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Fentanyl deaths in Minnesota surge into 'public health crisis'

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Fentanyl is a synthetic opioid.
Fentanyl, a synthetic opioid, has been used for decades as a painkiller in the operating room, here on July 10, 2009.
Joe Amon | The Denver Post/Getty Images via NPR

Updated: 12:51 p.m. | Posted: 11:45 a.m.

Minnesota last year saw an alarming jump in deaths tied to fentanyl, the powerful synthetic opioid that killed Prince and has shattered lives across the Twin Cities.

One hundred seventy-two people died from synthetic opioid-involved deaths in 2017, a 74 percent increase from 2016, according to a preliminary analysis of death records by the Minnesota Department of Health.

Of those 172 deaths, 156 had fentanyl listed as contributing to the death on the death certificate, the department said Monday.

Department of Health Commissioner Jan Malcolm said there are signs that fentanyl is taking the place of heroin in street drugs.

"We suspect that Minnesotans who are addicted to opioids may unknowingly be exposing themselves to far greater and more deadly risks than they know," Malcolm said. "Because of the increased risks, we are encouraging people who are concerned about their opioid use or that of someone close to them, should keep naloxone on hand in case of an emergency."

While officials cautioned the data needed more analysis and statistics could change, they said their first look at the numbers shows the "growing impact of fentanyl is so great that it is outweighing progress in other areas, such as decreases in prescription opioid and heroin deaths."

"Given the current opioid crisis and dramatic increase in fentanyl deaths that we see in these data, we felt that it was critical to get this information out as soon as possible, so that health care providers, law enforcement, users of opioids and others can take steps now to avoid more deaths," Malcolm said.

Drew Evans, superintendent at the Minnesota Bureau of Criminal Apprehension, said the agency has seen a dramatic increase in cases involving fentanyl in the last few years. In 2015, the agency saw only 12 cases involving fentanyl but by last year that number had risen to 140.

"Fentanyl is relatively cheap in terms of obtaining fentanyl compared to heroin, and so that's part of the reason we see them mixed together," Evans said. "That fentanyl is very regularly bought from overseas locations such as China and then trafficked in through Mexico or directly into the United States."

Heroin-related deaths, which had been increasing dramatically since 2011, declined by 29 percent from 2016 to 2017.

Opioids are a family of drugs that include everything from heroin to prescription painkillers. About 40,000 Americans each year now die of opioid overdoses.

The Drug Enforcement Administration says fentanyl is about 50 times more potent than heroin.

The preliminary numbers from the Minnesota Department of Health showed that most opioid overdose deaths in the state are still caused by prescription painkillers. Overall, 401 people died from opioid overdose deaths in Minnesota last year, a number that's jumped significantly the past few years.

State government has been working across agencies to address the opioid crisis, including through connecting people to opioid treatment and issuing new opioid prescribing guidelines, said Chuck Johnson, the acting commissioner of the Minnesota Department of Human Services.

"It's imperative that we take all the efforts we can to prevent addiction and support those who have become addicted as they seek treatment," Johnson said.

Both commissioners called for the Legislature to act swiftly to address the opioid crisis by passing legislation, supported by Gov. Mark Dayton.

A bill that recently passed the state Senate would charge pharmaceutical companies that sell opioids $20 million in fees each year to fund programs to address the opioid epidemic and support county services. The House version of the bill is expected to be heard on the floor this week.

Dr. Rahul Koranne of the Minnesota Hospital Association said legislators from both parties need "to look beyond the powerful lobbyists and look beyond these powerful interests" of the pharmaceutical industry and require them to help pay for the crisis they helped to create.

Koranne said the medical industry in the state has been successful in reducing the number of opioid prescriptions, but that more work needed to be done.

"Even one prescription of opioid in the right person can lead to addiction and potentially death, so we need to take this very seriously," Koranne said.

There were at least 694 confirmed drug overdose deaths in the state last year, a number that's increased dramatically over the last two decades, largely due to opioid overdoses. The state did report a 9 percent increase in methamphetamine-related deaths last year as well. Most fatal drug overdoses happened in the seven-county metro area.