We’ve had enough death to last us several lifetimes, but consider this: Last year, as the pandemic raged and fentanyl was everywhere, South Carolina had the distinction of ranking No. 1 in America for growth in drug overdose deaths. We were No. 1.
While states such as West Virginia and Kentucky have long been at the heart of the opioid epidemic, South Carolina saw overdose deaths spike 65% in the first eight months of 2020 compared with a year earlier, according to the Centers for Disease Control and Prevention, allowing us to edge out No. 2 Louisiana by a few percentage points. The CDC estimated the state had 1,625 overdose deaths for the 12 months through September 2020, the latest figures available.
To put that in perspective, South Carolina has more than 400 homicides a year and about 850 suicides, and about 960 people die on the roads annually. Drug overdoses are quieter than murder: Lose a family member to fentanyl, and many people would rather not talk about it. It almost never makes the news.
The endless supply of opioids has turned into a full-fledged epidemic of drug addiction. It began in the 1990s when the pharmaceutical industry falsely told us these pills weren’t addictive. Overdose deaths exploded starting in 2013, when illicitly manufactured fentanyl, a synthetic opioid, flooded the market. The pandemic has supercharged overdoses by leaving the most vulnerable further isolated — fertile ground for deaths of despair.
In Charleston County alone, annual overdose deaths jumped 57% from 2019 to 2020, to a record 180. The increase over five years was 140%, according to the coroner’s office. Charleston police recently warned that fentanyl is turning up in everything from heroin to cocaine to marijuana. It is 30 to 50 times more powerful than heroin; two to three grains (think grains of salt) can kill you. The coroner’s data show the vast majority of opioid deaths involve men and fentanyl.
In March, three guys, ages 19-21, overdosed in a house two doors down from me in the East Side. I watched as they carried two of them out on stretchers at 5:30 in the morning; the third was revived with Narcan. According to the police report, someone had just dropped off what was thought to be cocaine. The three slipped into the bathroom, and 30 seconds after they came out, they were unconscious, witnesses told police. Luckily, everyone survived this time.
“Fentanyl is everywhere,” says Deputy Chief Jack Weiss.
Dr. Joshua Smith, a psychiatrist at the Medical University of South Carolina who specializes in substance abuse, says only a tiny fraction of drug overdoses end in death. One overdose often leads to another, he says. Many of the people he treats know they are going to overdose and plan for it through various strategies, including having Narcan on hand.
The drugs rewire their brains, and they can’t stop even if they want to. “We hear about things that are really deadly, and we move away from it,” Dr. Smith says. “They move toward it. They think it must be really good.”
Greg was up to 15 shots of morphine and as many as 30 pills a day. “I went from one shot to the next to keep from going into withdrawal and getting horribly sick,” he told me. “There was no more high to it. You are barely keeping from getting sick. It got desperate.”
He started using drugs in middle school growing up in Charleston, but his life went completely off the rails after he was injured in a car accident while living in Costa Rica. He started taking pain pills, and the morphine was cheap and available. He overdosed in the bathtub in a failed suicide attempt, one of two near-miss overdoses.
Back home in Charleston, the pattern repeated itself. “People started overdosing all around me,” he said. “People I knew, people I didn’t know. That is when I started to get scared.”
Now, at 47, he has been clean for seven years, thanks to the drug Suboxone and the steadfast support of his parents. “I would not be alive if it wasn’t for them.” He volunteers as a mentor, trying to save the next person.
COVID deaths are falling. Opioid deaths are rising. The opioid crisis is not somewhere else. It is right here. And there is no vaccine in sight to end this deadly epidemic. We can’t afford to look away and think it’s someone else’s problem.
Steve Bailey can be reached at email@example.com. Follow on Twitter @sjbailey1060.