How to use this Dashboard
The SC Opioid Treatment Dashboard contains real data about how well our communities identify and treat opioid use disorder. Here’s what it means for you, depending on the work you do.
What is this dashboard? This tool tracks how South Carolina identifies and treats opioid use disorder (OUD) from first diagnosis through 90 days of treatment and county by county. Data covers Medicaid enrollees and uninsured adults seen at county drug treatment centers, specialized opioid clinics, or emergency departments in 2021.
🏛 County & Municipal Leaders
Elected officials, county administrators, public safety directors, and local policymakers
Why this dashboard matters to you
Opioid use disorder is not just a health problem. It affects public safety, economic productivity, and the wellbeing of entire communities. This dashboard gives you county-level data on how many people are being diagnosed and treated, so you can see how your county compares with the rest of South Carolina and make the case for targeted investments.
The bottom line: Approximately six South Carolinians die every day from drug overdoses. Fewer than 10% of people with an active opioid addiction receive any treatment. This dashboard shows exactly where your county stands in the pipeline from diagnosis to sustained care – and where the gaps are.
Key numbers to know statewide
>50%
of SC residents with active, untreated OUD are never diagnosed
>60%
of Medicaid enrollees with OUD are not receiving timely medication
>70%
of Medicaid enrollees with OUD are not receiving timely counseling
How to navigate the dashboard
| 1 | Find your county. Use the interactive map on each dashboard page to zoom in on your county or multi-county region. Note that some small counties are grouped together (e.g., the Barnwell area includes Allendale, Bamberg, Barnwell, and Hampton counties). |
| 2 | Read the four stages. The dashboard tracks four stages of care (Diagnosis → Medication → Counseling → Retention) showing what percentage of people at each stage actually received care in time. Each stage shows what percentage of people diagnosed actually received that service within the recommended timeframe. |
| 3 | Look for the drop-off points. The biggest drop between stages in your county is where people are falling out of care. That gap is your highest-priority target for investment or policy change. |
| 4 | Use the ‘What Works’ guidance. Each dashboard section ends with evidence-based strategies local governments have used to close these gaps from pre-arrest diversion programs to mobile medication clinics. |
Specific actions local leaders can take
- Use county-level diagnosis data to see whether your health care system may be missing people with opioid use disorder and support training for clinicians in how to identify and refer them to care.
- Support or fund pre-arrest diversion programs and post-overdose response teams that connect first responders with behavioral health services.
- Use opioid settlement funds to expand evidence-based programs. The SC Guide to Opioid Settlement Fund Uses identifies approved strategies.
- Advocate for or fund jail-based medication-assisted treatment programs. Research shows these programs reduce re-arrest and improve long-term outcomes.
- Share this data with your county council, health department, and local hospital systems to build a coordinated local strategy.
Important note on interpreting the data: Differences in diagnosis rates across counties reflect both health care system practices and differences in the underlying prevalence of OUD in each community. A low diagnosis rate doesn’t automatically mean your health care system is failing to identify residents with OUD. It may also mean OUD is less prevalent in your area. Use these numbers as conversation starters, not scorecards.
🩺 Clinicians
Physicians, nurse practitioners, physician assistants, pharmacists, behavioral health providers, and hospital staff
Why this dashboard matters to you
Every time you see a patient with opioid use disorder, you are standing at a critical decision point in a chain of care that if it holds, can prevent overdose and death. This dashboard shows how well that chain is holding across South Carolina, measured against national benchmarks. You’ll find data directly relevant to your clinical decision-making and quality improvement efforts.
Core clinical message: Untreated opioid use disorder doubles the risk of death from any cause. FDA-approved medications (buprenorphine, methadone, and naltrexone) are evidence-based and lifesaving. Medication should begin immediately after diagnosis, with or without concurrent psychosocial (counseling and behavioral therapy) treatment. Do not wait for a counseling slot to open before prescribing.
What the data shows about timely care
36%
of newly diagnosed Medicaid enrollees received any medication for OUD within 30 days of diagnosis
27%
started psychosocial treatment within 14 days of diagnosis
45%
of those who started medication were still on it at 90 days
What the Cascade of Care means for your practice
The Cascade of Care framework divides OUD care into sequential stages. Each stage on this dashboard maps to a clinical action you can take:
| 1 | Diagnosis: Are you systematically screening for OUD using validated tools (e.g. DAST-10, TAPS, ASSIST)? The dashboard shows that over half of SC residents with active OUD are never diagnosed. Using Screening, Brief Intervention, and Referral to Treatment (SBIRT) in your setting can change this. |
| 2 | Medication initiation: All clinicians with DEA Schedule III authority can now prescribe buprenorphine. The first 14 days after diagnosis are the highest-leverage window. Early medication dramatically reduces overdose risk. |
| 3 | Counseling initiation: While medication should never be withheld pending counseling, psychosocial treatment adds significant benefit when available. The dashboard tracks whether patients completed at least one counseling session within 14 days and two sessions within 34 days. |
| 4 | Retention at 90 days: Longer engagement in treatment is associated with better outcomes. The dashboard counts patients as retained if they had no gap in medication longer than 7 days (or 14 days for counseling) during a 90-day period. |
Clinical resources embedded in this dashboard
- The SC Center of Excellence in Addiction operates a free, confidential clinician warmline for medication management questions: 864-914-1301 (Mon-Fri, 9am-5pm ET).
- The American Society of Addiction Medicine’s (ASAM) Clinical Practice Guideline on the Management of Stimulant Use Disorder & 2020 National Practice Guideline for the Treatment of Opioid Use Disorder
Quick reference: the three FDA-approved medications
Buprenorphine – Partial opioid agonist (acts on the brain’s opioid receptors, but with a ceiling effect that limits misuse risk). Usually a daily tablet or dissolvable film. Reduces cravings with lower overdose risk than full agonists. Any DEA-registered prescriber with Schedule III authority can prescribe it.
Methadone – Full opioid agonist. Available only through federally certified Opioid Treatment Programs. Highly regulated; often requires daily clinic visits initially. Highly effective for severe OUD.
Naltrexone (Vivitrol®) – Opioid antagonist. Monthly injection. Non-addictive. Blocks euphoric effects. Requires full opioid detoxification before initiation. Injectable form is rarely used in SC currently.
🔬 Researchers & Public Health Professionals
Epidemiologists, health policy analysts, program evaluators, state agency staff, and academic researchers
Why this dashboard matters to you
This dashboard makes publicly available a novel application of the Opioid Cascade of Care framework to South Carolina Medicaid and uninsured claims data – a rare combination that allows comparison across insurance status, county, and region. Whether you’re designing interventions, conducting surveillance, or supporting legislative decision-making, this data can anchor your work in real-world population patterns.
Data & Methods Summary
Data years – 2021-2025 healthcare claims (any care during the COVID-19 pandemic, interpret accordingly).
Medicaid cohort – 464,493 SC Medicaid enrollees aged 18-64 with at least 10 months of enrollment in 2021. See the dashboard methods section for cohort numbers in subsequent years.
Uninsured cohort – 221,589 uninsured adults aged 18-64 with a continuous 3-month period without insurance evidence, seen at a County Alcohol and Drug Authority, Opioid Treatment Program, or emergency department in 2021. See the dashboard methods section for cohort numbers in subsequent years.
New diagnosis definition – OUD diagnosis with a clean 2-month lookback window (no prior OUD diagnosis or treatment in preceding 2 months, not necessarily first-ever diagnosis).
Measure specifications – Adapted from the National Committee for Quality Assurance (NCQA) HEDIS measures. Initiation windows: 14 days (first treatment), 34 days (two treatment encounters). Retention: 90 days without treatment gap >7 days (medication) or >14 days (psychosocial).
Geographic groupings – Small counties collapsed for statistical stability (Barnwell area, Greenwood area, Newberry area). Counts ≤10 are suppressed.
IRB – Approved by University of South Carolina IRB. Data accessed under data use agreements with the SC Office of Revenue and Fiscal Affairs (ORFA), Department of Health and Human Services (DHHS), and Office of Substance Use Services.
Key findings worth noting
1.4%
of SC Medicaid adults 18-64 had an OUD diagnosis (in 2024) – below the national Medicaid average of ~3%
81%
of uninsured adults 18-64 with OUD did not receiving timely medication in 2024.
0-80%
range in county-level medication treatment retention rates (in 2024)
| 1 | Data captures only Medicaid enrollees and uninsured individuals seen at CADAs, OTPs, or EDs – does not represent privately insured individuals or uninsured individuals seen at FQHCs. |
| 2 | Medicaid claims data reflects billed services only; unprescribed, unused, or non-reimbursed care is not captured. |
| 3 | 2021 data reflects care patterns during COVID-19, which may not represent typical trends. |
| 4 | Percentages are estimates based on claims; they are not exact population counts. |
| 5 | Injectable naltrexone is excluded from the medication measures due to very low prevalence in SC. |
How this dashboard can support your work
- Baseline benchmarks: Use county- or region-level cascade rates as baseline measures for intervention studies or program evaluations.
- Disparity analysis: The parallel Medicaid and uninsured data allows comparison of treatment access across insurance status, a relatively rare public data feature.
- Quality improvement monitoring: HEDIS-based measures allow comparison with national plan performance data, supporting benchmarking and policy recommendations to Medicaid managed care organizations.
- Identifying research gaps: The ‘What Works’ sections explicitly flag where evidence is limited, pointing to priority research questions for the field.
- Geographic targeting: Substantial county-level variation in all cascade measures across the state.
The Cascade of Care framework is referenced by CDC’s MMWR (Vol. 73), NIH, NIDA, and SAMHSA. The dashboard team’s methodology is grounded in NCQA/HEDIS and National Quality Forum specifications – methods that are peer-reviewed and widely used for health plan performance comparison across states.
🚒 First Responders & Social Service Workers
Paramedics, law enforcement officers, EMTs, social workers
Why this dashboard matters to you
You are often the first – and sometimes the only – point of contact between a person with opioid use disorder and the health care system. The data on this dashboard shows what happens after that contact: how many people receive a diagnosis, get connected to medication, attend counseling, and stay in treatment. It reveals where the pipeline breaks and where your referrals and warm handoffs can make the difference between life and death.
The most important thing to know: Most people with opioid use disorder are never diagnosed. Of those who are, the majority do not receive timely treatment. Every time you connect someone to care, you are working against a system that loses most people before treatment even begins. This dashboard makes that visible and shows which approaches are working.
What the data reveals about where people get lost
>50%
of SC residents with active OUD are never diagnosed – they never reach the first step
80%
of uninsured adults with a new OUD diagnosis are not receiving timely medication
>65%
of uninsured adults with OUD are not receiving timely counseling after diagnosis
How to read the dashboard with your role in mind
| 1 | Look at the Diagnosis page first. Your county’s diagnosis rate tells you how effective the health care system is at identifying OUD among the people you’re already seeing. A very low rate may mean few clinical settings are doing systematic screening and your outreach is filling a critical gap. |
| 2 | Notice the uninsured column. The dashboard shows separate data for uninsured adults, many of the people you encounter. Uninsured individuals consistently have lower rates of medication and counseling receipt, even after diagnosis. This is who needs the warmest handoffs (a direct, supported introduction to a treatment provider, rather than just giving someone a phone number) and strongest referral relationships. |
| 3 | Find local provider maps. The dashboard links to Just Plain Killers (a SC overdose awareness resource) and the Office of Substance Use Services (the SC state drug treatment agency) – useful resources to have ready when you’re in the field. |
| 4 | Use the ‘What Works’ sections for advocacy. Each dashboard page lists evidence-based strategies including post-overdose response teams, pre-arrest diversion programs, and harm reduction programs – giving you specific language to advocate for resources in your community. |
Evidence-based strategies your work supports
- Post-overdose response teams: Following up with overdose survivors, as SC’s Community Outreach Paramedic Education (COPE) program does, creates an opportunity for warm handoffs to treatment and peer support that would otherwise be missed.
- Pre-arrest diversion: Programs that redirect people with OUD to treatment instead of arrest are highlighted in the dashboard as promising approaches to increasing diagnosis and treatment initiation rates.
- Authorized EMS unites can provide buprenorphine: Authorized EMS units can now provide buprenorphine to patients they see for an overdose. Apply here.
- “No wrong door” referrals: Emergency departments, jails, resource centers, and harm reduction programs are all recognized as valid entry points to treatment. Your referral, however informal, can be the first step toward treatment.
Resources to bookmark: The Office of Substance Use Services can be reached at 803-896-5555 for information about local treatment options. The SC Center of Excellence in Addiction also offers technical assistance and training for community workers and clinicians: addictioncenterofexcellence.sc.gov
Community Outreach Specialists
Peer support specialists and harm reduction workers
Why this dashboard matters to you
As a peer support specialist or harm reduction worker, you often build the kind of trust that gets someone to take a next step toward care, sometimes well before they ever see a clinician. This dashboard shows what happens after that trust is built: how many people go on to get diagnosed, start medication, attend counseling, and stay engaged in treatment. It can help you see where the system tends to lose people, and where your relationship-based work is most likely to make the difference.
The most important thing to know: Most people with opioid use disorder are never diagnosed, and most of those who are diagnosed don’t receive timely medication or counseling. Your contact with someone may be the most consistent point of contact they have with any part of the care system. Harm reduction approaches that meet people where they are, without requiring abstinence first, are associated with better long-term engagement in treatment.
What the data reveals about where people get lost
>50%
of SC residents with active OUD are never diagnosed – they never reach the first step
80%
of uninsured adults with a new OUD diagnosis are not receiving timely medication
>65%
of uninsured adults with OUD are not receiving timely counseling after diagnosis
How to read the dashboard with your role in mind
| 1 | Look at the Diagnosis page first. Your county’s diagnosis rate shows how many people with OUD the formal health care system is reaching. A low rate often means people you’re already in contact with, through outreach, syringe services, or peer support, simply haven’t been connected to a diagnosis yet, even if they’re ready for one. |
| 2 | Notice the uninsured column. The dashboard shows separate data for uninsured adults, who make up many of the people you work with directly. Uninsured individuals consistently have lower rates of medication and counseling receipt, even after diagnosis. This is exactly where a warm handoff, walking someone to an appointment or making the introduction yourself rather than just giving out a phone number, can change whether they actually get connected to care. |
| 3 | Find local provider maps. Just Plain Killers (a SC overdose awareness resource) and the Office of Substance Use Services (the SC state drug treatment agency) are useful resources to have ready when you’re in the field. |
| 4 | Use the ‘What Works’ sections for advocacy. Each dashboard page lists evidence-based strategies, including harm reduction programs, peer support models, and pre-arrest diversion. Use them to advocate for resources in your community, and to show that your role is part of the evidence base for closing these gaps, not separate from it. |
Evidence-based strategies your work supports
- Harm reduction programs: Syringe service programs and naloxone distribution not only prevent death – they are also effective points of connection with individuals who may eventually enter treatment.
- “No wrong door” referrals: Emergency departments, jails, resource centers, and harm reduction programs are all recognized as valid entry points to treatment. Your referral, however informal, can be the first step toward treatment.
- Peer support: Peer support specialists working alongside clinical teams are part of the evidence-based continuum of care described in this dashboard.
Resources to bookmark: The Office of Substance Use Services can be reached at 803-896-5555 for information about local treatment options. The SC Center of Excellence in Addiction also offers technical assistance and training for community workers and clinicians: addictioncenterofexcellence.sc.gov
Ready to Explore the Data?
Use the interactive maps and charts on the dashboard to find your county, see how it compares, and identify where the biggest gaps in care exist.