In recent years, opioid-involved overdose deaths have been steadily increasing in South Carolina. From 2014 to 2017, the total number of opioid-involved overdose deaths increased by 47%, from 508 to 748 deaths, and the rate increased by 46%, from 10.6 deaths per 100,000 persons to 15.5 deaths per 100,000 persons.

The Prescription Drug Crisis In South Carolina

Over the past five years, deaths caused by opioid overdoses have increased 33 percent. In some states, the increase in opioid overdoses is reaching a nearly 200 percent increase. The Centers for Disease Control and Prevention (CDC) report that 30 states within the country have experienced increases in deaths caused by opioid overdoses, including New Hampshire, Maine, Massachusetts, Connecticut, and North Dakota.

While these states have seen massive rises in the abuse of opioids, South Carolina is currently grappling with the largest heroin death rate in the country at a 57 percent increase between 2014 and 2015. The state is also grappling with a lofty rate of prescription drug overdose rate.

Fentanyl is starting to take center stage within the country, including in South Carolina and the greater Lancaster area. This medication has a hand in the dramatic increase in opioid-related deaths within most recent years in the state.

Fentanyl is a prescription opioid medication that is often used in the treatment of moderate to severe physical pain stemming from a surgery or other form of medical procedure, as well as acute short-term pain. This medication is exceptionally potent, as the National Institute on Drug Abuse (NIDA) reports it to be 50 to 100 times more potent than morphine.

What was once a medication only able to be obtained through a physician's prescription, Fentanyl is now available for illicit purchase on the streets of South Carolina, and is known through nicknames such as Goodfella, China White, and Tango.

In 2017, South Carolina providers wrote 79.3 opioid prescriptions for every 100 persons compared to the average U.S. rate of 58.7 prescriptions for every 100 persons. Overall, this represents a less than 12 percent decline in South Carolina opioid prescriptions, since 2006 (per the CDC).

From 2013 through 2014, the rate of overdose deaths involving opioid prescriptions doubled from 4.0 to 7.8 fatalities per 100,000 persons. Since 2014, however, this rate has remained unchanged overall with 7.1 deaths per 100,000 persons in 2017.

In the year 2017, there were 749 overdose deaths--- involving opioids in South Carolina — a rate of 15.5 deaths per 100,000 persons compared to the national rate of 14.6 deaths per 100,000 persons. The greatest increase in opioid deaths occurred among cases involving synthetic opioids (mainly Fentanyl), with a nine-fold increase from 46 deaths in 2012 to 404 in 2017.

Heroin involved deaths also increased in the same five-year period from 19 deaths in 2012 to 153 in 2017. Overdose deaths involving prescription opioids have remained steady in recent years after a nearly twofold increase from 186 in 2013 to 378 in 2014.

Looking at the breakdown of counties in South Carolina, three major metropolitan areas (Charleston, Greenville, and Richland counties) all saw considerable increases from 2016 to 2017 in opioid-involved deaths. However, Horry County, which has the largest burden of opioid misuse in the state, saw a substantial decrease in opioid-involved overdose deaths (24%, from 101 in 2016 to 77 in 2017).

Efforts around response and prevention, such as an unified task force and coalition, have been implemented in Horry County, which may have contributed to the decline in the overdose death rate.

In 2017, Governor Henry McMaster declared the state's opioid crisis to be a public health emergency and established the state's Opioid Emergency Response Team (OERT).

The SC OERT developed a multilateral strategy to prevent and treat the misuse of prescription opioids and use of illicit opioids in order to strengthen public health, security, safety, and the economic well-being of the citizens of South Carolina.

NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. NAS/ NOWS in South Carolina doubled from 2009 through 2013 from 1.9 to 3.9 cases per 1,000 hospital births (per the CDC).

Of the new HIV cases in 2016, 757 occurred in South Carolina. Among males, 5.9 percent of new HIV cases were attributed to opioid abuse or male-to-male contact and opioid abuse. Among females, 11.5 percent of new HIV cases were attributed to opioid abuse.

In 2015, an estimated 16,425 persons were living with a diagnosed HIV infection in South Carolina — a rate of 394 cases per 100,000 persons. Of those, 14.4 percent of male cases were attributed to opioid abuse or male-to-male contact and opioid abuse. Among females, 14.8 percent were living with HIV attributed to opioid abuse.

There were approximately 10 new cases of acute HCV (0.2 per 100,000 persons) reported in South Carolina in 2016 (CDC).In South Carolina, there are an estimated 36,100 persons living with Hepatitis C (2013-2016 annual average), a rate of 970 cases per 100,000 persons. A significant amount of these cases were linked to opioid and prescription opioid abuse.

Addiction Treatment In South Carolina

The good news is that there are numerous centers of treatment and rehab in place in South Carolina. There are many types of treatment centers such as long term addiction treatment facilities, short term drug abuse treatment, outpatient detoxification programs, outpatient substance abuse treatment services, inpatient drug abuse treatment and others.

There is a wide range of drug and alcohol rehab facilities available. They include individual psychotherapy, dialectical behavior therapy, couple/family therapy, trauma therapy, trauma-related counseling, cognitive/behavior therapy and others, to name a few. If you need rehab in South Carolina, all you need to do is place a call to any of the available rehab centers.

CITATIONS

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs

https://www.dea.gov/resource-center/2016%20NDTA%20Summary.pdf#page=40&zoom=auto,-80,792

https://www.carnevaleassociates.com/our-work/emerging-drug-trends-prevention-issue-brief.html

https://www.dea.gov/sites/default/files/2018-11/DIR-032-18%202018%20NDTA%20final%20low%20resolution.pdf

https://www.getsmartaboutdrugs.gov/news-statistics/emerging-drug-trends

https://www.ncbi.nlm.nih.gov/books/NBK234579/

https://www.shadac.org/publications/50-state-analysis-drug-overdose-trends-evolving-opioid-crisis-across-states