TWISC: Opioid Crisis Update

This Week in South Carolina host Gavin Jackson sits down with Sara Goldsby, director of South Carolina Alcohol and Other Drug Abuse services, to discuss the ongoing opioid epidemic.


  • 70,000 Americans died from drugs, 47,600 just from opioids in 2017, that’s more than how many died in the Vietnam war.
  • South Carolina has medium of severity of this issue compared to other states
  • Hepatitis C rates jumped up 92% since 2014 in South Carolina whereas HIV cases remained steady
  • Fentanyl is 50-100% more powerful than morphine, just a little bit could kill someone
  • It takes 8 years and and 5 treatment attempts to achieve a single year of drug abstinence

The mortality rate in South Carolina continues to rise with the increase of opioid overdosed from heroin, fentanyl and prescription drugs—which is what fueled the current epidemic. In 2017 alone, 748 South Carolinians died from opioids, 132 more deaths than the previous year.

The increase is, “related to the elicit acetyl fentanyl that is coming into the states from out of the county,” Goldsby said. “The access to that really potent non medical fentanyl is very deadly if even used once.”

The black market of elicit substances is very economic. Goldsby noted that drug dealers and cartels, “pay close attention to the habits of Americans, and as we reduce the access of the prescription drugs that are used and abused, the outsiders have stockpiled elicit substances to fill the gap.”

With the increase in intravenous heroin use, Goldsby notes that certain infectious diesaes are are increasing. “We are in an addiction crisis right now, but we are going to be in a Hepatitis C crisis in 10 years.”

South Carolina is pursuing federal funding right now to get more testing in coordinated care in the places where folks with addiction show up for treatment. This will allow anyone who comes in with a substance disorder to be tested to see if they have an infectious dieses and coordinated to infectious dieses doctors.

The fentanyl crisis that came on the scene in 2013 has greatly increased our death rates. It is the reason the rate of overdose reversal uses has gone up. First responders administered naloxone—which reverses the effects of opioid overdose—7,200 times in 2017.

Goldsby said every death related to overdose is preventable. It is important to recognize who is at risk, and think outside of who we would normally perceive who is at risk.

Congress has been generous giving one-time appropriations to states. South Carolina was eligible to receive the state opioid response grant which was $14 million a year for two years. That funding ends September 2020. “This funding has allowed us to do so much more statewide interims of prevention, intervention, treatment, and recovery. We were able to get access for treatment, supporting community organizations, supporting the department of corrections, getting naloxone available everywhere, and environmental prevention strategies.”

Moving forward:

Goldsby said all states need a long term guarantee with federal support. We need health care providers to address addiction as a medical, treatable, long term chronic dieses. Most importantly people need to understand how to help and prevent others who are going through this addiction. Also, properly disposing of unused medication in your home can help prevent addiction in the first place.

Medically assisted treatment is becoming more widespread and accessible, especially for Medicaid recipents. Additional innovations with treatment pilot project in several coastal hospitals as well as helping newborns addicted to opioids in Greenville are likely to expand.

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