Minnesota experts welcome Trump's declaration but hope it brings additional funds

Addiction and public health authorities in Minnesota welcomed President Donald Trump's emergency declaration on Thursday, saying they hope it will reduce stigma and promote treatment in a state where overdose deaths have soared in recent years.

"Individuals struggling with addiction had been [treated as] the stepchild of the family," said Dr. Roger Laroche, medical director for addiction services at Allina Health. "If addiction is declared a national emergency, then families can openly discuss it at the dining room table."

At the same time, they argued that the government must increase funding to turn the tide and said the president was unclear on this point.

While the declaration frees up the federal government's public health emergency fund for the task of preventing and treating opioid abuse, the fund contains only $57,000, said Lexi Reed Holtum, executive director of the Steve Rummler Hope Foundation in Minnesota.

That's less than her nonprofit's $100,000 budget to increase access to opioid antidotes and train doctors not to overprescribe painkillers, said Reed Holtum, whose foundation is named after her fiancé, who died from an overdose. "That's not enough even for Minnesota, and Minnesota is nowhere near the worst state," she said.

The annual number of opioid-related deaths in the state has more than doubled in the last decade, reaching 402 in 2016, according to a Star Tribune review of state death records. (The count is slightly higher than official state tallies.) In the first six months of 2017, records show 186 opioid-related deaths in Minnesota, down from 221 in the first six months of 2016.

Minnesota has responded with a variety of efforts to increase access to treatment, decrease access to prescription opioids such as oxycodone, and to stem the flow of illicit versions such as heroin.

The Minnesota Board of Pharmacy created a prescription monitoring program to track how opioids are dispensed, and then appointed a doctor to search the data for patients who were "doctor-shopping" to obtain multiple opioid prescriptions.

In Little Falls, Minn., leaders with CHI St. Gabriel's Hospital have attracted national attention for a program that has reduced opioid prescribing and weaned more than 300 people off the highly addictive painkillers. Meanwhile, Sanford Bemidji Medical Center has worked with pregnant women to treat opioid addictions before childbirth.

While opioid prescriptions have declined in Minnesota, death and treatment records suggest that people with addictions have consequently turned to heroin or synthetic drugs such as fentanyl.

More and more patients are discovering that the drugs they took were surreptitiously mixed with powerful and sometimes dangerous synthetic substances, said Dr. Joseph Lee, medical director for Hazelden Betty Ford Foundation's youth treatment services. "These synthetic opioids are cut into all kinds of things."

Pledging that "we are going to overcome addiction in America," the president said he wants to remove legal barriers to treatment, enhance border security, sue irresponsible manufacturers and work with foreign governments to stop the flow of illicit drugs.

Hennepin County Sheriff Rich Stanek said the president's comments give him "hope" for more resources in a county where "we are experiencing opioid-related deaths at a rate of roughly three times that of murder."

U.S. Sen. Amy Klobuchar, D-Minn., wasn't so sure. She said she agrees with the president's call to end a federal restriction against Medicaid funding for treatment centers larger than 16 beds — a restriction designed decades ago to discourage the warehousing of patients. But as she listened in person to the president, she said, she was left to wonder whether he would support more funding for treatment, or at least sign legislation that increases funding.

"If he really wanted to go for broke ... on treatment funding and law enforcement funding, he could have been much more specific," Klobuchar said.

For example, a number of elected leaders are pressing for federal legislation that would raise funds for treatment by charging a fee on drug manufacturers who make opioids. Gov. Mark Dayton and Lt. Gov. Tina Smith on Thursday encouraged state lawmakers to approve such "Penny a Pill" legislation to fund treatment in Minnesota.

Dayton's health commissioner, Dr. Ed Ehlinger, echoed that theme, saying that the president's proposal "does not appear to provide the right mix of actions and resources," while U.S. Sen. Al Franken, D-Minn., responded with his own $45 billion proposal to increase prevention, treatment and prescription monitoring services.

Lee said he, too, worries that treatment funding hasn't kept pace with the epidemic. But he also expressed hope. Recalling Minnesota's response to the death of the music legend Prince, he said the president's words might produce a shift in public attitudes.

"I thought the whole state showed a loyalty and compassion, and we withheld so much judgment" when Prince died, he said. "Man, if we could do that for other people who are addicted, that would be tremendous."

Jeremy Olson • 612-673-7744