South Carolina has approximately 200 licensed substance abuse treatment facilities and recorded over 2,100 drug overdose deaths in 2023. The state faces significant treatment access challenges, with many rural counties classified as "rehab deserts" due to limited or no local treatment infrastructure. The South Carolina Department of Alcohol and Other Drug Abuse Services (DAODAS) is the single state agency responsible for planning, developing, and coordinating substance use prevention and treatment services.
Substance Abuse Statistics in South Carolina
According to NSDUH data, approximately 7.3% of South Carolina adults reported a substance use disorder in the past year. Fentanyl and other synthetic opioids are now the leading cause of overdose death, with fentanyl-involved fatalities increasing over 90% between 2019 and 2023. Methamphetamine has also surged as a major concern — meth overtook heroin as the second most frequently cited substance in treatment admissions.
Alcohol remains the most commonly misused substance, accounting for roughly 29% of all treatment admissions. The state has also seen rising cocaine-related overdose deaths, particularly in urban areas like Charleston, Columbia, and Greenville.
Types of Treatment Programs Available
Medical Detox: Medically supervised detox facilities operate in major cities including Charleston, Columbia, Greenville, and Myrtle Beach. Programs provide 24/7 medical oversight during the acute withdrawal phase. Access to detox in rural areas remains a challenge, with patients often needing to travel to urban centers.
Residential/Inpatient Treatment: South Carolina has over 60 residential treatment facilities ranging from short-term 28-day programs to long-term therapeutic communities. DAODAS funds several state-operated residential facilities. Private facilities offer evidence-based programs including CBT, trauma-informed care, 12-step facilitation, and family therapy.
Outpatient Programs: IOPs and standard outpatient services are available through DAODAS-funded county alcohol and drug abuse authorities and private providers. South Carolina's 32 county alcohol and drug abuse authorities serve as the primary point of access for publicly funded outpatient treatment.
Medication-Assisted Treatment (MAT): South Carolina has approximately 40 Opioid Treatment Programs. DAODAS has invested in expanding MAT access, particularly in rural areas through telehealth-based prescribing. South Carolina Medicaid covers buprenorphine and naltrexone, and methadone is covered through OTPs.
Treatment Access Challenges
South Carolina ranks among the lowest states nationally for treatment capacity relative to need. Many rural counties lack any residential treatment facilities, and the state's county alcohol and drug abuse authority offices — while present in all 46 counties — often face long wait times due to limited funding. DAODAS has worked to address these gaps through telehealth expansion, mobile crisis services, and strategic funding of new capacity in underserved areas.
Insurance & Payment Options
Medicaid: South Carolina has not expanded Medicaid under the ACA. SC Medicaid covers SUD treatment for eligible populations including assessment, outpatient counseling, MAT, and limited residential services. Eligibility is restricted primarily to children, pregnant women, low-income parents, elderly, and disabled individuals.
Private Insurance: Major carriers including BlueCross BlueShield of SC, Select Health, Absolute Total Care, and Molina cover SUD treatment under federal parity requirements. Verify your insurance to check your benefits.
State-Funded Programs: DAODAS funds treatment through 32 county alcohol and drug abuse authorities, which provide free or sliding-scale services to uninsured and underinsured residents.
Finding Help in South Carolina
SAMHSA National Helpline: Call 1-800-662-4357 for free, confidential, 24/7 referrals.
DAODAS Helpline: Contact DAODAS at 803-896-5555 or visit daodas.sc.gov for referrals to county authorities.
211 South Carolina: Dial 211 for local resource referrals including treatment programs, crisis services, and support groups.