COLUMBIA — The number of overdose deaths has been on a decline in recent years, but people should remain vigilant about counterfeit pills and other drugs, especially with new illicit substances on the rise, officials said Thursday.
In South Carolina, the number of overdose deaths decreased nearly 30% between April 2024 and 2025, according to the Centers for Disease Control and Prevention. That was higher than the national average of about 24%, said Michael Tooley, who oversees the Drug Enforcement Administration’s Columbia office.
By the numbers
So far in 2025, as of Thursday, the Drug Enforcement Administration in South Carolina has:
Source: Drug Enforcement Administration
That continued a trend of decreasing overdose deaths, which declined in the state in 2023 for the first time in nearly a decade, according to the state Department of Public Health.
The exact reason for fewer deaths is unclear, Tooley told reporters Thursday.
Part of the reason may be that more people know about and carry naloxone, often referred to by the brand name Narcan, which can reverse an opioid overdose, he said.
“I think public awareness is helping significantly,” he said. “People know what to look for now.”
Health clinics and schools have begun offering the medication for free in recent years, in an effort to increase awareness. The Department of Public Health offers free opioid overdose kits at its local health clinics, which include naloxone nasal spray, as well as test strips to detect fentanyl and xylazine, which are highly fatal substances often mixed into other drugs without the buyer knowing.
The University of South Carolina began making naloxone available for free in 2022, a move that other public colleges soon followed. In 2023, legislators passed a law creating a list of lifesaving medications nurses in K-12 public schools were allowed to administer, including naloxone.
And state prisons offer naloxone to visitors, since people with a loved one convicted of a drug crime often know others at risk of overdosing, said Bryan Stirling, acting U.S. attorney and former director of the state Department of Corrections.
Because of the rise in awareness of naloxone, a decrease in deaths doesn’t mean a decrease in overdoses, Tooley said. And new synthetic drugs that are more fatal, more potent and less responsive to naloxone, such as the highly lethal fentanyl, can pose new dangers, he said.
Naloxone only works on opioid overdoses, so for drugs such as xylazine that don’t come from opiates, the medication will be ineffective, Tooley said. High-potency opioids known as nitazenes might require multiple doses of naloxone to reverse the effects, Tooley said.
Drug enforcement agents have not yet found nitazenes in South Carolina, Tooley said. With busts uncovering the substance in Texas and New York, however, he warned that it was likely a matter of time before the drug arrived in the Palmetto State, he said.
Dealers frequently mix the cheaper and highly deadly fentanyl, xylazine and nitazenes with other drugs or pass them off as prescription medications to maximize profits and increase the high a person gets, bringing them back for more, Tooley said.
That also increases the risk of overdoses, since people often don’t know what they’re getting, he said.
For instance, a person without a prescription trying to get a certain drug might believe they’re buying oxycodone, Adderall or Xanax only to end up with fake pills containing a much more deadly substance, Tooley said. Not knowing what’s in the pills, which are often nearly identical to the real thing, a person might accidentally take a deadly dose, he said.
Illicit substances are cheaper to produce than the genuine medications, often selling for as much as 10 times what they’re worth, Tooley said. Plus, getting a person hooked on a much more addictive substance, such as methamphetamine or cocaine, can lead to higher profits for drug dealers, he said.
More than 99% of the pills agents seized during drug busts in 2024 were counterfeit, as opposed to dealers illegally selling the real thing, Tooley said.
Record seizure
Overdose deaths went down as the amount of drugs seized by agents during busts rose, Tooley said.
So far in 2025 in South Carolina alone, the Drug Enforcement Agency has seized 232 kilograms of cocaine, more than triple the 62 kilograms found during all of 2024. And fentanyl busts increased seven-fold, from 18 kilograms in 2024 to more than 140 kilograms in 2025, Tooley said.
In July, drug enforcement agents carried out the largest seizure of fentanyl in state history, uncovering 71 kilograms, or 156 pounds, of the drug from a tractor trailer in Lexington County, according to the U.S. Attorney’s Office.
People should remain diligent, Tooley said.
Patients should only take medications prescribed by a licensed doctor, and parents should talk to their children about the dangers of drugs, many of which are advertised through social media as if they were legal, Tooley said.
“Don’t take this warning lightly,” Tooley said. “It only takes one counterfeit pill with a lethal dose of fentanyl to kill you or your loved one.”
Skylar Laird covers the South Carolina Legislature and criminal justice issues. Originally from Missouri, she previously worked for The Post and Courier’s Columbia bureau.
SC Daily Gazette is part of States Newsroom, the nation’s largest state-focused nonprofit news organization.
