South Carolina hit hard by the opioid pandemic
In August of 2019, the South Carolina Department of Health and Environmental Control (DHEC) published information detailing the number of overdose deaths that occurred in the State of South Carolina in 2018. Regrettably, overdose deaths in South Carolina continued to rise at a disturbing rate, especially those associated with the opioid pandemic. Statewide, overdose deaths involving opioids jumped from 748 in 2017 to 816 in 2018, an increase of 9.1%.
Reporting indicates that South Carolina experienced approximately 1,103 total overdose deaths (all drugs) in 2018, a 10.2% increase from the preceding year. Since 2014, South Carolina has seen a 53.6% increase in total overdose deaths, jumping from 718 to 1,103. During the same timeframe, opioid-involved overdose deaths in the state rose from 508 to 816, an approximate 60.6%.
While a single overdose death often includes more than one category of drug, and can be included within multiple reporting categories, the DHEC report indicated that of the 1,103 total overdose deaths, 863 involved prescription drugs, 816 involved opioids, 460 involved fentanyl, 168 involved heroin, 254 involved cocaine, and 242 involved psychostimulants. This last group includes such drugs as methamphetamine, amphetamine, methylphenidate (Ritalin), and 3, 4-methylenedioxymethamphetamine (MDMA; a.k.a. ecstasy and molly).
In 2018, the number of opioid-involved deaths was highest in the following counties of South Carolina: Greenville (131); Charleston (100); Horry (85); Spartanburg (56); and Richland (51). Greenville County observed a 79.5% increase in opioid-involved deaths, the highest in the state, jumping from 73 in 2017 to 131 in 2018. The highest number of opioid-involved deaths was in the age group of 25 to 34, with 203 total deaths. Closely behind was the age group of 35 to 44, with 202 total opioid-involved deaths. White males accounted for most of the opioid-involved deaths, tallying 54% of the total.
Naloxone, an opioid antagonist, was reported by DHEC to have been administered 8,102 times in 2018, an approximate 110% increase from the 3,847 administrations in 2013.
Comprehensive and accurate overdose data remains critical to formulating pragmatic strategies to battle this continuing public health emergency. Thankfully, the timeliness and quality of drug mortality data is improving. Information sharing among all governmental entities that deal with the dilemma is vital to addressing the opioid and overdose epidemic. Fortunately, in response to the crisis, data is becoming increasingly more detailed and precise, thereby permitting for more targeted and successful approaches.
In December of 2017, Governor Henry McMaster issued an executive order creating the South Carolina Opioid Emergency Response Team (SCOERT) to address the opioid crisis, something he declared to be a public health emergency. 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. The team was created to collaboratively develop an effective strategic plan to combat the opioid crisis through the sharing of information, resources and expertise.
In June of 2018, the governor announced that the SCOERT had created the South Carolina Opioid Emergency Response Plan (SCOERP). Addressing the opioid crisis, the plan emphasizes coordinated efforts in four major areas, including: education and communication; prevention and response; treatment and recovery; and coordinated law enforcement strategies. The SCOERP begins with basic guidance for how stakeholders should work collectively to combat the opioid epidemic in South Carolina. Regarding its adaptable feature, the Governor declared, “This plan is a living, breathing document that we will add to and amend as we encounter new issues and achieve successes …”
In January of 2019, as part of a SCOERP progress report, it was announced that the SCOERT had created an opioid data dashboard, which is now displayed on the South Carolina Department of Alcohol and Other Drug Abuse Services education website (www.justplainkillers.com). The interactive dashboard includes local-level data, downloadable factsheets, statistical reports, and drug prevention resource information.
The SCOERP progress report also noted that, as of January 2019, 7,920 law enforcement officers from 190 different departments across 44 of South Carolina’s 46 counties have been trained in the administration of naloxone. These law enforcement strategic efforts have been credited with 619 overdose reversals and 554 lives saved. Noteworthy progress and increased public awareness continue through the efforts of the SCOERT.
Likewise, during the spring of 2019, due to South Carolina’s continuing overdose death trend, U.S. 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), to spearhead the creation of the Addiction Crisis Task Force (ACT Force) in Charleston. For nearly a decade, Judge Hendricks has overseen one of the nation’s first federal drug courts, and is keenly aware of the local overdose crisis. As the 2018 DHEC data illustrated, Charleston also observed a 6.1% increase in opioid-involved deaths, rising to 100 from the 94 reported in 2017.
The ACT Force is an assembly of the highest ranking local law enforcement officials and their supervisory staff, drug treatment providers, mental health professionals, first responders, physicians, pharmacists, education experts, drug intelligence analysts, drug and family court judges, and citizen volunteers who work collectively to formulate strategies to address the addiction crisis and drug overdose epidemic. Its primary goal is to reduce the number of overdose deaths in Charleston and its surrounding communities.
Emulating successful programs from other regions of the country that are dealing with the same threat and its related consequences, the ACT Force aims to bring together all entities touched by the crisis. As noted in a recent article by The Post and Courier about the task force, “For too long, healthcare professionals and police didn’t share information on opioid abuse. . . [because] of differing missions.” Central to the ACT Force mission is the bridging of communication gaps between the various entities that are dealing with the problem.
Through promoting enhanced communication, the ACT Force seeks to improve the effectiveness of law enforcement strategies and initiatives, increase access to treatment and recovery services, reduce the stigmatism commonly associated with drug addiction, offer evidence-based drug awareness and prevention educational programs, decrease the amount of unneeded prescription medications in homes, and support drug courts that facilitate rehabilitative treatment options instead of merely imposing incarceration sanctions for first time drug offenders with substance use disorders.
As many other areas 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.
Douglas Treasurer is a Daniel Island resident and a Drug Enforcement Administration (DEA) Intel Analyst with the High Intensity Drug Trafficking Area (HIDTA) program in Charleston. HIDTA provides assistance to federal, state, local, and tribal law enforcement agencies operating in areas determined to be critical drug-trafficking regions of the United States. Prior to serving with HIDTA, Treasurer served a full career as a federal agent with the DEA.