Between the ages of 17 and 22, Deb Smith was institutionalized 13 times. She calls the time around 2010 and 2011, when she was 18 and 19 years old, her “lowest spot.” The “darkest,” she says.
Even at such a young age, she found herself abusing alcohol and other substances, unable to get clean. She had left school and her parents’ home and was living in foreclosed properties with others who, like her, found their daily lives to be a routine of substance use. After a few months of squatting at one spot, people would kick her out, fed up with her character when she was high. She’d moved on to the next empty house and empty friends.
“Each group I found around Greenville that hung out I found had Percocet, Lortab, codeine,” she says. “That was just the stuff that was around.”
The painkillers were easier to get than alcohol, and not just from the people she wound up with, but doctors also.
“I would go in and say ‘I have a tight chest, I’m wheezy’ and that’s all it took to get a bottle of codeine,” she says. “It was easy. I just had to space it out and I could get codeine.”
For more than a year, opioids became one of the ghosts that haunted the void carved out by her substance abuse disorder.
“I really just got sad and depressed and fell asleep with people doing the same things as me. That’s what it looked like for me. … I just got completely numbed out. It was just a sad pit of nothing going on.
“I always felt a sense of loneliness, but it was so buried that the surface level of getting high and drunk with the people I was around, I let that be enough. We were destroying our lives together.”
At 18 she gave in to that sense of destruction. She attempted suicide by swallowing a cocktail of pills.
“I remember waking up and being so angry I was alive,” she says.
Before she turned 20 years old, she tried to kill herself once more, this time by downing a handful of sleeping pills.
She survived. While it was a few more years, Smith began long-term recovery the day before she turned 23. Sober for more than two years now and working as a recovery coach with a Greenville-based organization, she says finding friends and music outside of the circle of addiction and connecting with nature helped change her life — as well as simply being able to experience the world sober while she was outside an institution.
Smith embraces her past — that time has value and meaning and she can use it to help others.
“I don’t have to put this dark time in the corner,” she says.
But if opioids were around in 2011 like they are today, Smith doesn’t know if she would have made it.
For one thing, more people are using opioids — and dying from them — than ever.
And for another, a drug called fentanyl has dramatically increased fatal overdoses.
Opioids — a category that covers drugs from heroin to semi-synthetic prescriptions such as Oxycontin and totally synthetic drugs — were responsible for 33,091 deaths in the U.S. in 2015, according to the Centers for Disease Control. Since 1999, opioid overdoses have quadrupled. While the increase in fatalities was seen before the turn of the millennium, the steepest increase in opioid-related deaths has occurred from 2010 until 2015, the last year the CDC has reported. The graphs show a near vertical line of increasing lethal doses stretching those five years and culminating in 62 people dying of overdoses per day in 2015 — the highest of any year recorded.
“Opioids — prescription and illicit — are the main driver of drug overdose deaths,” the CDC says.
While we may think of street drugs and prescription medications as two separate things, the opioid epidemic has knocked down barriers betwen the two, with users abusing both, or one habit flowing into the other.
Indeed, opioid addiction often follows an insidious cycle — an individual is involved in an accident or medical procedure. A doctor prescribes medication like Vicodin to address the pain. Unbeknownst to the person, they suffer from substance abuse disorder and spiral into perpetual use of the medication. When they find they can’t be prescribed the medication anymore, they turn to heroin. And heroin and fentanyl are a deadly combo.
Horry County coroner Robert Edge says he now deals with three or four opioid-related deaths every week. The increase in deaths from the drug came to his county about two years ago.
“The biggest obstacle we have, you go to a family and they’re totally shocked this has happened to their child,” Edge says. “They just didn’t see it coming. And there are some young people who have been clean for a while and suddenly they go out on a Saturday night and Sunday morning, they don’t wake up.
“[Heroin] it’s easier to get and less costly and it’s just not a hassle to find it if you got the connections,” Edge says. “That’s the cycle we’re in right now and I don’t see it ending for a long time.”
Fentanyl’s Death Toll
Jess Bannon is one of those who didn’t make it.
“She was a very strong-willed person,” says Susan Moore, Bannon’s mother, who lives near Clemson. Through tears, she’s laughing.
“She was a total vegan. I would say, ‘Jess, you won’t touch a hot dog, but you’ll do heroin.’ I was like ‘Honey, I don’t understand that.’ … Her soft, sweet self was there but she wanted to do what she wanted to do. So it was a battle within herself and with us.”
In January of 2015 Bannon died of an overdose of heroin mixed with fentanyl. One of the main differences in Smith’s and Bannon’s situations can be seen in the rise of that lethal combination.
In the last five years, according to the CDC, law enforcement across the South has encountered exponentially more fentanyl, a synthetic opioid which has gotten out of the control of doctors and into the hands of black market producers. The drug is 50 to 100 times more potent than morphine. Those illegal producers use fentanyl to cut heroin. Sometimes, the synthesized drug is bought or sold under the belief it’s heroin, to deadly consequences.
South Carolina is becoming one of the most poisoned states.
The percentage of heroin deaths from 2014 to 2015 escalated in South Carolina far more dramatically than any state in the South. While the overall fatalities are lower than many places, the Palmetto State saw a spike of more than 57 percent in people dying from the injected drug.
Heroin and fentanyl are becoming indissoluble. Death follows the mixture.
“I think the fentanyl is the big culprit here,” says the Horry County coroner. “If the fentanyl wasn’t in the heroin we might not be having as many deaths as we’re having. Heroin’s been around a long time and it’s when this fentanyl started getting added to it is when these deaths increased so much.”
Bannon kept her heroin use hidden, says her former partner Dave Toole, who lives in Columbia.
People touched by opioids and other substance abuse often say the stigma — the fear of being judged as inferior for their use — is one of the dangerous elements of any addiction.
“It was terrible that it was Jess because she was such a passionate person,” Toole says. “The hardest thing was just the image of someone you love being that lost. I would just cry all the time. ... Seeing her face and thinking about her goofy-ass laugh and imagining that she was so lost in that shit. It was so surreal. The hardest part was just how unbelievable it was.
“It’s still hard to imagine the Jess I knew getting tangled up in heroin.”
Toole, along with another friend, tried to take on Bannon’s use, getting her mother involved. But fentanyl took away any hope of recovery, in Moore’s mind.
“I tried hard. I really, really tried hard,” Moore says. “I’ve learned a lot, and in learning I don’t know what I could have done differently. … I thought we could help her and she could overcome. But with the fentanyl factor there’s no chance. She was just gone.”
Along with the stigma and the fentanyl, money may also have been a factor in Bannon’s death.
Nobel Prize-winning economist Angus Deaton recently testified before the Joint Economic Committee of Congress, linking the rise of opioid deaths with income level in the United States.
“We think of opioids, not as the fundamental cause of the epidemic of midlife mortality and morbidity, but as an accelerant, a set of drugs that added fuel to the fire, and made an already bad situation much worse,” Deaton said in his testimony.
While she searched, Moore never found a place she could afford to get her daughter treatment for her addiction. She went as far as contemplating having her daughter arrested, a process they discussed together, in order to get her into a recovery program.
“I went all over Columbia looking for a spot or place to put her,” Moore says. “There was no availability for anything. … There was no voluntary place to go for somebody that didn’t have a lot of money. I don’t have money. She didn’t have money. And what do poor people do?”
Going After the Dealers
As opioid addiction worsens and deaths mount, some have sought to punish those who sell the drugs.
Driving on the interstate from Simpsonville to Greenville, Roy Davenport gripped his wheel with anger — the welding of sadness, disappointment, frustration, and rage of a father having to confront a demon he believed his son had exorcised. When he got to his son’s location, the anger left him.
“I saw the EMS vehicle and I got scared,” Davenport said at a recent public hearing in Greenville before a State House committee to study opioid abuse.
For more than two years, Scott Davenport, Roy’s son, hadn’t used opioids and heroin. But on March 7 of 2015, co-workers found Scott unconscious on the bathroom floor at the restaurant where his shift had ended.
Roy ran in, held back by the cops, yelling at them that he needed to get to his son.
“An officer said, ‘You can’t go in there,’” Davenport recalled. His son was dead.
Scott was a musician, studied philosophy, and was extremely smart, his father says — a person who would by all accounts do well in the world.
“He had a disease called addiction,” Davenport said.
Roy suspects his son began using heroin to cope with the disappointment of not accomplishing what he wanted in life. Heroin is what Davenport believes his son thought he got the night of his fatal injection.
“I hadn’t even heard of fentanyl and I’m convinced my son hadn’t,” Davenport says. “Whoever sold to him sold him fentanyl.”
Now, Davenport is channeling his grief and anger from his son’s death into a law that’s meant to punish those who deliver lethal doses.
“Shortly after my son’s death I was speaking to the detective that investigated his death, and I said, ‘I hope you’ll throw them under the jail when you catch the person that sold my son the fentanyl,’” Davenport says. “He said, ‘Even if we catch them, we can’t charge them with his death. The only thing we can charge him with is selling drugs.’ … We have laws on the books that allow someone to be prosecuted if they have a few drinks and get in their car and accidentally kill somebody.”
Davenport wants to see that same principle applied to those who sell drugs that kill.
In May of 2015, only two months after his son’s death, Davenport began working with the Greenville county solicitor as well as members of the legislature to craft Scott’s Law — a bill that charges individuals who sell drugs that lead to mortal overdoses with murder and require harsh minimum sentences — homicide by drug delivery or drug-induced homicide, such laws are often called.
When the legislation got to Senate and House committees in May of 2016, the penalty was quickly knocked down to involuntary manslaughter with a five-year maximum sentence. A bill never reached the floor. With the potential law still up for debate, Davenport says he doesn’t want the law he helped to start see the light of day. Scott’s Law as it stands is toothless, he says.
“A senator looked me in the eyes and said, ‘I don’t think we need more laws to punish drug dealers,’” Davenport says. The senator told him there are already laws on the books to deal with cases involving drug-related deaths.
“If we do, they aren’t working,” Davenport says.
Eric Sevigny, a criminology professor at the University of South Carolina told the Greenville News in 2015 he wasn’t aware of any research that shows drug-induced homicide laws reduced illegal sales, and that such laws are often symbolically passed to show that legislators have taken action.
Others have suggested more rigorous regulation of the industry behind opioids and stricter rules for doctors to follow when writing prescriptions. Still others call for alternatives to opioids such as medical marijuana.
Law enforcement can only go so far, Walter Wilkins, Thirteenth Circuit Solicitor, said at the hearing.
“We can’t prosecute our way out of this problem,” he said.
S.C. Government Takes on the Changing Crisis
With 761 people dead from opioids in South Carolina in 2015 alone, amounting to a near 10 percent increase each year since since 2012, the trajectory of this drug epidemic shows no signs of slowing down.
To try and curb that cycle, S.C. House Speaker Jay Lucas created the Opioid Abuse Prevention Study Committee in April of this year, a body tasked with identifying preventive measures and increasing treatment and recovery options for opioid users.
“This issue affects every community and does not discriminate against race, age, gender, socioeconomic class or profession,” Lucas said in a statement. “Because opioid abuse is different from other drug addictions, it is most important to consider and study every available option to prevent further damage and loss of life.”
Previous efforts could eventually show some results.
In 2014, then-Gov. Nikki Haley created the Governor’s Prescription Drug Abuse Prevention Council in response to the rising tide of opioids in South Carolina. The council found that a heavy burden was being placed on the residents from overdoses and abuse. The findings helped rally legislative efforts to address the bad medicine flowing through the state.
The Overdose Prevention Act passed the following year. The law allowed first responders to administer Narcan with immunity from civil or criminal liability. Narcan, generically known as naloxone, reverses the effects of opioid overdose, essentially bringing people back from the brink of death after an overdose from heroin, fentanyl or similar substances. The act also allowed the general public to obtain a prescription for Narcan and permitted them to administer the medication. By 2016 the Legislature had allowed Narcan’s sale without a prescription.
This past legislative session lawmakers passed a slew of laws addressing the state’s strengthening scourge. Bills were signed that allowed people to report overdoses to law enforcement without fear of being charged for drug-related crimes if they happen to be using or in possession. Also, pharmacies became eligible drop-off locations for unused pills. Another law now requires doctors to check a state database before prescribing highly addictive medications. As part of the state’s budget, $1.5 million was allocated to medication-assisted treatment for opioid addiction.
One of the strongest advocates for these new efforts is Greenville Rep. Eric Bedingfield. He helped craft and pass much of the recent legislation. His fight stems from the death of his own son.
Like Davenport, Bedingfield’s son, Josh, fought heroin addiction. He was clean for more than two years, but after a new job forced him to travel and miss support group meetings, Bedingfield says “those cravings crept back into his mind.”
And like many others, fentanyl masked as heroin killed Bedingfield’s son.
Results of the recent political resolutions against opioids won’t come quickly, he says.
“It’s almost impossible to predict,” Beddingfield says about when new laws might lessen the drug-related deaths. “My hope would be much sooner, rather than later. The goal behind all of this is to save lives. I would hope within six months we could see lives changed.”
In that time at least some bad prescriptions might stop being written, he says.
But the fight against opioids will be a long one, and the laws they’ve passed up until this moment might not have been enough to stop the death of his son in Bedingfield’s mind.
“I don’t know that he would be alive now,” even with the current laws, Bedingfield says. “I don’t think there’s anything I’m doing today that would have necessarily changed his particular outcome. But my thought, prayers and wishes would be that they would have effect on saving future lives.
“It’s hard to try to say how or if any of this stuff would have saved Josh. I’m just trying to take this information that I learned through Josh and going through this process to find holes in the system.”