Fighting Fentanyl
At a recent Council meeting, we heard a disturbing presentation from the Fire Department about fentanyl overdoses.
Opioid abuse, and in particular fentanyl abuse, is a serious problem across the country and Saint Paul is no exception. We see the effects every day; I hear often from constituents who feel unsafe after witnessing illegal drug dealing and other antisocial behaviors. We want people in our community to get the help they need, but it sometimes feels like we are caught in an endless cycle of responding to emergencies without ever finding long-term solutions.
We asked the Fire Department how their medics were responding to people who were suffering from fentanyl overdoses. According to the department, first responders were administering naloxone or “Narcan” to resuscitate individuals who had overdosed but that unless those individuals accepted transport to the hospital, there was no further treatment. Unfortunately, Narcan brings people back from overdose into a state of withdrawal, producing aches, nausea and other flu-like symptoms. In this condition, many people would not accept transport to the hospital, and were left on their own, often to overdose and require resuscitation again. The Fire Department sometimes resuscitated the same people more than once in a single day.
Our Council could have responded to this information in any number of ineffective ways. We could have shaken our heads, expressed concern and then moved on to the next topic on the agenda. We could have passed the problem onto someone else, asking staff to “come up with a solution” with no guidance as to what that solution might be. We could have promised to think about it, table it, come back to it at another time - all diplomatic ways of doing nothing at all.
Instead, we chose a different path. Council Vice President Hwa Jeong Kim and I convened a meeting with the Fire Department, St. Paul/Ramsey County Public Health and Dr. Dwize Ntaba, an emergency medicine doctor at the University of Minnesota doing innovative work with a drug called buprenorphine or “Suboxone.” Suboxone is a highly safe yet controlled substance that reduces withdrawal symptoms, prevents cravings and blocks the effects of additional opioids. If first responders used Suboxone along with Narcan, they could revive people and make them feel well enough to accept transport to the hospital and long-term treatment.
Our Fire Department was impressed and sprinted to get a pilot program up and running; they launched the Suboxone pilot at the beginning of November. Along with their Regions Medical Direction and Education teams, they trained our frontline staff to recognize, treat, engage, and inform residents of this cutting-edge option for treatment. They are actively reaching out to city and community partners to spread awareness of this treatment option. Now, an individual that is suffering from withdrawal from an opioid addiction and is willing to take Suboxone will be able to receive this medication orally and on site, literally meeting people where they are. Once the medication is administered, the patient is offered several options on how to proceed: they can be transported to any receiving ER within our guidelines or they can remain at their location under a “non-transport.”
I share this story because it shows why I’m grateful to do this work in the city I love at this particular moment. We have a City Council that asks hard questions and commits to help solve problems, not just talk about them. We have staff who are honest about what’s not working, who are open to new ideas and willing to work quickly to try them out. We live in a city that is socially connected enough that we can find out about new people and ideas and help put them together. (For example, I’d learned about Dr. Ntaba’s work from counselors at Humboldt High School.) We have a community that cares for one another and is willing to invest in one another’s wellbeing. We have a lot to be grateful for.
November 2024