WebFi How St. Paul-area cities are spending it

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.