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Rural Minnesota is facing its own drug crisis

"I made sure she had a container for sharp objects, Narcan, (fentanyl) test strips, HIV information," Purchase later said.

Born in Duluth, grew up in Cloquet and veteran of social service activism in Minneapolis. Purchase launched a delivery service that plays a unique role in combating drug overdose and death in rural areas of Northland.

It's a tough fight in places where the resources of metropolitan areas are lacking.

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"It's difficult enough for people to make a decision to seek care," said Debra Wamsley, a Behavioral Medicine Specialist from the University of Minnesota's College of Continuing and Professional Studies.

"If there are external barriers, be it distance, lack of access, lack of treatment facilities, lack of choice of the types of treatments a person could look for, it will be even harder for people to get the care they need need. And ultimately, this leads to overdoses and deaths.

Those involved in the struggle in Northern Minnesota are making profits when it comes to life or death situations.

Narcan (also known as naloxone), a drug used to reverse overdoses of opioids, saves lives both in rural areas and in cities, they report. Carlton County Sheriff Kelly Lake reported 12 overdoses that its deputies had responded to since 2017. In six cases, the victim was revived when the deputies arrived and were taken by ambulance to a hospital. In the other six, MEPs administered Narcan.

"I think the Narcan definitely saved them in these cases," Lake wrote in an email.

However, in rural areas, there is less help to address the underlying problem, according to Adam Shadiow, executive director of the Arrowhead EMS Association, which represents first responders in northeastern Minnesota.

"We need to expand programs to help people out of the cycle of addiction to these drugs," he wrote in an e-mail. "There is a tool that helps first responders to reverse opioid overdose after onset, but there is little help for the person who overdosed after treatment and release."

  Sue Purchase explains that she keeps a container with sharp objects. Mini Sharps containers for people, Narcan and Fentanyl strips for people in rural areas.

Sue Purchase states that it keeps a Sharps container and mini-Sharps container for delivery to humans and Narcan and Fentanyl strips for the care of people in rural areas. "Public health is for everyone," Purchase said. Tyler Schank / [email protected]

Limited treatment options

Drug treatment – the use of drugs to combat drug addiction – is recommended in conjunction with counseling and behavioral therapy through substance abuse and mental health administration.

Minnesota has 12 out of 16 drug-assisted treatments in the Twin Cities metropolitan area with seven counties, Wamsley said. One of the remaining four is located in Duluth, the center for alcohol and drug treatment. Only such suppliers can deliver methadone, an opioid used in controlled doses to control the craving for other opioids. This means that people from all over the arrowhead and the iron area who are seeking treatment with methadone need to travel to Duluth. And not just occasionally.

"Because it's so tightly controlled, patients usually need to visit a methadone clinic for their daily doses every day," said Colin Planalp, Senior Research Associate at the University of Minnesota State Health Access Data Assistance Center.

"Access is limited to people in rural areas, unless they can travel long distances to receive their daily methadone dose," said Planalp. "And that makes it difficult to just run your daily life, have a job, something like that."

There are other treatment options for drugs, each of which has its own barriers, he said. Unlike methadone, buprenorphine may be prescribed by your doctor – provided that it has been waived by the federal government.

"And they can take this medication home with them and take their daily dose, so in some cases they do not have to drive miles to a methadone clinic," said Planalp. "(But) there is a shortage of health care providers who can do without the prescription of buprenorphine, and this mainly affects rural areas."

Finally, there is naltrexone (also known as Vivitrol), which is unlike methadone and buprenorphine It's not an opioid but an "antagonist" that blocks opioid receptors in the brain, and doctors do not need to give up on prescribing naltrexone, Planalp said, but many of them reject it because they feel they do not have the education they need

Again, this is especially true of rural areas: in metropolitan areas, the doctor can consult patients or refer to addiction specialists, he said, "but in rural areas where GPs know that they do not necessarily have access to the same specialists in their own country Region may cause them to be reluctant to prescribe naltrexone. "

  Sue Pur chase holds a sharps container (left) holding clean needles on one side and used needles in another compartment and fentanyl test strips (right). Tyler Schank / tschank@duluthnews.com

Sue Purchase holds a sharps container (left) holding clean needles on one side and used needles in another compartment and fentanyl test strips (right). Tyler Schank / [email protected]

The New Meth

Although heroin and other opioids may be considered an urban phenomenon, the number of deaths from opioids in Minnesota has risen faster than in the US Twin Cities subway Range, said Planalp. From 2000 to 2017, deaths from opioids in sister cities increased five and a half times; in the Greater Minnesota, deaths increased twelve-fold.

Meanwhile, methamphetamine, a drug especially known for rural America, has returned in a new form.

"The meth you see now is not the homemade laboratory material we saw 10 to 15 years ago. Jeff Kazel, commander of the Lake Superior Drug and Violence Crime Task Force. "That's pretty dry out, and when they did the legislative changes, it really did a good job of drying up these labs."

"The cartels in Mexico picked it up and flooded the market, and there's a lot of methamphetamine."

Es could be more deadly than before.

"In rural America, methamphetamine has never left," said Marc Condojani, director of adult treatment and recovery at the Colorado Office of Behavioral Health. "Now it's up again. It is on the rise. This one will be different because it will involve a higher mortality rate. We already see it. "

The reason Condojani told a group of journalists last month in Denver: Unknowingly, part of today's meth is spiked with fentanyl, the exceptionally potent opioid that is also blamed for deaths when it's added to other opioids like heroin.

"And I do not know that this is an intentional process of the drug traffickers or whether it is unhygienic practices," he said. "Fentanyl on your scale while measuring different products can be fatal, so we do not know – we just know that the drug supply is now spoiled."

The United States Centers for Disease Control and Prevention reported that In 2016, 11% of methane overdose deaths related to fentanyl (a larger proportion, 22%, was heroin.)

Kazel has not received any reports of meth with fentanyl in northeastern Minnesota, he said, but he is aware of this Well aware of the kind of scenario.

"You do not know what you are getting out on the street," he said, "You could let someone tell you that this is a bag of heroin and it turns out to be pure fentanyl. Buying on the street is a crap. "

However, this is not what consumers are aware of, said Marcia Gurno, on the drug abuse prevention and intervention team for the St. Louis Health and Health Service." They're going to us Adults and children say, "I trust my dealer."

Whatever the reason, more deaths are attributed to methamphetamine. According to the CDC report, in 2011 methamphetamine was in eighth place with over 1,800 medications due to overdose. Meth finished eighth in 2012, seventh in 2013 and 2014, fifth in fifth in 2015 and fourth in fourth (after fentanyl, heroin and cocaine) with 6,762 deaths in 2016 – an increase of more than 250% over 2011.

Kazel said the volume of meth seems to be high. The US Drug Enforcement Administration reported last week that its Omaha division saw a 31% increase in methamphetamine seizures in the first half of 2019. The total of the division comprising Minnesota, Iowa, Nebraska, and North and South Dakota was approximately 1,437 pounds or $ 9 million worth of meth.


The fight against drug overdoses in rural areas a multi-faceted undertaking involving law enforcement agencies, social services, religious organizations, public health, medical personnel and Sue Purchase.

After Work When he has been on the frontline against drug addiction in Minneapolis for more than 20 years, Purchase returned to Northland a year ago. "I wanted to close the gaps that I always knew existed up here, especially for people who are poor and are taking drugs.

Purchase, which works part-time for the Rural AIDS Action Network in Duluth and Virginia, initiates the needle exchange of this agency with the so-called Harm Reduction Sisters. Mitigation is the idea behind a needle exchange. It is believed that people who at least consume drugs have the opportunity to do so in a hygienic way.

But Purchase knew that some people could not easily get to RAAN's store on First Street in Duluth or his satellite office in Virginia. That's why she launched a mobile needle exchange in May, bringing in the syringes and other damage-reduction tools. During this time, she has distributed 10,000 syringes according to purchase in the past week.

"These are all donations," Purchase said. "I'm not funded. But I'm good at finding supplies. "

It's not just syringes, but also other supplies like Narcan and the strips that can tell a user if fentanyl is in the drug that's being consumed.

I will gladly deliver the supplies myself.

Purchase visited a household last week where "over and over" overdoses had occurred, she said.

"It was the best experience," Purchase said. "We had a great conversation. (The housekeeper) talked about how she wanted to come to Duluth, but not because she did not have a car.

  Sue Kauf's contact information is listed on her business card Tyler Schank / tschank@duluthnews.com

Sue Purchase's contact information is displayed on her business card Tyler Schank / [email protected]

For help

  • Call the opioid hotline at 218-730-4009.

  • To reach Harm Reduction Sisters, send a text or call Sue Purchase at 218-206-6482. [19659055]
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