Minnesota overdose deaths plateau in 2022 after years of increases

After several years of steep increases, overdose deaths in Minnesota plateaued in 2022 — but fentanyl-related overdoses continued to keep deaths at a historically high level.

There were 1,343 overdose deaths in Minnesota in 2022, according to preliminary data from the Minnesota Department of Health. That is a slight decline from 1,356 the year before. Both are about twice what was reported in 2018.

Fentanyl is involved in 92% of all opioid-involved deaths and nearly two-thirds of all overdose deaths statewide, according to the early data for 2022. Fentanyl is 50 times more potent than heroin.

According to Dr. Brooke Cunningham, the state's health commissioner, MDH is responding to the threat of fentanyl with a new policy for saving lives passed by the Legislature this year, including increasing the availability of naloxone and covering its costs.

As of July, the state Comprehensive Drug Overdose and Morbidity Prevention Act required all schools, law enforcement officials, emergency responders and residential treatment programs to have naloxone readily available.

Naloxone is a medication used to reverse drug overdoses involving opioids. It doesn't work with other types of drugs, and overdoses frequently involve multiple drugs, but it is "always helpful, never harmful," said Mary DeLaquil, an MDH epidemiologist.

Deaths involving heroin in 2022 were the lowest in a decade, falling by 56% from 2021 to 2022. Other deaths with prescribed opioids and methadone also saw a decline.

Cocaine-involved deaths saw the largest increase of any drug category, rising by 27%.

It's important to note that 2022's trends involving overdoses and fentanyl aren't limited to Minnesota — they're being seen nationwide, DeLaquil said, and there is no one cause behind the decline.

Overdoses affect people, families and communities beyond deaths. There were 13 non-fatal drug overdoses for each fatal overdose, according to the MDH data.

"An overdose is like a shockwave, reverberating outward," said Jeremy Drucker, state director of addiction and recovery. "Every death is a shock."

Gov. Tim Walz and Lt. Gov. Peggy Flanagan's 2023 budget allocated $200 million to address substance abuse and overdoses — $50 million of which will go to MDH over the next four years. The funds will address prevention, harm reduction, treatment and recovery.

Remaining funding will be distributed to the departments of Corrections, Public Safety and Health and Human Services to invest in the same spectrum of care.

Harm reduction means access to Naloxone as well as behavioral and primary health care, housing support, and brick and mortar locations where people can test their drugs, Drucker said.

"This session, Minnesota took a big step forward in responding to addiction as a public health issue," he said.

The policy passed by the Legislature is going to help save lives, and help people achieve recovery, Drucker said, but paying consistent attention to the epidemic in coming years is essential.

The policy prioritizes seven strategies for supporting communities most affected by the overdose epidemic. They include enhancing prevention and support services for homeless people, who are at elevated risk of fatal overdoses, and providing culturally specific outreach to Native, Black and other communities that experience some of the highest rates of overdoses, said Dana Farley, supervisor of the drug prevention unit at MDH.

There is also a focus on supporting people after they complete recovery programs and ensuring that recovery is sustained, Drucker said. Staying in recovery communities decreases chances of relapse.

MDH and the Department of Education worked together to launch the MN Naloxone Portal where mandated groups can access no-cost naloxone.