ROCHESTER, Minn. — Minnesota experienced a 32% increase in overdose deaths between October 2019 and September 2020, according to preliminary data released last week by the U.S. Centers for Disease Control and Prevention.
With 1,000 overdose deaths in the state during the period of collection, the jump marked an increase of 246 overdose deaths in the state over the previous year. During this same period, North Dakota experienced a 20% increase in overdose deaths, while South Dakota saw overdose deaths fall by 5%.
The 2019-20 spike in Minnesota mirrors nationwide trends, a 12-month period in which 87,000 Americans died from drug overdose for an increase of 28.8% over the previous year. By comparison, 2018-19 marked just a 5% increase in overdose deaths within the United States.
"I think one of the things that is particularly alarming is there used to be a margin of safety," said Dr. Halena Gazelka, a Mayo Clinic anesthesiologist and chairwoman of the clinic's Opioid Stewardship Program. "People would believe that they were buying an oxycodone pill that was made as an oxycodone pill medically and distributed from a pharmacy, so they knew what they were getting."
"But now with the pill presses that are being used, or pills being brought in or manufactured here that look just like an oxycodone that you could buy at a pharmacy — but are in fact laced with fentanyl or one of the synthetic analogs — people aren't getting what they think they are getting."
The rise in overdose deaths during 2020 appears to have preceded the onset of the coronavirus pandemic. Emergency room data published in February in JAMA show the U.S. saw a 30% increase in opioid overdoses in the first three months of 2020, a period prior to the arrival of COVID-19 in America.
Health care providers have cut back sharply on the prescribing that drove the first decade of the epidemic, a crisis that has claimed over half a million lives in the past 20 years. By 2010, a second wave of cheap heroin had arisen, often driven by addictions to prescription painkillers or diverted prescriptions.
The CDC now believes the country is battling a third wave of the opioid epidemic, one characterized by the illicit sale of counterfeit prescription drugs containing fentanyl, a medical opiate 100 times more powerful than morphine — and one capable of causing sudden death in those not accustomed to such a large dose.
Overdoses in Minnesota are increasingly tied to these counterfeit version of the pills, according to authorities. Last summer, DEA officials reported they had seized 46,000 such counterfeit opioids in the first seven months of the year, a fourfold increase over 2019.
The pills, supplied by Mexican drug cartels or coming directly from China, look identical to legitimate medications such as hydrocodone, Xanax or other pain or anxiety medication, the DEA said in a news release in July. Based on a sampling of tablets seized in 2019, the DEA found that 27% contained potentially lethal doses of fentanyl.
"We'll get bags full of these pills, and they got the proper stamping," Olmsted County Sheriff Kevin Torgerson said. "They look just like the real deal that you got from Walgreens or the pharmacists at the hospital, but they came from some crazy factory ... It's a money-making industry right now, and they don't care who dies and who survives."
'I could tell something was off'
For Judy Greske, a Mayo EMT who told her story at the same media briefing, the rising toll within Minnesota of opiate addiction is personal. Last September, a counterfeit opiate laced with fentanyl claimed the life of her son, Jason Richard Dobosenski, 36, in Mankato.
Dobosenski first became addicted after being prescribed Percocet following injuries suffered in a car accident in his late teens. By the time her son was 24, Greske said, "I could tell something was off."
"His life was not going in the direction that he wanted, there was the slurring of his words, the sleepiness ... At the beginning of it, as his mother, I didn't know what to do or where to go."
"I used to tell him what his life could be without drugs, because he was so smart. When he was sober he was productive and caring and would carry Narcan with him."
"He's part of that 87,000," Greske said. "I just wanted to take this opportunity to put a human face on him. To say that people with addictions have families and people who love them ... He felt it every time a medical professional treated him like an addict, a person who didn't deserve to be held or loved."
Sheriff Torgerson says Olmsted County has seen a wave of opiate deaths in recent weeks.
"I can't remember what night it was, but we had an overdose out in the country in a residential home, then the next morning I heard the Rochester Police Department handling one where somebody hadn't woken up in the morning, and shortly after that, they had another one, and then we had another one more in the afternoon. All of those were accidental. "
"It's not the homeless guy on the corner," Torgerson added. "The real driver is the average person functionally using drugs, maybe holding down a job, not the one mom thought they would have, but they are functional people until the addiction runs them over. They get something they didn't expect ... a pill they took 100 times before, and they get that one fentanyl-laced one, and that's the end."
"At Mayo we've been encouraging individuals get a prescription for Naloxone," Gazelka said, "even if they are not a user of opioids. It may be someone you meet or encounter in an overdose. It's a very safe medication to use. I have some in my home and car and which I carry in case I could be in an emergency situation. I compare it to those defibrillators that we use in public spaces.
"There's way more people overdosing than are having heart attacks in the street."