In Duluth, advocates say wider access to anti-overdose drug is saving lives
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From a distance, the white van parked outside Duluth’s Damiano Center looks like a food truck. For the people lining up on this day, though, it’s there to meet a different kind of need.
Run by Harm Reduction Sisters, a women-run nonprofit that supports people who use drugs, the van hands out clean syringes, safe smoking tools, fentanyl and xylazine test strips, safe sex kits, menstrual supplies and, maybe most importantly, the anti-overdose medication naloxone.
While skeptics say handing out syringes and test strips for illegal drugs promotes addiction, critics and supporters of the approach both agree on one thing: Getting naloxone into the hands of people who might need it is saving lives.
“If we can get this stuff into people’s hands, they’re going to be the ones that are locked, ready, and loaded to be able to administer this and save somebody's life instead of having to call 911,” said Missy Jellison as she handed out products from the Harm Reduction Sisters van.
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Like many places in the United States, Duluth was hit by waves of an opioid crisis that began with prescription pain medication in the late 2000s and shifted to fentanyl and other illicit synthetic opioids during the last decade.
Fatal and nonfatal overdoses jumped in Duluth during the COVID-19 pandemic, but the grim numbers have shifted the past few years.
A data analysis by MPR News and the APM Research Lab found the number of opioid-related emergencies declined in nine Minnesota zip codes from 2021 to 2024, including the area of Duluth where Harm Reduction Sisters operates.
While it’s difficult to tell what’s led to the downward trend in reported opioid-related health emergencies, the Harm Reduction Sisters crew believes efforts to widely distribute naloxone, also known by the brand name Narcan, are paying off.
Duluth police agree. Increased availability of naloxone without a prescription has played an important role in the police response to the opioid crisis and that “maintaining easy, stigma-free access to Narcan is an important component to our ongoing efforts to reduce opioid-related overdose deaths in our community,” a spokesperson told MPR News.
‘Reduce their use’
Naloxone became available to the public without a prescription in 2023. People can buy it over the counter at most pharmacies for about $35.
It’s been shown to be an incredibly effective overdose reversal medication. According to the Centers for Disease Control and Prevention, naloxone when used reverses more than 75 percent of drug overdoses.
In Duluth and across St. Louis County, naloxone is key to the public and private approach to reducing the consequences of opioid use disorder.
Government services center buildings in downtown Duluth, Virginia, Hibbing and Ely are all naloxone access points. They also have programs that distribute the antidote to community partners for free. (Harm Reduction Sisters does not receive Narcan from the country as a partner.)
Distributing naloxone is standard practice now and it’s made a huge difference, said Harm Reduction Sisters founder Sue Purchase.
Purchase grew up in the area and spent years using drugs. When she wanted to stop, abstinence-based treatment programs weren’t a good fit, but small and practical steps made sense.
“When I started delivering supplies people did not have a choice to take it. And then as we build these relationships, people would be like, ‘Sue, I got it … I’m handing it out to other people.’”
Purchase has been helping people for 30 years, providing many with the means to stay alive and work on their addictions. “Whether they seek formal treatment or not, gradually people reduce their use and change their use patterns,” she said.
‘Yeah, I’m an enabler’
Harm Reduction Sisters specializes in the public health approach known as harm reduction. In a nutshell, this strategy gives people tools to reduce the potential consequences of drug use like infection, disease, or even overdose death. The group also offers services five days a week in an office at the Damiano Center.
Jellison and her colleagues in the white van, Michela Jourdain and Delainey Hardy, understand the people they serve because they’ve also struggled with addiction in their lives.
They’re friendly and warm with visitors who find their van. It’s not uncommon to hear them call a client “dear” when asking what they need. There isn’t a hint of judgement when someone asks for supplies.
“Because of harm reduction, I am standing here today being able to talk to you about it and being able to help these people make safer choices,” said Jellison.
While there’s near-universal agreement that distributing naloxone widely has saved lives, the harm reduction approach that includes distributing syringes remains controversial and has become a target of the Trump administration.
The Department of Health and Human Services in June announced $700 million in new funding to address mental illnesses, addiction and homelessness, but the money cannot be used for harm reduction programs.
HHS said that decision aligns with President Donald Trump’s executive order to end crime and disorder on America’s streets.
Purchase is undeterred. She started working in harm reduction before there were federal dollars supporting some programs. She said she’s always hustled to get supplies and is committed to pressing on with her work, including distribution of naloxone.
“People will say that harm reduction is enabling. And I say, hell yes, it is,” Purchase laughed. “We enable good public health and care every single day, and I am so proud of that. Yeah, I'm an enabler.”
APM Research Lab data journalist Elisabeth Gawthrop contributed to this report.
This story comes from the Upper Midwest Newsroom, a public media collaboration between Wisconsin Public Radio, South Dakota Public Broadcasting, Prairie Public in North Dakota and Minnesota Public Radio News made possible by the Corporation for Public Broadcasting.
