Cottage Grove Parks Superintendent Jim Fohrman carries a naloxone kit in the center console of his city-owned Ford Ranger pickup.
Fohrman, who has worked for the city for 27 years, hasn’t had to save someone from an opioid overdose yet, “but it’s nice to know I have it in case I come across something,” he said. He’s one of about 150 city employees who have been trained this year on how to use opioid-overdose prevention medication.
“I have it with me at all times,” Fohrman said. “I figure it would take about 30 to 45 seconds to rip it open and have (the syringe) ready to go. That’s really what it comes down to: You can help save someone’s life, or you can stand back and watch. I would prefer to do what I can.”
Cottage Grove has been a leader in the response to the opioid crisis, and city staff are poised to do even more as settlement funds from pharmaceutical companies that made and sold opioid painkillers are paid out.
The city of almost 40,000 people is one of more than a dozen east-metro communities that will benefit from the more than $50 billion in settlement funds that will be paid out over the next 18 years to state and local governments nationwide. In 2021, the three biggest pharmaceutical distributors — AmerisourceBergen, Cardinal Health and McKesson — agreed to a $21 billion nationwide settlement alongside a $5 billion deal with opioid manufacturer Johnson & Johnson. The following year, major opioid manufacturers Teva Pharmaceuticals and Allergan, and three of the nation’s largest retail pharmacy chains — Walmart, CVS and Walgreens — agreed to multistate settlements worth $20.4 billion.
Minnesota is eligible to receive more than $540 million in opioid-settlement funds, according to the Minnesota Attorney General’s Office. The money must be used to combat the opioid crisis, including detailed programs and strategies focused on treatment, prevention and harm reduction. Counties and cities will receive 75 percent of the funds, and the state will receive 25 percent.
The $540 million figure does not include settlements with Purdue, Mallinckrodt and Endo — the final amounts for all of which are still unknown, according to the attorney general’s office. The figure also doesn’t include the settlement with McKinsey, which did not go to cities and counties. Tribal nations have negotiated their own separate settlements, which will bring additional money into Minnesota directly to tribes, the attorney general’s office notes.
“No amount of money can ever make up for the death and destruction these companies caused in every community of our state, but it’s still important to hold them accountable, and that’s what we’ve done,” Minnesota Attorney General Keith Ellison said Friday. “In Minnesota, unlike some other states, we’ve made sure that the majority of the money will go directly to where the pain is — to the communities that have been hurt the most and know best how to use it on treatment, remediation, prevention and making their own communities whole.”
Who gets funds
Local government funds will be directly allocated to all 87 counties in the state and to cities that have populations of 30,000 or more, have filed lawsuits against the settling defendants, or have public-health departments. There are 143 cities in Minnesota that meet the criteria, according to the attorney general’s office.
Minnesotans can track how the money is being spent via the state’s Opioid Epidemic Response Spending dashboard, which allows the public to see which municipalities and organizations are receiving funding and how departments are planning to spend it. Ten counties and cities received settlement funding in 2022 and spent more than $515,000 on prevention, treatment, workforce development and other programs to address the opioid epidemic, according to the dashboard.
Cottage Grove has already received $147,000 in settlement money, and city officials expect to get another $437,000 over the next 18 years. The city plans to use the money “to attempt to make a difference in the lives of our citizens and those who visit Cottage Grove who are experiencing addiction or have family members or friends who need help with their addiction,” said Dan Schoen, community-engagement officer for the Cottage Grove Police Department.
Cottage Grove Public Safety Department employees since 2014 have been trained to administer naloxone, also known as Narcan, the medication that can reverse an opioid overdose. Last fall, city officials held a naloxone training session for city employees and members of the public. The session was so successful that Cottage Grove officials decided to work with Rise Up Recovery in Hastings and the St. Paul-based Steve Rummler HOPE Network to expand the training to all city employees, including those who work in public works, parks and recreation, at the Cottage Grove Ice Arena and at the city-owned River Oaks Golf Course and Event Center, Schoen said.
Schoen said he thinks Cottage Grove is the first community in the state putting “naloxone in the hands of staff from many different divisions.”
“We recognize that these folks are out in the community — every day — in our parks, on our streets, and having that opportunity for folks to be more aware and, possibly, if they have a kit with them, could help somebody that could be seconds away from dying,” he said. “If it were one of my family members, I would pray there was as little delay as humanly possible.”
Overdose deaths increasing
Opioid-involved overdose deaths among Minnesotans increased 43 percent from 2020 to 2021, and the number of deaths has more than doubled since 2019, according to the Minnesota Department of Health. There were 978 deaths in Minnesota in 2021, and fentanyl, a highly potent synthetic opioid, was involved in most of the deaths, according to the health department.
An overdose happens when the level of opioids — from prescription painkillers, fentanyl and/or heroin — in a person’s system gets too high, which slows or stops their breathing.
“The signs really start with the person being lethargic,” Schoen said. “It’s not uncommon where you’ll see someone all of a sudden, just in a snap of a finger, go from alert to unconscious. That is one of the scariest things that we deal with.”
Administering naloxone can restore normal breathing within minutes as it blocks opioid receptors in the brain, he said.
“We recognize that this is where public safety and public health come together,” Schoen said. “Not everything is about trying to figure out whether people need to go to jail or not. We just need to do our best to take care of our citizens in the best way possible.
“We know that there is a long way to go, and we’re still learning, but now our part is: How do we face what’s in front of us, and how can we keep people alive long enough to go to treatment? People are dying of overdoses. We need to bring about awareness. We need to bring about intervention. And we need to bring about treatment. This just touches the surface of what we need to do. We’re just getting started.”
The Pioneer Press surveyed communities and counties in the east metro to learn more about how they plan to use the settlement funds.
Dakota County expects to receive $9,127,527.20 from the distributor and Johnson & Johnson settlements and an additional $7,429,374.49 from second-wave settlements, according to the attorney general’s office. To date, the county has received $1.9 million.
The county hired a Public Health Opioid Prevention Coordinator this spring to help coordinate the county’s response to the opioid epidemic and lead efforts to identify and respond to opioid misuse, according to the Dakota County Public Health Department. The county is also reviewing applications for community members, health care representatives and local government representatives to serve on its new Opioid Response Advisory Committee that will recommend funding for community efforts in addressing the opioid crisis.
The city of Apple Valley has received $156,860 out of its anticipated $1.1 million by 2038, said Tom Lawell, city administrator.
To date, the city has spent nearly $23,251 on law enforcement expenditures related to the opioid epidemic through its participation in the Dakota County Drug Task Force, Lawell said.
Going forward, the city plans to work with the county and nearby cities to determine how future funds will be spent.
To date, the city of Burnsville has received $222,984 and anticipates annual installments through 2038 totaling around $1.1 million.
Burnsville operates its own ambulance and emergency medical services, and funds will be used to continue those efforts as well as expand education and outreach and the response and intervention to opioid-related instances.
According to the Burnsville Fire Department, with the help of the settlement funds, some of the city’s police officers have been equipped with Narcan and the rest received Narcan training. The funds will also be used to conduct in-home visits to work with those who have opioid addiction.
The city of Eagan has received $191,849 so far out of the anticipated $812,000 to be doled out over 18 years from the Janssen settlement, said the city’s finance director, Josh Feldman. Eagan is also expecting additional funds as other settlements come through, he said.
The city council is working with the city’s police chief and fire chief on developing long-term programs around prevention and education, Feldman said, as the police department and the fire department will be the main recipients of the funding.
Inver Grove Heights
Inver Grove Heights has received $111,773 so far out of $412,019 from the state’s settlement with the three distributors and Johnson & Johnson, according to Amy Hove, the city’s finance director. The city also received an additional $3,265 from the National Opioid Abatement Trust II and is waiting to hear about any additional state settlements.
The city has not yet decided how its funds will be used, Hove said in an email, but is working with community partners including nearby cities, school districts and Dakota County.
From the Johnson & Johnson settlement, the city expects to receive roughly $627,000 over 18 years, according to documents from the city council’s May work session. So far, the city has received more than $41,000 from this settlement with an additional $21,272 expected by the end of this summer.
From the Janssen settlement, Lakeville has received $81,033 so far of an expected $116,000 over 11 years. The city also received an additional $4,201 from the National Opioid Abatement Trust II.
Lakeville’s settlement funds will be used in part to fund the city’s Drug Task Force, said Justin Miller, city administrator for Lakeville, in an email. The funds will be used to pay task force officers who work to treat people suffering from substance abuse, prevent over-prescribing and the misuse of opioids as well as bring community awareness to the opioid epidemic.
Ramsey County expects to receive $15.8 million over 18 years from the first wave of payments from the distributor settlement and the Johnson & Johnson settlement. In addition, the county expects to receive an estimated $11.9 million as part of the second wave of payments over many years from the recent settlements with Teva, Allergan, Walgreens, Walmart and CVS. To date, the county has received $3.7 million and anticipates an additional $2.5 million this year from the Teva, Allergan, Walgreens, Walmart and CVS settlements.
So far, the funds have been used for a coordinator position in the Opioid Response team, consulting for the development of a priority-to-action plan that engages community members and partners, and building communications for greater awareness of the issue, according to St. Paul-Ramsey County Public Health Director Sara Hollie. In the future, Ramsey County will use funds to launch the pilot naloxone community-distribution program and provide grants through the Ramsey County Community Opioid Response and Prevention Grant Program.
Since 2022, the county has launched an Opioid Response website, trained county staff with naloxone and reopened the detox and withdrawal management facility to clients. Ramsey County also offers a Syringe Service Program in downtown St. Paul and a Medication-Assisted Treatment Program focusing on African Americans and American Indian communities who are overrepresented in the corrections system and chemical health facilities like the Ramsey County Detoxification Center.
From the distributor settlement agreement and the Janssen settlement agreement, Maplewood has received $95,553 of an expected $291,603 through 2038. The city received an additional $2,791 from the National Opioid Abatement Trust II in 2023, according to City Manager Melinda Coleman.
Maplewood’s settlement funds will be used toward embedded social workers and assisting the police and fire departments with their Unsheltered Outreach activities.
North St. Paul
From the distributor settlement agreement, North St. Paul received $12,810 and is anticipating an additional $83,864 through 2038, according to Daniel Winek, the city’s finance director. The city also received $16,533 from a another settlement and expects to receive an additional $5,686 through 2031. To date, the city also received a settlement of $857 from the National Opioid Abatement Trust II.
Winek said the funds have yet to be formally allocated.
According to Corey Yunke, community relations manager for Roseville, the city has received $87,746 from the distributor settlement agreement and the Janssen settlement agreement, with an additional $2,563 from the National Opioid Abatement Trust II.
Funds have not yet been formally allocated.
Over 18 years, St. Paul expects to receive $14,091,376 from the opioid distributors and manufacturer settlements. Of that, the city has received $1,965,470, according to St. Paul Finance Director John McCarthy.
St. Paul has preliminary plans on using the funds toward staffing to support residents with substance use disorders, safety infrastructure such as cameras, and Narcan deployment.
Washington County has received $1,618,146 to date, according to David Brummel, the director of the county’s public health and environment department. The county expects to get $11.5 million over the 18-year period, or $642,000 a year.
The county has not spent any opioid settlement funding yet. Staff are in the process of conducting a survey to gather input from community members and relevant professionals in Washington County to inform local planning for opioid settlement funds, Brummel said.
County staff have already been responding to the opioid crisis through initiatives such as Medications for Opioid Use Disorder in the Washington County Jail in Stillwater, medication drop-off locations and access to free naloxone kits and fentanyl test strips at the county’s public health department locations in Cottage Grove, Forest Lake and Stillwater, he said.
The county is partnering with the Steve Rummler HOPE Network to offer the naloxone kits and fentanyl test strips; residents can pick up the naloxone kits and fentanyl test strips anonymously and for free — no insurance or personal info is required. The program is intended for individual access to kits; county officials are not able to provide kits at an organizational level as the supply is limited, Brummel said.
County staff will be compiling survey results in the next month and plan to hold a workshop in October to present the findings to the county board and recommend a structure to help guide opioid settlement spending, he said.
Woodbury will be receiving $1,750,000 over 18 years; the city received its first payment of $33,545 in November, according to City Administrator Clint Gridley. The money will remain in a special fund until the city spends it, he said.
Woodbury officials plan to use $143,200 of the settlement funds in 2024, mostly to fund the local portion of an embedded Washington County social worker who will work with the city’s public safety department to address substance abuse, said Public Safety Director Jason Posel. The rest will be used to supply patrol vehicles with first-aid bags that contain medication used to reverse overdoses and other essential emergency-aid supplies, he said.
Other decisions about how the funds will be spent will be made after city officials learn more from Washington County regarding its survey results, Gridley said.
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