Dirty San Francisco

A discarded syringe is shown with litter before being removed by the San Francisco AIDS Foundation's Syringe Pickup Crew in 2018.  AP Photo/Lorin Eleni Gill 

For the third consecutive year, the number of deaths from opioid overdoses went up in South Carolina.

And for the first time, Charleston County had the most overdose deaths of any county in the state, with 94. Charleston County slides into the worst spot as Horry County appeared to begin to handle its opioid overdose problem.

The new information shows 748 people died from an opioid overdose in 2017, compared with 616 the prior year. Deaths by heroin overdose increased sharply. In 2017, 144 people died of a "heroin-involved overdose," according to a press release from the S.C. Emergency Management Division. The count stood at 57 people in 2014. 

But deaths from the drug fentanyl offered an even darker picture. Overdoses involving fentanyl increased by 432 percent from 2014 to 2017. The new data released Monday shows 362 people died from a fentanyl overdose last year. Men were victims in two-thirds of fentanyl deaths between 2014 and 2016. 

The data is maintained by the S.C. Department of Health and Environmental Control. Information from 2016 is available at justplainkillers.com.

The rise in deaths from illicit drugs is tied to increased supply, according to DHEC. Some of the deaths from heroin and fentanyl may overlap if the person used both drugs.

The governor's Opioid Emergency Response Team released a plan in late June aimed at tackling the epidemic from a range of angles. It involves state agencies, law enforcement officials, health insurance companies, experts and advocates in the field.

"There is still much work to be done," Gov. Henry McMaster said in a statement Monday. "I know we have the right team in place to continue improving the services we provide to those suffering from opioid use disorder.”

Horry County's numbers were a bright spot this year. Though it has "the largest burden of opioid misuse in the state," according to DHEC, deaths in Horry County have decreased since 2016. A number of efforts have been put in place there to confront the epidemic, which may account for improvements.

Horry County had 77 opioid overdose deaths in 2017, down from 101 in 2016. But in most places in the state, the number of overdoses is still rising. They are up in Greenville, Richland and Spartanburg counties.

Deaths from the opioid methadone decreased from 79 in 2014 to 45 in 2017. Though methadone can be abused, with surveillance it is considered a gold-standard treatment for opioid use disorder. The local Charleston Center offers methadone treatments in tandem with therapy. 

Sara Goldsby, director of Department of Alcohol and Other Drug Abuse Services, said in a statement resources for prevention, treatment and recovery have to be supported. The state should also increase the availability of naloxone, a drug often used by law enforcement to reverse an overdose, Goldsby said. 

Reach Mary Katherine Wildeman at 843-937-5594. Follow her on Twitter @mkwildeman.