The drug and overdose epidemic continues to rise in South Carolina (SC). In 2021, there were 2,618 drug overdose deaths in SC, which is a 25% rate increase from 2020. Opioid-attributed deaths rose by 25% while fentanyl-attributed deaths rose by 36%. Since 2017, SC has witnessed a 116.6% increase in total drug overdose deaths, a 131.7% increase in opioid overdose deaths, and a 312.7% increase in fentanyl overdose deaths. SC is also experiencing the emergence of the drug xylazine, a non-opioid tranquilizer. Data indicates that drug-related overdose deaths involving xylazine are anticipated to increase by 379% from 2020 to 2021.
The epidemic also creates a heavy burden on the SC healthcare system. In 2021, there were 44,534 total drug overdose-related hospital discharges and 6,248 patients in state-funded drug treatment facilities. Additionally, in 2022 there was an estimated 13,644 Emergency Medical Services (EMS) responses to suspected drug overdoses, with 81% of those estimated being related to opioids. There is now a growing disproportionate burden nationwide among non-Hispanic black men and women as well. From 2017 to 2021, the rate of drug overdose deaths among non-Hispanic blacks increased by 316% in SC.
The continuous increases in drug-related morbidity and mortality reiterates the need for efforts already established through our current funding of the Overdose Data to Action (OD2A) grant (2019-2023). Through OD2A States, the SC Department of Health and Environmental Control (DHEC) will continue and enhance our surveillance and prevention work to affect positive change and support our communities in the fight against the drug epidemic statewide. Over the next 5 years DHEC will enhance surveillance infrastructure by increased staffing throughout the state, continue to collect and analyze syndromic surveillance data, and support the State Drug Overdose Reporting System (SUDORS) for drug mortality surveillance.
The Division of Injury and Substance Abuse Prevention (DISAP) will work with partners from the Prisma Health hospital network, the Prescription Drug Monitoring Program, and DHEC’s Division of Oral Health to support clinician and health system engagement. DISAP will increase public safety partnerships and interventions by continuing our Community Outreach Paramedic Education (COPE) program, providing adverse childhood experiences (ACEs) training to law enforcement, oversight to communities implementing Handle with Care (HWC), and by supporting the Overdose Mapping Application Program (ODMAP). Harm reduction initiatives will be promoted across SC by utilizing peer navigators, creating partnerships with syringe service programs, providing mental health and opioid education to faith-based communities, conducting an environmental scan of available data and services, and working with local health departments to distribute Naloxone and fentanyl test strips. Finally, DISAP will support linkage to care efforts through continuing implementation of the Nurse Family Partnership (NFP) program for at-risk mothers and their children, Youturn Health’s virtual assistance program for people who use drugs (PWUD) and their families, and continuing support of Strengthening Families Program (SFP) and Botvin LifeSkills Training (LST) curriculum at-risk families.
Long-term outcomes of the project include: Decreased fatal and nonfatal drug overdoses; Decreased illicit opioid and stimulant use; Increased uptake of evidence-based treatment and retention with long-term recovery supports; Improved health equity among groups disproportionately affected by the overdose epidemic and those previously underserved by overdose prevention programs and the healthcare system; and Decreased stigma related to substance use and overdose.
