Minneapolis sees spike in overdoses, with opioids causing most deaths

With just over a month left in the year, Minneapolis has recorded more than 1,300 drug overdoses — a sobering milestone that's the highest in at least a dozen years.

The 1,360 count through Nov. 18 easily surpassed the 954 overdoses reported in all of 2018 and left city and public health officials scrambling to respond to the opioid crisis. The data dating back to 2007 only captures cases in which police, firefighters or paramedics respond to a reported overdose, fatal or otherwise, and not those instances in which victims are revived by someone at the scene or get to the hospital on their own.

While rates of methamphetamine and cocaine abuse are soaring, heroin and prescription opioids are still the No. 1 killer on city streets, according to Noya Woodrich, a deputy commissioner for the city's health department. Parts of Minneapolis are now experiencing spikes in overdoses after being spared the full force of the opioid epidemic that ravaged parts of New England and Appalachia for much of the past decade, she said.

"Our problem is probably not as bad as theirs, but I would still say it's pretty bad, and in Minneapolis for the American Indian community and for the African-American community, in particular, the numbers do tell us that this epidemic is hitting those communities the worst," Woodrich said. "What the data is telling us, though it's not perfect, is that the opioid problem is serious enough that we have to do something with it."

Still, she and others cautioned against comparing the recent numbers to the crack epidemic of the 1980s and 1990s, or any other period, when data reporting for nonfatal overdoses was inconsistent.

"The bottom line is that, at the minimum, this reflects that there's still a great deal of work to do in addressing opioid overdoses," Woodrich said, while adding that there isn't one solution to the problem.

Although the tally for fatal overdoses in 2019 was not yet available, Minneapolis totaled 97 overdoses last year. Health Department data show that fatal drug overdoses in the city almost tripled between 1999 and 2018 — from 34 to 97 — peaking with 117 in 2017. This mirrored a national trend that saw overall drug deaths fall 5.1% from 2017 to 2018, the first significant decline since the 1990s. There were 331 opioid overdose deaths statewide last year.

While the number of fatal drug overdoses seems to have plateaued, the threat of overdosing is as high as ever, officials say.

Stephanie Devich, a harm reduction specialist at Valhalla Place, a treatment center, said that dealers, in search of cheaper and stronger product, have taken to mixing heroin with fentanyl and other synthetic opioids. As a result, drug users don't always know what they are taking, increasing the likelihood of an overdose, she said.

"So, I think we're seeing a lot of people become dependent faster," she said. "We're seeing it in the Somali community, where we're seeing overdoses, but it's very hard to track it in that community because it's very closed off."

Tom Combs, a former ER doctor at North Memorial Health Hospital who has studied addiction and opioids, echoed that theme. "I think it's still a huge overwhelmingly public health threat," he said.

Carol Falkowski, a leading expert on the subject, said the reported increase could stem from a number of causes, including a greater willingness to report drug usage.

"Or it could be an actual increase in the prevalence, the number of people in the population who are overdosing, or the number of people who are becoming unconscious, therefore not necessarily an increase in the number of users, but a change in the potency of the product," said Falkowski, a career epidemiologist who for years compiled biannual reports on drug trends. "And it could be a combination of all of those things that could be producing that increase — and it likely is."

That more people aren't dying is likely thanks to the increased availability of the opioid antidote naloxone, known popularly as Narcan, she said.

Meanwhile, hospital admissions in Minneapolis for drug-related issues also decreased slightly last year, from 1,711 in 2017 to 1,639 in 2018, the data show.

The crisis, which in its early stages was largely confined to neighborhoods just south of downtown, has in recent years spread to others, notably the Cedar-Riverside neighborhood and parts of the North Side.

Council Member Jeremiah Ellison said it's time for the city to start exploring innovative solutions for the opioid crisis, pointing to the example of cities like Philadelphia, where a legal fight is brewing over the opening of a "safe injection site," where users can consume illicit drugs under medical supervision.

"There's steep opposition to harm reduction strategies, but I don't think that we should allow that to deter us from seeking those solutions," Ellison said.

At a meeting of Somali mothers last month, several speakers spoke of the need for honest conversations about ways to stop what remains a largely unspoken problem in the East African community.

"What you can do? You ask them, but they deny it," one of the mothers asked.

Mayor Jacob Frey's 2020 budget proposal sets aside more than $400,000 toward implementing recommendations from a mayoral task force on opioid abuse.

Last year, police officers spent the equivalent of 34 calendar days responding to overdoses, officials said.

Libor Jany • 612-673-4064 Twitter: @StribJany