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As overdose deaths spike, Minnesota families grapple with grief

Overdose deaths increased 38% in Minnesota from 2020 to 2021, and hit new highs across the nation.

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Jason Dobosenski sits with his mom Judy Greske. Dobosenski died at 36 years old in September 2020 when he used heroin laced with fentanyl. Drug overdose deaths spiked 38% in Minnesota from April 2020 to 2021 and reached new national highs, according to CDC data.
Contributed / Judy Greske
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ROCHESTER — The calls for overdose cases came one after another when Judy Greske worked as a paramedic. While she gathered her supplies and traveled to the scene, she was always struck with the same horrific thought: would she be trying to save her own son’s life?

Greske’s child was one of millions of Americans who struggled with an opioid addiction. It began when he was prescribed medication for an injury he sustained in a car accident when he was a teenager.

“Every time a call would come out about a heroin overdose, I would just be like, sick,” said Greske, a Duluth resident. “When you're doing resuscitations on three heroin overdoses a day, it’s a serious problem.”

On the morning of Sept. 12, 2020, Greske wasn’t on paramedic duty, but she received the call she had dreaded for nearly two decades. Her son, 36-year-old Jason Dobosenski, overdosed on heroin laced with fentanyl.

Drug overdose deaths spiked 38% in Minnesota from April 2020 to 2021, according to data from the Centers for Disease Control and Prevention. It was the 12th highest increase among the 50 states. Nationwide, there were more than 100,000 overdose deaths in a 12-month period for the first time on record.

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The surge was fueled by a myriad of factors, including decreased access to resources during the pandemic and increased fentanyl use. The synthetic opioid is 100 times stronger than morphine and 50 times stronger than heroin.
The quiet battle has intensified in the shadow of the pandemic. Unlike Covid-19, which has claimed more lives of the elderly, the victims of the opioid spike are mainly younger. Deaths over the last decade were highest among the 25-34 and 35-44 year age groups.

'It knows no boundaries'

Greske left her work as a paramedic after her son died. But while she held the position, she tried to break down the stigma surrounding mental health and its connection with drug abuse.

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Jason Dobosenski, 36, died in September 2020 when he used heroin laced with fentanyl. Drug overdose deaths spiked 38% in Minnesota from April 2020 to 2021 and reached new national highs, according to CDC data.
Contributed / Judy Greske

She recalled the many times where she revived an overdosing patient, only to have the person express how embarrassed they were to be in that situation. She always felt for the pain these people endured.

“They aren’t doing it to party,” said Greske. “People go underground and they start self-medicating.”

There is no single face for the epidemic, said Dr. Halena Gazelka, a Mayo Clinic anesthesiologist and expert on the surge in opioid abuse.

“Substance use disorder happens to everyone at every level of society and education. And it knows no boundaries,” Gazelka said.

While the surge in overdose deaths may serve as a frightening indicator of an unmanageable problem, Gazelka said there are some solutions in sight. The largest is ensuring that treatment is available. Many of these services were stalled in the pandemic.

“There's so many facets that feed into this, like spokes from a wheel. But if we just start with individuals who have substance use disorder, they need treatment for their substance use disorder so that they don't go out into the street and buy drugs that might be laced with fentanyl,” Gazelka said.

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There is also a growing emphasis on providing preventative measures to those who use drugs, such as strips that test for fentanyl. Some parts of the country, like Rhode Island, are advocating for the adoption of clean use sites where people can use drugs under the supervision of nurses.

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Cheryl Otto is a peer recovery specialist supervisor at Recovery is Happening, an organization that provides resources and recovery programs for individuals in the Rochester area. She said having an assortment of support strategies available to people struggling with addiction is essential. It’s important to consider housing, healthcare, child support services and other factors when aiding in the process of recovery, she said.

“With our outpatient treatment, we never bring an individual in and tell them this is a 30,60 or 90 day program. What our treatment providers here have offered is ... services for as long as you need them,” Otto said.

During the pandemic, Otto and her team continued to support clients, especially as many people struggled with losing their jobs or enduring more isolation.

“What the pandemic really created was a perfect storm for someone with a substance use disorder,” Otto said.

Fentanyl drives spike

While fentanyl has been misused by drug dealers, the synthetic opioid has several legitimate medical uses. It can manage pain when appropriately used in surgical settings or with anesthesia, according to Gazelka. But in larger doses than this, or when bootleg versions of fentanyl are produced, it can be extremely dangerous to use or even touch.

“People couldn’t appropriately titrate or dose themselves with fentanyl, not knowing how much they are getting, or even if they are getting fentanyl in the drugs that they're using,” said Gazelka.

According to the U.S. Drug Enforcement Agency , fentanyl is primarily shipped from China and Mexico. The substance became a popular additive to opioids because of its lower cost and more intense high.

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Percent change in predicted 12 month-ending count of drug overdose deaths, by jurisdiction: April 2020 to April 2021.
Centers for Disease Control and Prevention graphic

Percent change in predicted 12 month-ending count of drug overdose deaths, by jurisdiction: April 2020 to April 2021. Centers for Disease Control and Prevention graphic

“Fentanyl takes a very, very tiny amount to cause a high. So you can ship incredible amounts of the opioid in comparison with other drugs in very small shipping boxes,” said Gazelka.

When someone overdoses on fentanyl, it triggers a respiratory depression, which means breathing slows and the lungs stop functioning.

There are some drugs that can provide a lifesaving reversal of the effects of an overdose. Narcan, or Naloxone, is one of the most common. It’s injected or nasally sprayed into someone who is overdosing in order to revive them.

Gazelka said everyone should consider carrying Narcan on them. She holds a prescription for it, although she nor anyone in her family uses opioids, she said.

“The likelihood that you will come across a car accident in your life is pretty high,” said Gazelka. “The likelihood that you will come across someone who has overdosed on opioids is even higher.”

The Recovery is Happening team hopes to resume monthly public sessions where attendees can be trained on how to use Narcan, and receive doses of the drug to take with them in case they encounter someone who needs it.

Dobosenski, Greske’s son who died from an overdose, saved several people’s lives because he carried Narcan on him, said his mother.

Three people who he revived paid tribute to him at his own funeral.

Nora Eckert has previously worked with NPR, The Associated Press and The Wall Street Journal. She holds a master’s degree in journalism from the University of Maryland and undergraduate degree from St. Norbert College in De Pere, Wis. She’s reported on national investigations into jail suicides, how climate change disproportionately affects the urban poor, the spread of coronavirus in nursing homes and the race for artificial blood. She joined the Post Bulletin team in January 2021 as their investigative reporter.
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