In 2023, South Carolina saw its first year-to-year decline in overdose deaths since 2014. Statewide, overdose deaths fell by 6.1% from 2022, according to a report released Tuesday by the state Department of Public Health (DPH).
In a statement, interim DPH Director Dr. Edward Simmer said, “As we’ve watched the overdose epidemic’s impact across the United States and within our state, DPH and our partners have worked determinedly to build programs and offer resources to curtail substance misuse and prevent overdose deaths in our state.”
Simmer added: “This data reflects our hard work and shows our state heading in the right direction. While we celebrate this achievement, we still have a long way to go in our efforts to reduce drug overdose deaths in our state.”
Overdose deaths dropped in 17 counties. The largest number falloff occurred in Greenville County, where 215 overdose deaths were recorded in 2023 – down from 287 the year before. That represents a 25% decrease.
Percentagewise, the largest decreases occurred in Greenwood and Union Counties, which saw drops of 40.5% and 30.3%, respectively.
On the other side of the issue, the rate of opioid deaths in 15 counties, per capita, exceeded the statewide average of 41 overdose deaths per 100,000 residents. The highest rate occurred in Jasper County, which recorded 118 deaths per 100,000 residents in 2023.
Most deaths statewide were attributed to prescription drugs, even though the number of these deaths dropped.
Deaths from opioids, synthetic or otherwise, however, increased and were barely second-place to prescription-related overdoses.
“Drug overdoses by unintentional intent continue to represent the highest percentage of drug overdose deaths (95.6%) in 2023,” the report stated.
Counties that did see a rise in overdose deaths in particular saw an uptick in fentanyl-related overdoses and deaths connected to designer drug cocktails.
In Chesterfield County, overdose deaths doubled to 22 in 2023. Karen Short, the county’s Opioid Abatement Coalition Director at Alpha Behavioral Health, said drug mixtures factored heavily in the numbers the county saw.
“Toxicology screens from last year and year before showed methamphetamines, cocaine mixtures, fentanyl, xylazine, and an illicit substance combination referred to as Gray Death.
Gray Death is a cocktail of opiate drugs – mainly synthetic opioids and other synthetic narcotics, according to a 2023 report in the Annals of Medicine & Surgery – that is often fatal in even small doses.
Such cocktails have given Chesterfield County an unwelcomed distinction – group overdose deaths in 2023 and 2024, Short said.
“We had been a little protected from [the presence of designer drug mixes] prior to 2023,” she said. “Then in the summer of 2023, we did have an overdose spike that resulted in almost four deaths.”
Three people died within 48 hours – all their overdoses linked to the same batch of drugs – while a fourth person who was not expected to recover did recover, Short said.
But then, it happened again in 2024, only worse.
“Early in the summer, we had the same thing happen, where we had the presence of fentanyl and xylazine mixture that caused an overdose spike resulting in four individuals dying within a 48-hour period,” she said.
No other county in the region has seen that many overdose deaths in so short a window in recent years.
Short said that given the county’s recent history of deadly spikes, Alpha Behavioral Health – Chesterfield’s county substance abuse and addiction treatment center – is “really trying to ramp up getting supplies and Narcan and testing strips out prior to this summer, just trying to head off any other occurrence of a big spike like that.”
White men made up 57% of overdose deaths from psychostimulants – ADHD medication, for example – and the largest shares of cocaine- and opioid-related overdoses in 2023.
The only age group to see an increase in opioid-involved deaths in 2023 was ages 55 to 64, which increased from 274 in 2022 to 281. Opioid-involved deaths dropped the most among ages 18 to 34.
