Knowledge That Breaks Stigma
When we understand addiction, we open doors to healing, prevention, and progress.
Statistics
All figures we present regarding overdoses and fentanyl-related deaths come from official sources such as the South Carolina Department of Health & Environmental Control (SCDHEC) and DAODAS – Just Plain Killers Data Portal.
However, it is important to understand that:
Some deaths may be recorded under general categories such as “unintentional poisoning” without specifying the exact substance.
Toxicology results can take weeks or months, which may delay the accuracy of reporting.
In cases of multiple substances being used, it is not always clear which was the primary cause of death.
👉 For these reasons, the statistics are as close to reality as possible, but they likely underestimate the true magnitude of the problem in our community.
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Choose the right time and place – Find a private, calm setting for the conversation.
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Express your concerns honestly and with care – Explain what you’ve noticed and how it makes you feel.
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Listen without judgment – Let them talk, validate their feelings, and avoid interrupting.
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Offer concrete help – Remind them that substance use disorders are treatable and offer to help connect them to services.
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Be patient and consistent – Change takes time. Stay present and supportive even if setbacks occur.
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Don’t lecture, threaten, or shame.
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Don’t use blaming or stigmatizing language.
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Don’t cover up or enable the behavior.
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Don’t expect them to solve it alone without professional help.
Types of drugs & Facts
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Why is fentanyl so dangerous?
Extremely high potency. Fentanyl is a synthetic opioid up to 50 times stronger than heroin and 100 times stronger than morphine. Even very small doses can suppress breathing and cause death, especially in people without opioid tolerance.
Illicit fentanyl dominates the drug supply. Since 2013, illegally manufactured fentanyl (and analogs) has saturated the drug market and replaced heroin as the dominant opioid, sharply increasing overdose deaths because of its high potency and rapid onset.
Counterfeit pills and mixing with other drugs. Illicit fentanyl is often pressed into pills that look like prescription medications (e.g., “oxycodone,” “Xanax”), or mixed with cocaine/methamphetamine without the user knowing. This makes the actual dose unpredictable and drastically raises the risk of overdose. Fentanyl cannot be detected by sight,
smell, or taste; test strips are the only household screening tool.
Polydrug use = higher risk. Taking more than one drug—intentionally or unknowingly—further increases the risk of respiratory depression and death, and this is especially dangerous for those who do not regularly use opioids.
Persistent Crisis in South Carolina
Between 2014 and 2021, overdose deaths in the state rose dramatically, increasing from 718 to more than 2,100 per year
Fentanyl was a decisive factor: in 2020–2021 alone, it was present in nearly 1,500 annual deaths. Although there was a slight decline in 2023, the numbers remain alarmingly high, with more than 1,500 fentanyl-related deaths. These trends underscore the urgent need for prevention, access to naloxone, treatment, and community awareness.
National Level
Since 2015, overdose deaths in the US have shown a steady increase, reaching over 110,000 in 2021–2022.
In 2017, synthetic opioids such as fentanyl accounted for 28,466 of overdose deaths
In 2021, most overdoses involved opioids (~80,400) and synthetics (~70,600)
In 2023, it is estimated that more than 74,000 deaths involved fentanyl, out of a total of approximately 107,500 overdoses.
The Three Waves of the Opioid Crisis (according to the CDC and NIDA)
Widespread use of prescribed
opioid painkillers.
Increase in addictions due to
medical dependence.
Thousands of overdoses linked
to legal medications.
Wave 1 – Overprescription (1990s–2010s)
Many people dependent on prescription
opioids transitioned to heroin.
Heroin was cheaper and easier to
obtain.
Increase in deaths from heroin
overdoses.
Wave 2 – Heroin
(2010 onward)
Emergence of illicit fentanyl, 50 times
stronger than heroin.
Often mixed with other drugs without
the user’s knowledge.
Currently the leading cause of
overdose deaths in the U.S.
Wave 3 – Fentanyl and Synthetic Opioids (2013 onward)
Recognizing the Warning Signs of Substance Use
Why are youth deaths rising?
Explosion of counterfeit pills with fentanyl. Between 2019 and 2021, the CDC documented evidence of counterfeit pill use in overdose deaths among adolescents; in these cases, illicit fentanyls were often the only drug involved.
More lethal supply, not necessarily more use. NIDA reports that although adolescent drug use rates did not increase during or after the pandemic, deaths did rise because more counterfeit pills contain fentanyl. In other words, the supply is more dangerous, not that use has surged.
Market saturated with fentanyl. The shift from heroin to fentanyl since 2013 means that even those who think they are taking another substance (e.g., a prescription pill) may actually be consuming fentanyl. This has been key in the spike of deaths among young people and first-time users.
How to Support Someone Struggling With Substance Use
01
Deceptive marketing and aggressive promotion
For more than 25 years, pharmaceutical companies promoted opioids in misleading ways, portraying them as safe and non-addictive. This fueled a dramatic increase in prescriptions, opioid use disorder, and overdose deaths
02
Litigation and judicial accountability
An unprecedented trial in Oklahoma held manufacturers accountable, stating that thousands died of overdoses due to "false, misleading, and dangerous" marketing campaigns
03
Purdue Pharma and the Sackler family
Purdue Pharma—owned by the Sacklers—developed and marketed OxyContin using aggressive tactics. Physicians were invited to "educational" trips, product materials minimized the risk of addiction, and high dosages were pushed to maximize profits. It is estimated that more than
500,000 overdose deaths between 1999 and 2020 are linked to prescribed and illicit opioids. Purdue paid billions in penalties and filed for bankruptcy after admitting responsibility
04
Johnson & Johnson lawsuit
Johnson & Johnson was ordered to pay \$572 million in Oklahoma for its
role in the opioid crisis. Later, a nationwide settlement of approximately \$26 billion included distributors such as McKesson and AmerisourceBergen, along with Johnson & Johnson
05
Distribution and collective responsibility**
Distributors such as Cardinal Health, McKesson, and AmerisourceBergen agreed to pay more than \$26 billion for facilitating the massive oversupply of opioids.
What Was the Role of Pharmaceutical Companies in the Opioid Crisis?
Behavioral changes
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Frequent absenteeism or poor performance at work or school.
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Involvement in conflicts, fights, or illegal activities.
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Secretive or suspicious behaviors.
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Sudden mood changes: irritability, boredom, anger, anxiety.
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Loss of motivation or interest in previous activities; distant attitude.
Physical changes
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Bloodshot eyes, abnormal pupils (very small or dilated).
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Unexplained weight loss or gain.
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Neglect of personal appearance or hygiene.
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Unusual odors on clothing, breath, or body.
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Tremors, slurred speech, poor coordination.
Social changes
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Changes in peer group or abandonment of hobbies.
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Legal issues or unusual financial problems without explanation.
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Continued substance use despite negative consequences.