[opening music] Welcome to this week in South Carolina.

I'm Gavin Jackson.

The year 2020 saw an increase in the amount of people dying from opioid abuse.

Sara Goldsby, the director of the State's Department of Alcohol and Other Drug Abuse Services joins us to talk about the state's efforts to combat the crisis and other addiction.

But first, SLED Chief Mark Keel discusses the 2020 Crime report which showed a significant rise in certain crimes where more people were murdered than in any previous year on record.

Alright, Chief Keel, thanks for joining us today, sir.

<Chief Keel> Glad to be with you.

>> So sir, you just had a press conference recently outlining this new preliminary 2020 crime data.

Can you review some of the top line data that came up from this report?

Well, the most troubling statistic that we had in this information was the fact we've seen murders increase 25% over 1 year.

That is just from 457 to 571.

That's the most murders that we have ever recorded since records have been being kept all the way back to 1960.

So, needless to say that's very troubling to us.

Also, we saw aggravated assaults increased by 9.3% and so when you look at violent crime, those numbers are certainly going in the wrong direction.

<Gavin> So you're seeing these increases and like you said, murder, aggravated assaults arsons, as well, it sounds like, from what the press really said, but also some decreases too.

So, how would you describe what you're seeing, right now in the state when it comes to this kind of crimes?

<Chief Keel> Well, as you said, we did see a 21% increase in arson cases.

That was a little bit surprising because we had seen the previous 2 years.

2018, 2019, we've seen, had seen decreases in arson, property crimes on the other hand were down 6% this year and this continues a 6 year decline in property crimes.

And so we were again happy to see that, but the increase in violent crime obviously overshadows the decreases in property crimes.

>> How would you describe that data you look at this violent crime data that you're reporting here.

Is it worrisome?

Is it, do you think people should be concerned about it?

>> It's more than worrisome.

It's, we've seen this going on now since 2016.

So, we've seen this tracking upward and I said a year ago that we were very troubled by it.

We were very troubled by the number of murders, the continued increase in violent crime and we saw it again.

We saw it again in 2020 and we saw it in a much larger number than what we've seen in the past.

<Gavin> Any idea what's driving this, Chief.

I know it's still preliminary.

We're still working through the data here, but any indications, any anecdotes about what could be driving this data increase?

<Chief Keel> Well, I'll just tell you that the majority of what we're seeing, gangs, drugs, and gun crimes, we're seeing more and more younger people with guns.

We're seeing more and more younger people as victims of gun crimes and also we're seeing young people who are the trigger pullers in these gun crimes, as well.

but gangs and drugs seem to be the biggest thing that we're seeing.

We're seeing a lot of retaliatory murders when somebody will get killed in a community where there's gang activity and we can just about bet that within the next day or so, we're going to have another, a shooting and that's exactly what we're seeing.

>> So, you're talking about younger and younger folks being affected by this on both sides.

How difficult is that when you talk to the families or when you see these stories play out as a result of these crimes?

<Chief Keel> It's terrible.

I mean, it's tragic.

I mean, as I said, you know we're not - that's not the way we're supposed to have our end.

We're not supposed to die by being murdered and so when you see these young people that, you know, have their whole life in of them.

You see parents that are excited about these young people's future, you know, and if they end up ending in gun violence and death.

I mean, it's just a tragic, tragic situation.

And I can't imagine it.

I got children myself.

And I just, you know, I can't imagine a parent having to deal with a situation like that.

<Gavin> Yeah, and we just recently saw in North Charleston there was a mass shooting recently that took the life of one teenage girl.

Again, young people involved in that as well.

We just saw a double homicide down there in the Low Country with the Murdaugh family.

I'm wondering how data is looking, right now when we're talking halfway through 2021 and we're starting to look at some continued disturbing trends, it seems like.

>> It's not good.

If it continues at the pace that we're looking at right now, the numbers this year will exceed last year's numbers.

So, we're not very optimistic about 2021.

We're just very concerned about it.

>> So, Chief, we just talked about a lot of data here, a lot of issues concerning us.

What needs to be done right now?

You talked about communities needing to be more engaged.

Is there a fear of trust?

Is there a fear of retribution when it comes to working with law enforcement?

What's the issue you guys are running into?

>> It is part of it, I'm sure in some communities, it is, You know, what I said is we can't do it by ourselves.

Law enforcement cannot do it by ourselves.

We have to have the support of our legislature.

We have to have the support of our communities.

Law enforcement has to work together.

We can't be territorial.

We can't worry about who's going to get credit for anything.

We have to work together.

We need our faith communities working with us.

We - and a big part of it is our court system, our judicial system, our entire criminal justice system has to come together.

Now, we've had almost a year where our courts have been shut down.

So, quite frankly, a lot of victims are not getting justice because of that.

They have a huge backlog.

They already had a huge backlog before COVID, and now that backlog is made even larger, and so one of the things that I'm going to, I'm going to try and do is we have to have more judges.

We have to have more sessions of court to be able to get some of these cases prosecuted and that means that our solicitors need more help.

Our public defenders need more help to be able to get these cases through court.

I heard it said the other day in one particular judicial circuit that they had over 100 pending murder cases.

That's unbelievable.

<Gavin> And have you gotten any support from the State House?

I know they're still crafting that budget.

The House just put it together again.

You guys are getting some pay raises there for law enforcement.

What about some of these other issues that you just described?

<Chief Keel> Well, I mean, not at this point.

Of course, we didn't know what the numbers were until this budget had pretty much already been crafted and we're continuing to do our quality control on these numbers.

We hope to have final numbers about the end of July and I hate to say it, but the final numbers, they're only going to go up.

They're not going to go down.

So, whatever these final numbers are, we probably will see a small uptick in the numbers that we reported preliminary.

And, Chief, I spoke with earlier the head of DAODAS, Sara Goldsby and she's going to be in the show later and she was talking about how they saw a big jump, last year when it came to overdoses when it came to drug issues very heavily influenced by the pandemic for a variety of reasons.

I'm wondering, do you see a correlation there too, whether it be the pandemic driving these rates or drug issues driving these rates up?

>> Well, I mean, I've got this, same question before and I, the only thing I would say is I don't think so and I say that only because we've seen a steady increase since 2016 in violent crime.

So, if we had not seen an increase and things would kind of level off and then we had this big increase because of COVID.

I would say yes that that it would have some impact.

I'm not certain whether it has or not, but I would say that again, this is what we've been seeing.

We've been seeing an uptrend for the last 6 years.

<Gavin> And Chief, you were talking during that press conference recently about sentencing reform.

We did see that kind of move through the House.

They passed a bipartisan bill dealing with that, dealing with, you know, getting mandatory minimums for a criminal for drug offenders.

We're talking about changing up weights and possession and trafficking requirements.

I want to ask you just what your thoughts are because you did say efforts like sentencing reform always seem to incentivize criminal conduct.

How do you feel about what's working through right now?

>> Well, I'm not supportive of it.

Needless to say, again I think it does incentivize crime.

Anytime you make it more difficult to prosecute somebody, you make the penalties less and especially when again what we're seeing is so much drugs and gangs connected with violent crime.

I think that's an incentive for criminals and I don't think it's good for public safety.

But how about those low level offenders those drug addicts, essentially that get picked up should they maybe, should there be some sort of carve out for them in terms of maybe getting them more into diversion efforts, rehab drug courts, instead of kind of working them through the system?

<Chief Keel> And we support the drug court system and we continue to support that, but we're not talking about users here for the most part.

We're talking about dealers.

We're talking about the people that are trafficking narcotics and that are doing it in a violent way and carrying guns every single day that they're doing it and gangs that are territorial, and so again, we're not talking about the user when we talk about this.

When they talk about trafficking and drugs and lowering the penalties.

Those are not people, you know, that are just users.

If they have multi pounds of methamphetamine, heroin or marijuana, or whatever type of drug it is.

So, keeping those tight sentences.

So therefore, there's also a bill, the hate crimes bill, that sentencing enhancement for people that commit hate crimes especially aggravated, even deadly hate crimes.

Is that something that you guys also support then, when it comes to tougher sentences?

>> Hate crimes is a bill that came out.

It'll be interesting to see how that how that works in our in our system.

I think that to me anytime somebody murders somebody, it's a hate crime.

So, I mean, I have some concerns about that because again when I see violent crime, I see hate and so to me it's all hate crimes.

>> And then also looking at, you know, community concerns here and also you know, police misconduct issues obviously we've had a huge watershed moment in our country, following the death of George Floyd last year and the protests we saw come out of it.

Even at the State House level, we did see a lot of movement on reform bills but when you're looking at, you know officer misconduct, how do you - do you think enough is being done in our state to help maybe weed out those bad apples?

Obviously, not all cops are bad people but there are some that give them a bad name.

What do you think needs to be done in the state to help prevent that from happening further?

>> I will say this, I happen to be chairman of Law Enforcement Training Council, which is a governing body for our Criminal Justice Academy and I will tell you that we have one of the best programs to deal with officer misconduct in the country.

We meet once a month and every month, we are voting on officers who have been - information has been sent to us about officer misconduct and we are unlike most states, we can deny eligibility for that person to be a police officer, forever.

They don't have that opportunity to get back.

If they have been dishonest in their work.

That is one that we absolutely deny eligibility for law enforcement certification in South Carolina and not only that but we already put it in the National De-certification Index that is run by an association called IADLEST, which is all the training, training academies, training instructors.

And so, South Carolina has a great system for misconduct.

We in our profession, we have to regain the trust and respect of our communities.

This is not something that we can do after we have a tragic incident.

I have said for years that we must establish those relationships in our communities, that trust, that respect so that when we do have these tragic incidents, things don't, we don't end up seeing - They know that law enforcement's going to do the right thing and that's what we're trying to new in South Carolina.

>> And Chief, just one final question.

I know we have less than a minute but I want to ask you, for folks that just heard those crime stats and are maybe concerned about crime in South Carolina in their communities because it sounds like it doesn't discriminate in terms of wealth or poor rural or city areas.

What should folks know when it comes to what's happening, what they can do to maybe prevent themselves from becoming a victim?

>> Well, you know, it sounds simple but I tell my children and my wife, you got to keep your head on swivel.

I mean, I hate to say that, you know, we hate to be that way but the bottom line, you have to be aware of your surroundings, and I think that's the best advice that we can give.

The other thing is that again, I would plead with the communities.

We need your help.

Law enforcement needs.

The community's help to be able to make a difference to stop this trend of rising violent crime and to get it back below where it is.

We can not do it without the communities help and we understand that we have to gain that trust and respect in communities, but we desperately need the community's help.

>> SLED Chief Mark Keel.

Thank you so much for joining us.

>> Thank you.

>> Joining me now to discuss rising drug trends and more is Sara Goldsby.

She's the Director of the Department of Alcohol and other Drug Abuse Services.

Sara, welcome back to This Week in South Carolina.

>> Thanks, Gavin.

>> So, Sara, the last time we talked, it was last April.

The pandemic was just starting to ramp up unfortunately and you were sounding the alarm about what you thought was going to be happening as a result of the pandemic, increased isolation, other issues presented from it.

Kind of tell us what you guys have seen preliminarily over the past year when it comes to these trends, unfortunately?

>> Yeah, we've seen some really unfortunate trends with incidents of overdose and what we believe will be mortality from overdose incidents and first, I just have to say it's not only South Carolina but it's every state in the nation and you know, like I said last year, we anticipated this to some degree because of the isolation that we knew people would experience.

The other stressors, anxieties, and fears related to, you know, what was going on with COVID-19, and folks psychologically and we know folks use substances and drink alcohol to simply feel good or to alleviate negative feelings.

And so we knew that we would see an increase in those issues.

However, simultaneously, you know, we saw an increase in the availability of extremely potent illicit made synthetic opioids coming into the United States and reaching our state, as well.

These things are coming from China and from Mexico and, you know, Fentanyl is really the culprit in what we believe will be, you know, majority of the fatalities that we saw last year, unfortunately.

>> So, what kind of data do you have right now?

I know it's still very early but I feel like you guys released, excuse me, some stuff last year late last year, kind of pointing to, you know, maybe Narcan administrations or just actual data that you have so far.

What's it been showing?

What's some of the news there?

>> Yeah, so our overdose Rapid Response team has really been monitoring incidents of suspected overdose statewide and as close to real time as possible.

So, we've seen on a day to day and week to week basis where the hotspots are and where the incidents and the number of incidents that are occurring.

I think overall last year, we averaged around 50% increase in incidents of suspected overdose over 2019.

You know, levels have remained relatively high but we're really beginning to see things level off and taper down just a bit.

Thank goodness.

And it's, I believe really, too, a lot of cross sector communication.

The alerts that we've issued to local law enforcement who are working so hard on interdiction, and then really getting our treatment and recovery organizations along with hospitals to do some more rapid and proactive outreach and prevention.

Yeah, you just excuse me again, you just mentioned that 50% increase over the year.

So it looks like so far I saw some data saying that 915 suspected opioid overdoses happened last May alone, which is a month long high.

And that was really kind of corresponding with a lot going on looking also possibly with the availability of some stimulus money.

Do you think that might have played a role in people maybe being able to purchase some drugs or alcohol that they wouldn't have had the option to before?

Yeah, we don't have any absolute evidence that that's what occurred, but we have strong suspicions that folks were using that stimulus money to purchase their substance, and alcohol, of course, and so really a confluence of things that have just exacerbated issues that might have been already there.

>> And some other issues too, not just opioids, but you guys have seen increases in other drug use prescription drug abuse.

What are those trends looking like?

People talking about benzodiazepines, talking about Xanax and Valium, I assume.

What's happening there?

Are people just looking at these prescription drugs and thinking "Oh, they're safe.

I can have one or two and have some "alleviate some concerns and maybe not have a "prescription for them."

What's the trend happening there?

>> Yeah, you know, the trends in prescriptions dispensed in South Carolina have actually been improving over time.

We have seen, you know, an increase in the stimulants dispensed in our state, which is you know, concerning but what we've really seen is these counterfeit prescription drugs that are very pure, like I said, illicitly made Fentanyl products that look like things that folks would think are more safe, like Xanax or an Oxycodone.

And so these illicit drugs which are just pure poison, look like something that folks might perceive as safe, more safe and so really that's the trend that we've been seeing but I've really got to, give kudos to our prescribers who have been absolutely doing better especially with the laws that we've passed on prescribing over time.

<Gavin> I was going to say the scripts network that's in place in the state, they really kind of reinforced that recently too.

So, you are seeing results from from that legislation?

>> Absolutely, statewide.

You know, we still have a couple pockets in the state where we see high rates of prescribing, but overall prescribing is down, but you know, still there are always risks with co-prescribing, like you said the Benzodiazepines with the opioids and then some, you know, other new drugs that maybe have been marketed for off label use.

<Gavin> So, Sara with all this increase that we're talking about here.

Have you seen any increase in funding to help combat this, whether it's state or federal at this point?

>> Yes, absolutely.

So, you know, we have continued to ask the general assembly for just a little bit of funding to support our, you know, base budget so that when the federal funding goes away, we can maintain the efforts that we've worked so hard to build, but we have seen a couple ways of federal funding things to Congress, an act passed in December and then an act passed the American Rescue Plan Act in March, really supports our state and all states with supplement to the Substance Abuse Prevention and Treatment Block grant funding that we received and we've been the administrators of that for so long.

So, we know the federal requirements.

We have the providers to do the work and this really helps us expand and move more into the access space that we fell short on in the past.

<Gavin> Yeah, so does this money help maybe expand access to providers or what do you anticipate this money going to do and reinforce?

<Sara> So, we hope to support our providers in doing more outreach, having folks especially like peer support specialists embedded in non traditional settings to engage folks who may be uncertain about treatment.

We'd really like to get folks into jails.

We're really looking closely at mobile addiction treatment services.

We're thinking about addiction and recovery outside of the walls of what is traditionally a treatment center, right and making those recovery services and treatment opportunities more available where people are bringing the services to the people.

>> Gotcha.

And then also changing gears a little bit to Naloxone.

We're talking about Narcan.

We're talking about that opioid overdose reversal drug there.

Tell us a little about the critical nature of this drug and maybe where some legislation has been so far this past year in terms of increasing access to it in our state.

<Sara> Sure, you know, so Naloxone is the key to keeping people alive.

Everybody who's, you know, at risk of an overdose really needs to have Naloxone available when that overdose might occur and so a number of bills have been passed and amended, you know, the Overdose Prevention Act and and amended again Thanks to our general assembly, it's really allowed so much more access of what is a prescription drug, but a very harmless prescription drug that simply keeps people breathing when they're experiencing an overdose.

I think the legislation that we saw passed this year, really requiring prescribers to co-prescribe Naloxone to those patients that are at high risk of overdose is going to be beneficial in a number of ways and what we keep saying is that it really just invites the conversation between a trusted prescriber and a patient who may not know that they are at risk of overdose, right.

So, even if these Naloxone prescriptions don't get filled, patients are getting education and having a very important conversation and prescribers are actually becoming more aware of the risks of their patients.

>> So, it's really just a matter - it's one less hurdle for these folks who are at the highest risk to getting Naloxone to getting this life saving treatment, at least having it around potentially.

So, if the worst happens, someone maybe could have access to it that they otherwise wouldn't have.

>> Absolutely.

and I just keep reminding everybody.

It's more than just those folks who are experiencing a substance use disorder.

We've got to be thinking about our seniors who are on very high doses of this drug or other folks who maybe need high doses of opioids but have those, you know, in the home where others may have access to them and folks who are at risk.

There are a number of people outside of those who you might typically think that really might need access to this drug.

>> And Sara there were some stories earlier this year talking about some hospitals in the Upstate region.

The Greenville News did a story looking at how some of these hospitals and their Naloxone policies for their patients that are being discharged that have these substance abuse problems, not all of them were getting Naloxone or even aware of it.

There's other hospitals in the state that have different policies where they make sure that they have a prescription or they actually have it in hand when they leave and there's actually reference to counseling services and things like that.

Tell us why is there such a disparity here when we're talking about best practices for these people who are at the highest risk and what y'all are trying to do to kind of close that gap.

<Sara> Yeah, Gavin, I'm glad that you asked and first, I just have to say, I think we've learned a lot in recent months with those new stories just about the variation among hospitals and their practices with dispensing Naloxone for patients.

You know, folks who experience an overdose get transported to an emergency department.

If they are not stabilized and treated in that setting, they're at extremely high risk of returning to use and overdosing again.

And so getting the Naloxone to a caregiver of that patient, you know, when they touch a health care system is just critical and it makes so much sense.

So, I think over time, we probably made a lot of assumptions that hospitals had these assets and knew what to do and now we're seeing that there's wide variation among the assets that hospitals have and in particular, the kinds of pharmacies they have, the kinds of policies and practices that they've adopted.

So, what we're interested in doing is really going back to the boards of medical examiners, nursing and pharmacy looking at the joint protocol that allows community distribution of Naloxone.

That was an opportunity afforded to the state with the Overdose Prevention Act, and maybe offering some language clarifying to hospitals that they are eligible for community distribution, outlining the ways in which they can adhere to the regulations on dispensing and record keeping but still get that medication in the hands of folks who need it.

<Gavin> And then also, I want to ask you really quickly before we leave with a minute left just about a new effort called Embrace Recovery SC, that launched this year.

Tell us about that.

Obviously, some efforts to really kind of bring these people who have suffered and are on recovery to keep going on that path.

>> Yeah, it's a campaign we've wanted to do for a long time to truly celebrate what we estimate is the more than 378 thousand South Carolinians living lives in recovery.

These are folks with resilience, strength, and joy in their everyday life and they're everywhere.

They're all over the state and so this is an effort to really draw folks to the Embrace Recovery SC.com site.

For more information on how to achieve recovery, recovery groups, the recovery community organizations around the state and then adopt supportive language, you know, leave behind old terms that drive stigma and bias and adopt recovery supportive language.

And in addition to that, we have two very powerful new television spots running statewide that really drive an inspirational message and reinforce the fact that addiction is not a moral failing.

<Gavin> So, some positive news right there when it comes to recovery even amidst some disturbing trends we're looking at with drug use numbers.

So again, a lot of work to be done there but good to hear that things are happening.

Sara Goldsby, thank you for joining us.

She's the director of DAODAS here in the state.

Thanks, Sara.

>> Thanks Gavin.

>> 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 and you can find it on South Carolina Public Radio.org or wherever you find podcasts For South Carolina ETV.

I'm Gavin Jackson, Be well, South Carolina.