Today, 116 people in America will die from an opioid-related drug overdose. That statistic comes from the U.S. Department of Health and Human Services.
In 2015, four people in Beaufort County died from an opioid overdose, seven died in 2016, and 25 in 2017. So far this year there have been two confirmed opioid-related deaths, according to the county coroner's office.
In 2015, 550 South Carolinians died from a drug overdose that listed a prescription opioid on the death certificate. In 2015, there were 375 homicides. (South Carolina Department of Health and Environmental Control)
At the Lowcountry Alliance for Healthy Youth community forum on the opioid crisis in January, Beaufort County Coroner Ed Allen told the audience, "One death is one too many."
In 2016, state residents received nearly five million opioid prescriptions. That worked out to about one prescription per person for the state's 4.931 million residents that year, and the numbers have not changed. Prescribed opioids include morphine, hydrocodone, oxycodone, methadone, buprenorphine.
Those statistics from DHEC and the U.S. Census Bureau provide an overall look at what is going on in the state's growing opioid epidemic.
In October of last year, HHS declared the epidemic a public health emergency at the request of President Donald Trump, who directed all executive agencies to use emergency authorities to combat the crisis.
In December, South Carolina Gov. Henry McMaster brought the state into the fight by declaring it a statewide public health emergency.
Wade Bishop, director of Prevention Services for the Beaufort County Alcohol and Drug Abuse Department, spoke at an educational forum hosted Feb. 22 by the Congregation Beth Yam Social Action Committee, the second community forum on opioids held so far this year.
Bishop said his department was trying to heighten awareness of the whole opioid issue in the Bluffton area, where two-thirds of the deaths have occurred.
"We're trying to take away the stigma of what opioid users look like. ... They look like this and they dress like this and they talk like this," Bishop said.
Matt Burch, a certified addictions counselor and director of Recovery Concepts in Ridgeland, sees the same thing in the clients who participate in his facility's programs. "These aren't your traditional drug addicts," said Burch, who attended the LCAHY forum. "It's not people who 'live under bridges.' It's teachers, truck drivers and PTA moms."
Dr. Ravi Srivastava, staff psychiatrist for Hilton Head Regional Medical Center and Beaufort Memorial Hospital, served on both community forums. "We need to treat addiction as a medical illness, not a bad choice," he said. "A person does not choose to become an addict."
Dr. Philip Zitello, a board certified anesthesiologist with a specialty certification in pain management, spoke at the Beth Yam forum. As an anesthesiologist, he and his peers are among the first people consulted by surgeons and other medical professionals for the treatment of pain in patients.
"Despite what we're talking about tonight, the first treatment for pain is not necessarily narcotics," he said. The goal is to improve the pain so that patients can function without suffering, said Zitello.
Other methods used include physical therapy, psychotherapy, interventions including injection and acupuncture.
Srivastava said prescriptions from pain medicine doctors have such rigid controls now that it is very difficult to abuse it. Of the people who are abusers of prescription pills, less than a third get it prescribed by a doctor.
"The opioid epidemic, unlike what you read in the headlines, is not caused by pills prescribed by doctors," he said. "Only a very small minority become addicts," he said. "(The addicts) get it by stealing other people's medications, borrowing from family members, friends, buying it on the streets."
And that's a problem. All of the drug dealers that used to sell cocaine and heroin are selling pills now, said Srivastava, and those street pills and mail-order prescriptions can be deadly.
First responders face a growing hazard when they arrive at a scene involving drugs.
If the drug is heroin, it is possible that it could have been cut - or mixed - with carfentanil. According to any number of web sites, a unit of carfentanyl is 100 times as potent as the same amount of fentanyl, 5,000 times as potent as the same unit of heroin and 10,000 times as potent as a unit of morphine. One microgram can affect humans. According to the National Center for Biotechnology Information, an arm of the National Institutes of Health, it is marketed as a general anesthetic for large animals - such as elephants.
"The real epidemic is in the streets," said Srivastava. "This is the perfect time to make the intervention in this community to keep us from turning into Myrtle Beach, Greenville and other areas in South Carolina."
Gwyneth J. Saunders is a veteran journalist and freelance writer living in Bluffton.