♪♪ ♪♪ ♪♪ Gavin: Welcome to "This Week in South Carolina".

I'm Gavin Jackson.

The drug overdose crisis continues to rise in the state and country.

Sara Goldsby, the director of DAODAS joins me to discuss the latest numbers and what they are doing to curb the issue.

But first October is Domestic Violence Awareness Month.

and Monique Garvin, the deputy director of the violence against women's act and human trafficking programs at the Attorney General's Office joins us to look at the issue of inflicting the state where 36 South Carolinians died last year alone.

Monique, thanks for joining us.

Monique: Thank you for having me.

Gavin: So Monique, every October is Domestic Violence Awareness Month.

and in South Carolina.

The Attorney General's office holds the annual Senate witness ceremony which you helped spearhead to remember, those that we lost the year before, to domestic violence, including earlier this month, when we remember the 29 women and seven men who were killed in 2022.

Those 36 deaths did market decline from the year before when we saw 39 folks die.

And in 2020, another 39 people died as well.

and in 2019, that was that number was at 42.

So it seems like we're making some progress.

How do you measure success here?

If if you even see us having any successes or or moving the needle in any way?

Monique: Yes, absolutely.

So we have to define in domestic violence homicides in South Carolina over the last several years.

And I think we can attribute that to the visa well, not decent, the 2015 legislation that really targeted the way we were prosecuting and addressing domestic violence.

As you may know, domestic violence in South Carolina is defined by a household member to a person who might be living together, or living together as a child in common and common or married.

And so that is how we classify domestic violence in South Carolina.

and so based upon that information, we collect data from various legislative venue, and various law enforcement agencies in the States.

and to find that data.

What we also look at it because we know that definition, we might feel a little bit limiting in terms of what we're seeing in terms of intimate partner violence.

We also look at the violence policy spinner, which looks at the ways and the number of men who have killed women across the nation.

and we're also seeing an improvement in South Carolina, in terms of that ranking year to year.

Within the last two years, we saw South Carolina reach out of the top 10.

So they've been collecting this data for the last 25 years.

In South Carolina for the first for the second devices, that data has been collected has ranked outside of that top 10.

In 2021.

We actually ranked number 11. and then in 2022, we ranked out we ranked 23 rd.

and so we are seeing an increase.

We are seeing some improvements across the state in terms of the number of women killed by men, as well as an urgent message about common spots that are taking place in our state.

I think It's a more because we have looked at legislation.

We're constantly looking at legislation, but also making sure we have concerted efforts across the state and having partnerships between law enforcement listeners offices between services, agencies.

And so I think all those things combined, we're going to continue to see South Carolina improve the way they're responding, prosecuting and serving victims in South Carolina.

Gavin: It's encouraging to hear of course, like you're talking about we were in the top 10 states for 23-25 past years.

So that violent Violence Policy centers rankings, and in part because those rankings I mean, we were number one for several years, it was disturbing.

That prompted the legislature to act and 2015 Like you were saying about increasing CDV penalties, or making some judicial reforms there and also adding a law that generally prohibits the possession of firearms and ammunition by someone who's been convicted of CDV criminal domestic violence, are those weapons as you know, getting out of the hands of these offenders, as far as you can tell?

Monique: Well, I can't say that for certain, but I can say that we are in our office, ensuring that we are training prosecutors, judges, law enforcement officers on that legislation on those amendments, and watching it closely to ensure that they know that they have the ability to combat that Lautenberg Amendment to ensure those who've been convicted of domestic violence aren't able to possess those firearms.

and so we're continuing to do that work across the state to ensure that we are being effective.

Another thing we're looking at is strangulation for several years South Carolina has not had a strangulation bill.

But there are some conversations that are happening as of right now, to ensure that not only firearms are prohibited from those who've been who've been convicted of domestic violence, but we're also looking at adding a strangulation bill to South Carolina so that we can ensure that those who As we know that the lookout in the assessment for those who've been strangled or choked in those situations, The lethality assessment pieces dramatically.

and so we're looking at multiple ways in which firearms are being used just last year, and I saw the witness ceremony and we know that firearms were the primary weapons used in those situations, you know, that was followed by strangulation, and knives in and also choking.

And so we really want to make sure that we're targeting the issues across the board, not just looking at firearms, but looking at the various ways in which weapons are being used to harm other people.

Gavin: Yeah, Monique, I mean, you're talking about that 82% of the cases that gunshot was the primary cause of death and 3% was strangulation.

Really disturbing data there too.

So besides the strangulation, maybe getting on the books here with the CDV statute.

What else would you like to see the legislature do?

I mean, I know this is one of those problems we can't necessarily legislate our way out of.

But when it comes to funding, is it more domestic violence shelters?

Is it more money for outreach as a matter of just kind of keeping this issue front and center?

Because it is such a difficult issue to tackle?

Monique: Absolutely, that I think you're spot on in making that assessment is that we have to really look, look at how to prevent domestic violence, how to respond to that and how to prosecute.

So really, It's a great point approach.

In terms of prevention efforts, I would love to see for all of the schools in South Carolina, whether It's middle school or high school, to really start having conversations with our youth before they turn 18 and are able to be prosecuted for domestic violence that are having those conversations about how to navigate healthy relationships.

How do I have difficult conversations with conflict management so that when they come out to the world and start dating, or seriously, that we are really given them the tools they need to handle those relationships.

I'd also like to mention that we are doing some really great work with our domestic violence pleading counselors and our sexual assault response team across the state.

and so those teams are really designed to have a community approach to domestic violence and sexual assault.

And so they're situated on in the circuits, throughout the state.

And so those bring together, you know, victim services, law enforcement, prosecutors, anyone who's anyone who the victim might interface with during their abuse, or even after it to make sure that we're all collaborating, and keeping our finger on the needle, in terms of how to respond to our victims.

And then, of course, we're doing a lot of things in the prosecutorial side, and I'm not an attorney, but I know for certain that we are looking at the "Lautenberg Act" to see how we can continue to make sure that It's being enforced and that people know about how to address it when they do encounter it.

We're also looking at strangulation.

And we've also had some recent legislation passed around "Bond reform" , we know that sometimes those who are perpetrators are our own bond and sometimes do go back into harm thier... to harm their victims after the fact.

So we want to make sure that we have more strict policies and enforcement models in place to ensure that when we do go, we do go through the prosecutorial process, that even afterward, they don't have any leeway in terms of how they can go back and harm their victims.

We know that for domestic violence survivors and victims, the most challenging time and the most harmful time for them is when they leave.

So we have to make sure we have protections in place to ensure they're able to get restraining orders, make sure they have funds that are effective, and really keep them safe in their communities.

So just we want to say.

I think also, it is incredibly important to continue to fund the agencies who are doing that work.

We know that we don't nearly have enough domestic violence agencies in the state to adequately address domestic violence, especially in those rural communities.

Before I got a call this morning, before I got on this call this morning, I was actually having a conversation with someone down [indistinct] region.

and they were just talking me through some of the challenges that they're having as well.

So we really have to look at domestic violence and all this intersections were really distinct critical lens and really start follow... following these relational forms of abuse.

Gavin: Gotcha.

Yeah, I know, Monique, you said that, you're no lawyer but, you have an impressive background, regardless, because you have a master's degree in public administration and social work.

And you also are a mental health therapist for children and families.

So I wish we could kind of clone you and put you more Monique's across the state.

But when we talk about what you do at the AGs office, when it comes to the Violence Against Women Act, and then human trafficking programs, talk to us about how CDV and human trafficking, I guess, probably go hand in hand in a lot of cases and what people should be looking for and how you can tackle that problem.

Monique: Absolutely.

I'm so glad you brought that question up, because I really attend to what I was saying earlier, if I was not siloing, these relational relational forms of abuse.

What we know is that violence in our communities, especially when it comes to relational forms of violence, they're all fit into power and control.

And that's no difference between domestic violence and human trafficking.

Oftentimes, in these situations, they're complex in nature, and they can oftentimes go and look or on notice and it can be really challenging to differentiate between the two.

Because we do have sometimes have this more individual last perspective around when it comes to people's relationships, and It's not communal in some ways.

And so one of the most common trafficker profiles that we see is around the Romeo trafficker.

That's going to be someone who pretends or is a boyfriend or girlfriend, who might build that trust with, you know, from that person to being in a relationship, and then slowly start integrating in that isolation expectation.

So we know that our data, the data that we've seen, shows that human trafficking recruiters and exporters and not just romantic partners, so that could be family members, caregivers, friends, and employers.

That's why oftentimes, in these spaces, I talk about domestic violence, but I'll just talk about family violence, because those kinds of close knit relationships can really be a breeding ground.

For those who wants to abuse to abuse those who are close to them.

It can be can be can be difficult to speak up or just need to tell your mom or tell your boyfriend someone you love and care for.

And so that's what makes it so challenging.

Oftentimes, people ask me well Monique, why do victims go back to their abusers, we know that that's the most dangerous time and so they're gonna go back seven or eight times before they actually leave.

And that can be where their best that can be when we're seeing those homicides.

So It's really intricate.

We know that they're using things to maintain that power and control abuses or using things like physical violence, sexual violence, substance use coercion, psychologic, psychological manipulation through shame and guilt, financial abuse, so we're seeing so many various forms of abuse, whether it isn't domestic violence, or is human trafficking.

And so we have to be really diligent in being able to identify to respond and to make sure people are aware of what's happening to them, or might be happening to a loved one and that they won't be afraid to speak up.

Gavin: Yeah, a lot for people to be watching for there.

and that's Monique Garvin with the Attorney General's office.

Thank you so much, Monique, for what you guys do.

<Thank you for having me.> Join me now to discuss the ongoing drug overdose epidemic in our state is Sarah Goldsby.

She's the executive director at the State Department of alcohol and other drug abuse services.

Sarah, welcome back to the show.

Sarah: Thanks, Gavin.

Glad to be here.

Gavin: So Sarah in December 2017, Governor Mc Master issued an executive order declaring the opioid epidemic a statewide public health emergency.

And since then this problem has only ballooned.

Unfortunately, the most recent DHEC data from 2021 shows that 2168 people died from drug overdoses in 2021.

That's from prescription drugs, opioid's, and the synthetic opioid fentanyl.

So what continues to drive this epidemic?

Sarah: You know, since 2017, like you mentioned, just the epidemic has radically changed.

and that's primarily due to the illicit drug supply and really, primarily to fentanyl in the illicit drug supply.

So those mortality numbers that you mentioned, and the number of South Carolinians that we've lost.

Of that huge number that you mentioned, two thirds of that was related to fentanyl, specifically in the drug supply.

So It's just something that we couldn't have anticipated.

And we've just had to quickly respond and try to abate you know, this growing issue with you know, the synthetic illegal drugs coming into the nation.

Gavin: Yes, Sarah.

You work closely with SLED.

SLED Chief Mark Keel, are they still seeing a pretty big wave of fentanyl coming through and coming to our state?

Sarah: Yes, and we do work hand in hand with SLED we communicate almost daily.

And so keeping track of what public safety and law enforcement is doing for interdiction is really helpful to know how the supply is going to shift to the folks we're trying to serve.

And do interventions with and get treatment to.

And so we are seeing, you know, SLED share with us information on really large trafficking busts across the state that are having, you know, big impact on the supply.

And so It's really just cross sector work that is really essential to addressing this.

Gavin: And we looked at that big number, the 2116 people that was from 2021 alone, but over in Charleston County at the coroner's office, they maintain close to real time data on their web site, and you can see that there have been 158 confirmed drug overdose deaths so far this year, just in Charleston County.

And if you factor in the suspected and the pending cases that goes up to 212... 220... 202 deaths, I'm sorry, the year before that 215 deaths.

So it seems like an indicator that you know, we have 2021 data, but this current 2023 data might be indicating that the worst is still coming.

Sarah: Yeah, and a lot of that is just the unpredictability of the drug supply.

You know a few things.

cocaine and methamphetamine are now laced with this potent fentanyl and so people who are not seeking an opioid and who are opioid naive are more likely to experience an overdose Mmm and so we're seeing shifts in the demographics and in the people who are using substances, as well as just the sheer volume of what's available.

Gavin: Yeah, It's pretty horrifying.

We think about that maybe?

Do you think that the message is getting out to folks who are just perhaps trying something for the first time, they might have taken a pill, but you have no idea where that's coming from?

I mean, we hear these stories over and over again, you would think that'd be enough to maybe terrify some folks from not even trying any sort of illicit drug.

Sarah: Yeah, the messaging is spot on that there's no room for experimentation at all.

And so we've, you know, put forth this public education campaign and you'll see lots of billboards across the state, one fake pill can kill, because a lot of the supply is also mimicking, you know, licit, manufactured pharmaceuticals, things like oxycodone or Xanax that are are not real, that are counterfeit, and that can be incredibly deadly.

And so we want to raise awareness across the state about, you know, not using any prescription looking medication unless it was prescribed to you and dispensed from a pharmacy, primarily as well, as you know, the heroin supply, the cocaine supply, the methamphetamine supply, is also high risk for opioid overdose.

And so getting that message out through social media through our web site, (justplainkillers.com).

Which now has a wealth of information about fentanyl on it.

And really letting people know that Naloxone must be available prevention measures must be taken.

And really there's no room to try an illicit drug even once.

So a lot of messaging.

Gavin: Gotcha.

Yeah.

and some reporting by the Post and Courier of Charleston shows that a lot of this data might actually be underreported, too.

So even more worrisome there, but groups are passing out in our narcone, Narcan and fentanyl test strips.

But what more needs to be done here mean greater visibility?

Do you think there is enough messaging and visibility?

Like do we need to start putting fliers up in in bars or in the pharmacies?

So people actually just get more Narcan out there in case an accidental overdose happens to someone they know?

Sarah: Yeah, I think information sharing is key.

A lot of that is happening in the schools.

Certainly in the universities, we have over 100 Community distributors of Narcan now.

and so folks are able to access Narcan if they're unable to purchase it or get it through their pharmacy benefit at a pharmacy in over 100 locations around the state.

And also those communities, distributors are doing public, you know, dissemination in hotspots, right?

So week to week, at the state level.

and at the local level, we're really identifying through a mapping system where incidents of overdose are occurring.

So we can geographically target those areas where people are experiencing overdose, really get the Narcan out, get the information out, hopefully connect people to treatment, by way of outreach and engagement.

And so I think a lot of very targeted work is being done, you know, by our partners supported by the state, I will say, and it may be too early to sound hopeful.

But as we look week to week at the incidence of suspected overdose across the state, those numbers are falling.

And so they seem to be leveling off.

And while we don't know what that means for mortality, we know that week to week fewer people are experiencing overdose.

So it seems and that's been a trend since the late spring.

So we're looking to put our finger on that because It's dropping nearly as much as 10%, week to week and 10% month to month.

and we're about 7% right now under where we were last year and the year before.

And so I'm hesitant to say but but I do remain hopeful that all of these efforts that I've described, are really making an impact across the public safety and the human services sectors.

Gavin: Yeah, that is encouraging anecdotal news there.

And I'm sure It's something that you and your team and others in the state had been looking forward to, for some time, some sort of glimmer of hope at this point.

Sarah: Right.

and, you know, before 2020, really from 2018 to 2019, the numbers were falling, and we were actually in a pattern of you know, success in terms of seeing less impact.

But that was really before the fentanyl hit the illicit supply, which we just never could have anticipated.

Gavin: You know, Sarah, your agency, DAODAS is a cabinet level agency to what are you asking the legislature for perhaps in the budget this year, and maybe what you want to see when it comes to legislation, we're in the second year of the two year term coming up in January.

What do you want to see move out of the Statehouse this year?

Sarah: Well, we're hoping to get some support to schedule a drug called xylazine.

xylazine is also another adulterant to the illicit drug supply that's causing negative impact.

It's often in substances with fentanyl.

It's It's illicitly manufactured and used by many veterinarians but in the illicit market, It's causing a lot of devastation and overdose in a way that can't be reversed by antidotes like naloxone.

So we're really hoping the legislature takes action on that.

In addition to that, you know, just more support for our public health systems for the law enforcement systems, we saw the fentanyl trafficking bill pass June 15.

And we believe that that may be having some impact on the supply and the overdoses that we are seeing since June 15th.

There have been about 440 trafficking cases this year, and we're looking to put our hands on some data to demonstrate the effectiveness of that bill passing.

And so just ongoing support for really the systems and the people who are fighting this battle.

Gavin: Gotcha.

Yeah, last year.

On top of that, with the legislature, we're looking at the opioid settlement, that nationwide settlement in South Carolina is going to be receiving $360 million, over 18 years, we started receiving some of that money.

It's simply going to counties and municipalities.

What kind of progress are we seeing at the local level with this money coming to the state?

Sarah: Well, there were nearly 90 counties and local municipalities who were awarded those funds.

And so I think the real progress has yet to be seen as they're just getting those resources and implementing strategies that fit their communities.

And so I think long term, we really do need to measure the impact of that, when so much of this is being managed, at the local level for local needs with local plans.

I, you know, I think there will be impact, but It's certainly on us to measure that.

Gavin: And that could be something like we're talking about with Charleston County with greater data, just really maybe better testing, better autopsy reporting, a number of things.

Sarah: Certainly, and the South Carolina Center of Excellence and addiction, which was recently formed as a partnership among the institutions MUSC, Clemson University of South Carolina, DHEC and DAODAS.

We've really centered and pulled together our resources and expertise to sort of apply some data and metrics statewide to measuring change.

I think we'll be releasing a report in the late spring that looks at access to care, in terms of the evidence based treatment for opioid use disorder where people are receiving that being engaged in the right treatment and being retained in that treatment to successfully achieve recovery.

That data alone is going to tell us a lot about where success is and where we really need to invest targeted resources to bolster the treatment system.

Gavin: Sarah, we have a couple of minutes left on when asked about the mental health crisis, because It's so deeply intertwined with this epidemic.

you factor in the ramifications of the pandemic we talked about.

We'd like high schools and middle schools or out of school counselors.

That's a problem that the state is trying to fix.

And there's also the pressures and the unrealistic nature of social media, which is compounding all of this right.

In fact, South Carolina three two other states are suing Face Book and Instagram is parent company META, over the platform's alleged addictive features that harm young people's physical and mental health.

So what what's your message to parents?

What do they need to do to promote maybe more positive mental health in children's lives?

And maybe what do they need to watch for?

If they're worried about their teens?

Maybe getting involved in the wrong things?

Sarah: Yeah, well, I mean, primarily, everyone knows that teens, adolescents are kids, even adults, we're all just trying to cope and make it through.

It's been a hard couple of years.

With so many of the, you know, sort of pressures that you described coming from all areas.

One of the key things, especially for parents of kids and adolescents is to talk, talk early talk often have conversations have conversations about, about feelings, about how to cope, how to deal with feelings in healthy and positive ways.

I think a lot of what we need right now is individual resilience and the tools to be resilient, right in our own coping, but family resilience as well.

And it does take families and it takes communities to look out for these adolescents.

DAODAS will be launching a public education campaign in the coming weeks that you will hear about, It's called the conversations campaign.

A lot of advertisements will go out across the state and conversation kits to really encourage parents and caregivers to talk early and talk often with their kids about coping and substance use.

We've done study groups across the state focus groups and learn from our parents and adolescents that kids really do withhold information from their parents and caregivers to protect them.

They don't want parents and caregivers to know of the challenges that they're facing at school and the challenges that they're facing in their social circles.

And so, talking early and often building those relationships to have open conversations is key.

Gavin: And It's just as easy.

It's just as easy as that too.

But really quickly, Sarah with but with one minute left, I want to ask you about the US Surgeon General's has said that loneliness is an epidemic in our country, and some Gallup data recently found that 24% of adults worldwide feel lonely.

So we're not just talking about maybe teens and adolescents but also this affects adults as well.

I think a lot of folks are trying to fill that void with drugs with alcohol.

What's your message when it comes to recovery in South Carolina?

Sarah: Well, there's this old saying, and I've probably said it here before that the opposite of addiction is connection.

and I think that's an old adage among folks in recovery because they know that that isolation does drive addiction.

And so connection, connection to community connection to peers connection to people who are experiencing similar experiences, is key.

And I know that that can be very hard and in especially in the age of social media and in disconnection when we're across screens from each other.

But we all really do need to make an effort to reach out, embrace people and get back to a reality where we're connected as a community.

Gavin: So I will leave it there that Sarah Goldsby she's the director at DAODAS, thanks so much, Sarah.

<Gavin thanks.> To stay up to date with the latest news throughout the week.

Check out the South Carolina Lede.

It's a podcast that I host on Tuesdays and Saturdays that you can find on (southcarolinapublicradio.org) or wherever you find podcast's for South Carolina ETV.

I'm Gavin Jackson.

Be well South Carolina.

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