2019 involving psychostimulants jumped 39.6%, going from 242 to 338. Likewise, fentanyl involved deaths grew 16.7%, going from 460 to 537. Overdose deaths involving prescription drugs jumped approximately 6.9%, going from 863 to 923 during 2019. Cocaine related overdose death saw a decline of approximately 9.4%, dropping from 254 in 2018 to 230 in 2019.

 

In 2019, the highest number of opioid involved deaths was in the age group of 35-44, with 228 total deaths. Closely behind was the age group of 25-34, with 222 total opioid involved deaths. White males accounted for 55% of the total of opioid involved deaths.

 

Comprehensive and accurate overdose and drug mortality data remains critical to formulating pragmatic strategies to battle this continuing public health emergency, and is becoming more accurate with each passing year. Government and community coalitions are using this improved data to navigate successful campaigns against the overdose epidemic. 

 

Since December 2017, under the leadership of Gov. Henry McMaster, the South Carolina Opioid Emergency Response Team (SCOERT) is leading the effort to quell overdose deaths in the state. The SCOERT is comprised of representatives from more than two dozen state and local agencies with expertise in substance use disorders, treatment and recovery, public health, emergency response, and law enforcement. 

 

Likewise, during the spring of 2019, United States District Court Judge Bruce Howe Hendricks joined forces with Gil Kerlikowske, former director of the Office of National Drug Control Policy (i.e., Drug Czar) under President Obama, to spearhead the creation of the

Addiction Crisis Task Force (ACT Force), a local coalition that works collectively to reduce the number of overdose deaths in Charleston. 

 

Both the SCOERT and ACT Force were created to develop and implement effective strategies to combat the opioid crisis and reduce overdose deaths through collaborative sharing of information, resources and expertise. Some such measures include improving on the effectiveness of law enforcement response and strategy, increasing access to treatment and recovery services, reducing the stigmatism commonly associated with drug addiction, offering evidence-based drug awareness and prevention educational programs, decreasing the amount of unneeded prescription medications in homes, and supporting drug courts that facilitate rehabilitative treatment options instead of merely imposing incarceration sanctions for first-time drug offenders with substance use disorders. Central to both their missions is the bridging of communication gaps that traditionally exist between the various entities that are dealing with the problem. 

 

As many other areas of the country have observed, the successful elimination of opioid addiction and its unfortunate consequences depends greatly on community engagement. Working collaboratively with governmental stakeholders, including public health and public safety entities, a united front and consistent message will serve as a force multiplier in achieving the goal of reducing the number of overdose deaths. 

 

As McMaster recently declared while recognizing the achievements of the SCOERT’s work, “There is still much work to be done in combating the growing epidemic of opioid misuse and addiction.”

 

Doug Treasurer is a Daniel Island resident and intelligence analyst with the High Intensity Drug Trafficking Area (HIDTA) program in Charleston.