Why are K’nyaw and Karenni teens at risk of opioid abuse in Minnesota? And what solutions work?

Over the past year, Sahan Journal has taken a close look at the opioid crisis in Minnesota, analyzing five years’ worth of death records to determine which communities have been most vulnerable to the deadly drugs.

The Sahan Journal found that the death rate from overdoses increased for communities of color over the five years, while the rate dipped slightly among white people. Young people ages 25–34 faced the highest risk of death from overdose — and the risk of death among those ages 15–24 increased faster than any other age group.

The final story in this reporting series, focuses on the dual risks faced by young people from immigrant families.

What various immigrant communities share is a sense of identity crisis: teens living in two different cultures and pulled in competing directions. People described generational alienation and cultural stigma, and how those forces have contributed to opioid abuse and suffering.

Opioids have also never been easier for young people to buy. Teens can order drugs via Snapchat and have them delivered anywhere within minutes. A single fentanyl-containing pill costs $1.

And because most immigrant kids have less access to culturally appropriate treatment and recovery, they are more likely to suffer the worst consequences of addiction.

In programs that serve some of Minnesota’s newest immigrants — people who escaped civil war in Myanmar — opioid use has led toinvolvement in gangs.

The community of about 20,000 immigrants from Myanmar started arriving in Minnesota in the early 2000s, fleeing violence and overcrowded refugee camps in Thailand. Most settled in and around St. Paul.

Most Minnesotans know this community by the colonial term “Karen,” but younger members of the hill tribe tend to prefer the original term, K’nyaw. (Karenni people are a distinct group, also from Myanmar.) Young K’nyaw and Karenni people carry the fairly recent trauma of fleeing from violence, whether they experienced it or inherited it. Their parents are less likely to speak English and smoothly navigate U.S. customs and systems.

K’nyaw and Karenni teenagers appear to be at particularly high risk of substance-use disorder and arrest. The Karen Association of Minnesota tracked 75 youths, ages 13-18, who were affected by substance use in 2023 to 2024, up from 15 individuals just a few years ago. And among the 520 youths arrested in Ramsey County in 2023, at least 34 were K’nyaw — the highest youth arrest rate of any ethnic group. That trend has continued into 2024, according to arrest data from Ramsey County.

Young people struggling with addiction are vastly underserved. Most treatment centers for acute drug withdrawal don’t serve people under 18. And there is currently no Minnesota treatment program for substance use designed for Southeast Asians.

Often, Karenni and K’nyaw youth struggle in standard programs, said Kaziah Josiah, co-director of Urban Village, a community space for young people from Myanmar, launched to counter the effects of substance abuse.

Clara Tunwin, the health and human services program director at the Karen Organization of Minnesota, said some kids have run away from treatment because they couldn’t handle the food. Teens are at an especially vulnerable time when they enter treatment, craving the nourishment, cultural and spiritual beliefs, and traditions they grew up with, Josiah said. When those things are missing, it’s hard for young people to develop trust in the program.

Realizing the lack of such resources, Josiah founded the Asian Youth Outreach program in 2021 under the Karen Organization of Minnesota.

Around the same time, mental health practitioner Jesse Phenow decided to create a space with a similar mission. He officially launched Urban Village three years ago; Phenow and Josiah joined forces earlier this year. Urban Village has become one of a few programs that provides a safe place for kids from the same background.

On a rainy afternoon in November, inside Urban Village, about 25 teenagers lounged, chatting and peering at laptops. A handful of college students mingled. Soccer jerseys and traditional art from Myanmar decorated the walls..

At first, the program catered to kids in the throes of addiction. More recently, the focus has shifted to prevention. More kids can be reached, the directors realized, by intervening at a much earlier stage. Now, counselors at St. Paul high schools refer students who are struggling and may find escape with gangs and substances.

Each teen gets paired with a Karenni or K’nyaw mentor. Homework help is also available from college students.

Mar, a 14-year-old sophomore at Humboldt High School, failed most of her classes as a freshman, she said. After a friend referred her to Urban Village, she’s now on track in school. She says learning about mental health has been even more valuable than the homework help.

“They’re going through a lot of challenges and need help navigating the intersectionality of being a refugee youth,” Josiah said.

St. Paul police have pointed to addiction to explain the increased violence between two rival Southeast Asian gangs. Many gang members had long stretches of unsupervised time after school, Tunwin said.

The Karen Organization of Minnesota has stepped up efforts to keep kids engaged. The organization runs after-school programs for K’nyaw and Karenni youth that provide cultural activities.

“Some of the conversations I’ve had with kids include ‘If it wasn’t for our Karen club, we would be on the streets,’” said Arash Yousufi, a director of the after-school program.

While organization leaders point to improved school attendance and reduced substance use, Yousufi also expressed concern about cuts to funding. But for now, the leaders seem undaunted: Someone recently donated a house to Urban Village that Josiah hopes to turn into a sober house for Karenni and K’nyaw youth.

“We want to create something that better meets their needs,” she said. “It’s a big dream, and we know it will take time and community support, but we’re committed to making it happen.”

About the partnership

This story comes to you from Sahan Journal, a nonprofit newsroom dedicated to covering Minnesota’s immigrants and communities of color. Sign up for a free newsletter to receive Sahan’s stories in your inbox.