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Fentanyl detection up 400% in Minnesota, according to study

The report from Millennium Health analyzed urine samples from substance use disorder treatment testing in the first half of 2022. St. Louis County has seen a 2,500% increase in fentanyl positivity in 2022 compared to 2019.

Confiscated powder containing fentanyl.
A Drug Enforcement Administration chemist checks confiscated powder containing fentanyl.
Don Emmert / Getty Images / TNS
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SAN DIEGO — Illicit fentanyl positivity in Minnesota drug tests has increased by 400% so far this year compared to 2019, according to a new report from Millennium Health.

The San Diego-based company analyzed urine drug tests from substance use disorder treatment practices and compared the findings from the first half of 2022 to data from 2019. According to the report, fentanyl detection has increased 287% in persons using methamphetamine and has increased 208% in persons using cocaine. Fentanyl's positivity rate across the state increased from 1.76% to 8.79% in urine drug tests.

St. Louis County saw the most dramatic increase in fentanyl positivity of the state's six most-populated counties, increasing more than 2,500%. The positivity rate jumped from less than 1% to more than 17%, according to Millennium Health data. Heroin positivity in tests increased more than 1,200%, while cocaine positivity increased nearly 250% and methamphetamine positivity increased 150% from 2019 to 2022 in St. Louis County.

There have been 34 fatal drug overdoses in the county so far this year, and 312 nonfatal overdoses, according to St. Louis County Public Health data from the Overdose Detection Mapping Application Program.

Dr. Kelly Olson, director of clinical affairs at Millennium Health, said she's heard personally about the increases seen in the northern Minnesota region.


"I'm getting more phone calls from clinicians looking for assistance in measuring methamphetamine or fentanyl in the urine of their patients because they're tending to see more of those positives than they had in the past," Olson said.

Olson said there's still a lack of awareness in communities of just how harmful and prevalent fentanyl is — especially in port cities like Duluth. Because the synthetic drug is mixed on the streets, and often mixed into other street drugs, it's hard to know what dosage of fentanyl a person may be exposed to.

"When it comes to fentanyl or the mix of fentanyl and methamphetamine or whatever it may be, often times there's no 'trying' the drug," Olson said. "It's one and done, and that person may not survive."

All of Minnesota's five most populated counties in the Twin Cities metro area — Hennepin, Ramsey, Dakota, Anoka and Washington — saw increases of more than 100% in fentanyl positivity from 2019.

Fentanyl, a synthetic opioid, was developed for pain relief and can be up to 100 times stronger than morphine. As little as the amount of two grains of salt worth of fentanyl can be fatal if introduced into the bloodstream or a mucus membrane. It is frequently found in other street drugs, including pressed pills, methamphetamine, cocaine and heroin. Fentanyl is not fatal through skin contact alone.

Fentanyl penny.jpg
As little as 2 milligrams of fentanyl, similar to a few grains of salt, can be lethal for most people, according to federal authorities. (Photo courtesy of U.S. Drug Enforcement Administration)

Minnesota had the most opioid-involved overdose deaths on record in 2020, according to Minnesota Department of Health data. The 678 deaths were nearly 60% more than were recorded in 2019, the previous record high. Synthetic opioids were involved in more than half of the state's opioid overdose deaths in 2019.

"Oftentimes, one thing to remember is they may not know they're consuming fentanyl," Olson said. "They may think that they're getting heroin or methamphetamine, and come to find out in an autopsy or in a drug test that they have fentanyl positivity and they had no idea. You've got very tight-knit communities that are losing people that they know, so it's not just a statistic — it's a family member or a friend."

Olson said the increase in fentanyl is a problem nationwide because fentanyl is so inexpensive to produce and doesn't require variables like weather or growing seasons like heroin does. She also warned that fentanyl producers aren't always worried about trying to disguise the drug as an authentic pill, and it is sometimes created as colorful pills or powders known as "rainbow" fentanyl.


"The cartels are making sure that their product gets into every community," Olson said. "You see it in the little communities up in northern Minnesota, for goodness sakes. It's infiltrated everywhere."

Fentanyl test strips are legal to possess and carry in Minnesota and available locally from Harm Reduction Sisters and Rural AIDS Action Network. They also can provide naloxone (Narcan). Nystrom and Associates, WebMed Mental Health Services and the Center for Alcohol and Drug Treatment are also naloxone access points. Other free Minnesota naloxone access points can be found at knowthedangers.com/naloxone-finder .

“We have already seen too many Minnesota families lose loved ones to drugs," Dr. Angela Huskey, chief clinical officer at Millennium Health, said in the news release. "Our goal is to work hand-in-hand with public health and safety authorities, health care providers, and community organizations to proactively address drug exposures and help prevent drug overdose deaths.”

This story was updated at 9:41 a.m. Oct. 25 to clarify where fentanyl test strips and naloxone are available locally. It was originally published at 5:06 p.m. Oct. 22. The News Tribune regrets the error.

Laura Butterbrodt covers health for the Duluth News Tribune. She has a bachelor of arts in journalism from South Dakota State University and has been working as a reporter in Minnesota and South Dakota since 2014.
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