Here's why Minnesota has a big problem with opioid overdoses

Schedule 2 narcotics
Prescription opioids like morphine and OxyContin are at the root of Minnesota's opioid epidemic.
Rich Pedroncelli | AP file 2013

Deaths from opioid drug overdoses have hit epidemic proportions nationwide. In March, the Centers for Disease Control and Prevention for the first time urged doctors to avoid prescribing opiate painkillers for chronic pain, warning that the risks outweighed the benefits for most people.

Death from opioid poisoning, 1999-2014
MPR News graphic | Source: Centers for Disease Control and Prevention

In Minnesota, the struggle with prescription painkillers and illegal drugs has left communities grieving for people whose deaths could have been prevented.

Deaths in Minn. from opioid poisoning, 1999-2014
MPR News graphic | Source: Centers for Disease Control and Prevention

In 2008, the state saw 10 or fewer reports of heroin overdose deaths — too few for the CDC to count individually. Only six years later, it was more than 100.

Opioids used to be prescribed for severe post-surgical pain or end-of-life treatment. But in the 1990s, doctors began prescribing opioids to treat chronic pain, after some medical experts and pharmaceutical companies claimed they could be used without addiction.

Those claims were proven false and misleading in court.

Weight of opioid painkillers sold, 1999-2011
MPR News graphic | Source: U.S. Drug Enforcement Administration

That figure — 7.2 million mg — is the equivalent of 720,000 10-mg pills.

FDA-approved prescription opioids and illegal heroin have nearly the same chemical composition. They're incredibly addictive.

Total overdose deaths by opioid drug, 1999-2014
MPR News graphic | Source: Centers for Disease Control and Prevention

Opioids create a dependency because they increase the levels of dopamine in a person's brain, which causes the person to crave more of the drug.

When people overdose on opioids, it's often because they've taken a dosage their body isn't used to — which affects habitual users, relapsed users and new users alike. When people buy pills or heroin on the street, they can't be certain of the dosage or purity of the drug.

Overdoses kill by shutting down a person's respiratory system. Essentially, the victim's body forgets to breathe.

Opioid overdose
During an opioid overdose breathing may stop.
William Lager | MPR News graphic

Opioid overdoses kill people across demographic groups — the most common victim of an opioid overdose in Minnesota isn't a teenager experimenting with drugs.

Most people who die from overdose in Minnesota
William Lager | MPR News graphic

More white people in Minnesota die of opioid overdoses than anyone else, but Native American and African-American communities are hardest hit by the epidemic. Within those smaller subsets of the population, people die of overdoses at a higher rate than other Minnesotans.

Native Americans in Minnesota died of opioid overdoses at a rate nearly five times higher than that of white Minnesotans between 1999 and 2014, according to data from the CDC. African-Americans also died at a rate higher than whites.

Deaths from opioid poisoning, by age, 1999-2014
MPR News graphic | Source: Centers for Disease Control and Prevention

Opioid overdose deaths reach far out of the urban core to small towns and suburbs across the state.

Opioid death rates in Minnesota aren't highest in the population centers of Hennepin or Ramsey counties — they're highest in rural Mille Lacs and Cass counties, where emergency responders are more spread out and medical treatment can be difficult to reach.

Counties with the highest estimated death rates
This map represents the CDC's best estimate for deaths from overdose. The agency suppresses data for counties in which death totals are fewer than 10. Some counties in the state did not have sufficient data to calculate death rates.
MPR News graphic | Source: Centers for Disease Control and Prevention

Health officials and the public were slow to realize the extent of the danger presented by opioids until the problem became widespread enough that it was difficult to turn aside.

In 2014, Steve's Law expanded access to a drug called naloxone, sometimes sold under the brand name Narcan. It works as an antidote to opioid overdose and comes in the form of nasal sprays and injections. Naloxone is available without a prescription at most major drugstore chains in Minnesota.

Naloxone may stop an opioid overdose
During an opioid overdose breathing may stop, because opioids interfere with the signals that tell the body to breathe. Naloxone, also sold under the name Narcan, can stop an overdose by clearing the way for the breathing signals to resume.
William Lager | MPR News graphic

Other changes are also in the works. President Barack Obama has included more than $1 billion in his proposed budget to prevent overdose deaths by expanding treatment programs and options.

Full coverage: More stories of opioid overdose — and the families and friends it has left behind

And at the state level, law enforcement officials have stepped up their educational efforts and set up locations where residents can drop off their unused prescription drugs, which might otherwise be diverted to the street.

To deal with the realities of opioid addiction itself, many treatment centers have introduced new programs, and some established treatment centers have begun offering medication-assisted treatments, such as methadone, for the first time.

All statistics on opioid overdose deaths comes from the CDC's WONDER database. The datasets are based on multiple cause of death data from 1999-2014.