The number of opioid overdose deaths in Minnesota has risen sharply since 2018. In Minnesota, American Indians and Blacks are experiencing the opioid epidemic more critically and with deadlier consequences.
According to the Minnesota Department of Human Services, the number of opioid-involved deaths reached 924 in 2021, up from 343 in 2018, increasing by 44 percent from 2020 to 2021. American Indians are seven times more likely to die from a drug overdose than Whites, while Blacks are twice as likely to die from a drug overdose.
On February 24, the Minnesota Department of Human Services announced it is awarding $5.7 million in grants to 12 organizations—including Neighborhood Health Source, Pillsbury United, Hennepin Health, RS Eden, and Wayside Recovery—to expand the services available for people suffering from opioid addiction. Nearly all of the funding is going to groups primarily serving Native, Black, and communities of color that are disproportionately impacted by the opioid epidemic.
The grants will support culturally specific practices, including primary prevention and overdose prevention, workforce development and training, and expansion and enhancement of care. In addition, the funding includes $1 million for services focused on the East African population.
Over-the-counter naloxone
In mid-February, advisers to the Food and Drug Administration unanimously recommended that naloxone, an anti-opioid overdose drug, be made available over the counter. The panel voted 19-0 to make the treatment, which is currently available by prescription and at certain access points in Minnesota, more accessible.
The FDA is expected to make a final decision about the treatment by late March. If approved, naloxone could be available for purchase at convenience stores and supermarkets.
Over-the-counter access to naloxone would be a step toward advancing the fight against the opioid crisis, said Allie Carey, director of programs with the Steve Rummler HOPE Network. But she said it isn’t a magic bullet. Naloxone reverses the deadly respiratory depression associated with opioid overdoses. It comes in a nasal spray and an injection form, and is highly effective even when administered by people who are not medical professionals.
“It won’t be a universal solution,” said Carey. “An over-the-counter medication doesn’t necessarily take away some of the barriers that people might still face.”
Founded in 2011, the St. Paul-based Steve Rummler HOPE Network educates the public about the opioid crisis, provides training on naloxone administration, and distributes the life-saving drug via Naloxone Access Points across the state.
Naloxone can cost between $45 and $150 per dose depending on whether it’s Narcan or the generic version, Carey explained. Some people seeking to obtain naloxone to be able to treat loved ones may still be unable to access it, even if it’s made available over the counter.
Racial barriers to treatment
Race may also play a part in the gap in access to naloxone in a life-or-death moment, said Carey. When mistrust brews between emergency responders and communities of color, people might hesitate to call 911 in a crisis moment involving an overdose, delaying or preventing someone from receiving the treatment they need.
“African American or Black residents in our states face three times the risk of fatal overdose deaths that White Minnesotans do,” Carey said. That’s despite the fact that research shows “the actual use of these types of substances is really pretty level across demographic groups.”
Accessing naloxone via emergency responders could be complicated by the nature of the emergency response system. “The only way to seek emergency medical assistance is to engage the same system that deploys law enforcement,” Carey said. “We don’t have a designated system for just engaging medical services…and it makes total sense that communities of color would not feel safe engaging that system consistently.”
Other factors that could contribute to the disparity include restricted access to health care and a lack of access to representative mental health care.
Overcoming addiction stigma
Another barrier to more widespread use of naloxone is the negative stigma associated with the treatment, said overdose prevention administrator Willie Pearl Evans. Evans, who works with the Minnesota Department of Health, said that stigma stems from a “lack of education.”
At a naloxone access point, “Someone might see someone else there and they don’t want [them] to know that their family member or their loved one has a problem with substance use,” Evans said. “But they want to be prepared to save this family member.”
Misinformation about naloxone means some people might believe the treatment itself poses a danger. “A lot of people still don’t know what [naloxone] is,” said Christopher Burks, an outreach coordinator with the Twin Cities Recovery Project. “It is harmless.”
Burks and Evans both emphasized the need for more public education about substance abuse and treatment, particularly for youth. Drug overdose rates among adolescents rose exponentially during the pandemic, according to research from the University of California Los Angeles published last year.
“We’ve been trying to get into the school systems for the last couple of years…to make kids aware of what they’re taking, of the counterfeit pills they’re taking, so they can prevent it,” Burks said.
Within the state’s health department, Evans is working to increase investment in Minnesota’s vulnerable communities to build more resilient families and reduce risk factors for substance use, as well as implement harm reduction strategies that emphasize treating and preventing substance abuse over criminalizing it.
Learn more about the Opioid Epidemic Response Advisory Council and Minnesota’s fight against opioid addiction at gov/dhs/opioids. If you or someone you know is suffering from opioid use disorder, help is available. Visit knowthedangers.com/treatment-and-recovery to learn about treatment options, or knowthedangers.com/naloxone-finder to find naloxone near you.
