Minnesota puts harm reduction at the front of opioid response


Hannah Saunders


With an opioid crisis raging across the country, many health leaders have promoted harm reduction through the use of naloxone—an opioid antagonist designed to quickly reverse opioid overdoses. Leaders at the forefront of the opioid epidemic in Minnesota met at the 2023 Minnesota State of Reform Health Policy Conference to discuss opioid antagonists’ role in the state’s harm reduction response.

Alicia House, executive director of Steve Rummler Hope Network, a non-profit in St. Paul that provides overdose prevention resources, advocacy, and education, expressed her view on the importance of harm reduction and naloxone.

“I think what we can do is learn a lot about the way we distribute naloxone, and really emulate that in all the other resources of harm reduction, and what that looks like,” House said. 

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While Narcan is the most commonly known type of naloxone that comes as a nasal spray, there are others available on the market, like an injectable form of naloxone. According to House, Narcan costs about $41.50 per box, with other naloxone types being available at similar price points. 

“Naloxone should be free to all people who use drugs, and people likely to witness an overdose, and in many places it is free to the end recipient, but it’s also important to note that there’s no such thing as free naloxone—it’s coming from somewhere,” House said.

Over-the-counter naloxone became available last April, and in July, the Food and Drug Administration approved RiVive, which is another over-the-counter nasal spray for the treatment of opioid overdoses. 

House noted how states that receive free naloxone purchase the drug using federal dollars, which creates challenges like “bureaucratic gatekeeping,” supply interruptions, and inadequate supply volumes. In Minnesota, many community groups in the harm reduction and opioid response spaces receive naloxone products through grant funding and donations. 

While the Steve Rummler Hope Network has introduced Narcan, they continue to purchase the lower-cost injectable. House emphasized how the majority of individuals who reverse opioid overdoses also use substances, and that there needs to be easier and more affordable access to the lifesaving medication. 

Antony Stately, PhD, executive director and president of the Native American Community Clinic, said the scale of the substance use disorder issue in his community was “demonstrable.” In 2019, the Native American Community Clinic opened a suboxone dosing clinic in partnership with the Red Lake Nation to respond to the opioid crisis. Suboxone is a medication used to treat opioid dependence in individuals over 15 years of age. 

“We’re in our third year of a clinical trial network grant where we’re evaluating that program,” Stately said. “We did a non-narcotic pain management [program] … to understand better the antecedents leading up to opioid use disorder and addiction within our community, and we looked at that lens through understanding how we assess and treat and divert.”

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