Lieutenant Governor Peggy Flanagan lights sage inside of an abalone shell on March 9, 2023, and offers community members to smudge while a community member sang a Dakota prayer song. Flanagan met with local lawmakers and community members before the state House's vote on the Minnesota Indian Family Preservation Act.
Lieutenant Governor Peggy Flanagan lights sage inside of an abalone shell on March 9, 2023, and offers community members to smudge while a community member sings a Dakota prayer song. Flanagan met with local lawmakers and community members before the state House's vote on the Minnesota Indian Family Preservation Act. Credit: Jadia Grey Eagle | Sahan Journal

Governor Tim Walz and Lieutenant Governor Peggy Flanagan’s “One Minnesota” budget proposal seeks to allocate millions of dollars towards combating opioid addiction in Minnesota with a focus on culturally specific care. 

The budget, unveiled in March, proposes dedicating $115 million towards initiatives that will help Minnesotans access help despite their financial hurdles, cultural barriers, or housing issues. 

According to the proposal, the opioid crisis has surged across the country, with Minnesota seeing a 25 percent increase in opioid overdose deaths from 2020 to 2021. The state saw its highest opioid overdose deaths in 2021, with 1,356 fatalities.

Flanagan said the governor’s office wants to take an equitable approach to opioid addiction that administers treatment specific to different communities. Black Minnesotans are four times more likely to die from a drug overdose than white Minnesotans. American Indian Minnesotans are ten times more likely to die from an overdose compared to white Minnesotans, underlining the need to provide resources to the state’s historically marginalized communities, according to the budget proposal. 

“We try to fit things for our communities within systems that already exist instead of knowing the traditional ways that we have cared for each other grounded in identity,” Flanagan told Sahan Journal in a recent interview. “Those have to be part of recovery.”

This multifaceted approach, the proposal said, highlights systemic barriers that have played a major role in perpetuating the opioid crisis. Housing insecurity is one example of a significant factor that may increase the risk of overdosing.

The governor’s proposed budget to combat opioid addiction would be divided between the Minnesota Department of Health, which would administer grants, aids, and subsidies; and the Minnesota Department of Human Services, which would disperse funds to initiatives such as recovery sites, public awareness campaigns, and competency training. 

The state has had a keen focus on addressing the opioid crisis in recent years. Walz established the Advisory Council on Opioids, Substance Abuse, and Addiction in 2022 to provide insight on the state’s approach to combating the issue and to share best practices for supporting people with substance abuse disorders. 

In November 2022, the administration also appointed Jeremy Drucker as the *state’s addiction and recovery director. The council oversees funds Minnesota receives from prescribers, drug manufacturers, and distributors to fight the opioid crisis. The goal of the newly created role is to facilitate cohesion between different state agencies to better address addiction and recovery. 

Flanagan recently spoke with Sahan Journal about the administration’s plan to address the opioid crisis, and how the opioid epidemic budget proposal came together with community collaboration and equity in mind. 

Funding for the work is included in the governor’s overall budget proposal that also allocates money to higher education, infrastructure, and modernizing the state government. 

Though there may be some more changes to the proposal, the next step for the administration’s budget proposal is for committee chairs in the state Senate and House to draft budget bills before the Legislature’s last day on May 22. 

The conversation has been edited for length and clarity.

How will these resources be dispersed to the communities and organizations that will best make an impact?

The first is African and African American culturally specific outreach through the Department of Health. We have community health workers as well that are included in that in overdose and gun violence prevention. There’s faith community engagement and messaging and overdose and gun violence prevention. 

Through the Department of Human Services, there are Naloxone grants. This is something that we’ve heard frankly from all over the state—but I’d say particularly in Native and Black communities—is just the need for more Naloxone and more folks who know how to administer it. And then safe recovery sites. There’d be 15 of these sites across the state—11 in tribal communities, and then the rest would be four other sites throughout Minnesota. 

How much did the state Opioid Epidemic Response Advisory Council (OREC) influence this work?

A lot of the people who are now serving on the council are people who, before they were appointed, really had their fingerprints all over this in conversations that we’ve had with them. I think we’ve got the right people at the table and it was really important that we had a mix of folks who were frankly in recovery themselves.

We thought that that experience was really important as well as representing the voices of the communities who are most impacted. Jeremy Drucker is also now in his role leading our response to the opioid epidemic.

We’re pushing OREC pretty hard to also be more inclusive of the voices of the people who are most impacted—adding additional tribal seats as well as making sure that the Black community is represented on OREC as well. We don’t always get that right here in Minnesota. I think that it’s important to push for that and to push for that through our office.

What have you learned about the efficacy of culturally responsive care?

What I’ve really learned is that addiction and recovery are complicated and not one size fits all. What I have heard sort of anecdotally in the qualitative data that I have collected myself is that culturally specific and culturally relevant prevention and treatment are what works for our people, and we have to fund what works. 

We try to fit things for our communities within systems that already exist instead of knowing the traditional ways that we have cared for each other grounded in identity. Those have to be part of recovery.

I think for so many people who battle addiction, it’s that disconnect from identity and from community that can fuel that addiction. So, if we can make sure that is part of the work that we’re doing it makes a big difference.

What is the approach to combating substance abuse outside of opioids?

We’ve had a series of traditional healing grants that have been part of DHS (Department of Human Services) and have also had culturally responsive care that’s been included in previous grant funding. I think, the urgency here and the significant amount of dollars that you see is frankly because of the size of this crisis.

The rate of overdose and the amount of fentanyl that is now in our community and the one thing that we’ve also heard a lot about, too, is just the need for this prevention piece, and especially for education of our young people.

We hear all the time about, tragically, young people who overdosed and it’s maybe the first or second time they’ve taken opioids. We can’t underestimate how important that prevention piece is.

There’s a lot of people who are actively using also in recovery, but if we can stop them from using in the first place, I think that’s critically important. 

The other two pieces that relate to this as well that aren’t directly connected to opioids but are two of the proposals that we have in our budget: One is for the expansion of the Office of Native American Health, and then the Office of African American Health in the Department of Health. I think Commissioner Cunningham has been laser focused on equity and outcomes for disproportionately impacted communities, and I think these two offices really speak to that.

What is the public safety approach in this budget and where is the administration on this new issue with tranq, a sedative approved for veterinary use?

We are really focused on prevention, public safety, and recovery. People who are battling addiction need help, and that’s really where we’re focused.

We’re hearing more about this, especially coming out of Philly (Philadelphia), and it’s terrible. So, it’s certainly something that we’re monitoring, and it’s on our radar.

Has there been any insight into harm reduction spaces?

We’ve proposed that in our most updated budget. We’ve seen that these safe recovery sites, as they’re called, have been fairly successful. I think in this moment when our people are dying, every option needs to be on the table to make sure that we’re meeting people where they’re at, and then trying to get them into recovery.

I hope that we can pass this legislation. I think it’s innovative and a couple of other states, New York and Rhode Island, are also looking at that. These populations often avoid SUD (Substance Use Disorder) treatments and mainstream healthcare due to stigmatization and subsequent sustained societal marginalizations, so safe recovery sites have really proven to foster trusted and stabilizing relationships for marginalized populations. We’ve seen evidence that these sites work, and that’s why we’ve proposed funding for them. 

What sort of investments are being made in the training of first responders?

We want to make sure that they have the resources that they need, but currently there’s no statewide real-time overdose surveillance system and there’s no statewide overdose spike alert system. Within our proposal we have a provision that aims to address both needs through the collating of existing data systems that capture real-time suspected non-fatal overdoses and then enhancing the central alert system that will increase the timeliness and just comprehensiveness and access to overdose data for state and community partners.

Our public safety dollars can be used for individual cities. What we have proposed for EMS workers—for additional folks—to have access to this [a central alert system], and that’s a proposal that we included last year and are including again, which is getting public safety resources to communities to determine how they would like to use them.

I have friends who do street outreach who use it [Narcan] multiple times a week. This is their reality. We need to make sure that we are meeting this moment and we think that the additional resources in our proposal can help us. But I think more people overall just need to be trained and needing to be trained and how to administer it [Narcan], and it needs to be available to more Minnesotans.

How has using desegregated information helped to inform this budgeting?

The governor and I often talk about how we measure what we care about, and so making sure that we are being more intentional on the segregation of data is something that we value across the administration, and this is certainly something that we want to do more of. 

We had a meeting with the Somali American Coalition a few weeks ago, and one of the things that continued to be brought up was the need for disaggregation of data because when we talk about Black Minnesotans, what does that actually mean?

If we’re gonna have an appropriate cultural response, then we need to be able to segregate that data. There’s just stigma that is attached to this, to addiction, and it can be more difficult to navigate through addiction and recovery in some communities more than others.

I think this data helps us, and part of the proposal is that the Department of Health will create systems and tools to share data with local communities. That includes a charge from us to be more intentional, but what I would also say is that we have to do that work with community organizations.

We can’t just lead the charge. I anticipate that there’ll be more work done there as we get ready for our policy year in 2024. This is also the work of the Opioid Advisory Council as well.

*CORRECTION: A previous version of this story misstated Jeremy Drucker’s title.

Abdirahman Mohamed is a Somali journalist, filmmaker, and contributing reporter for Sahan Journal. Born in Mombasa, Kenya, Abdirahman was raised in St. Paul’s East Side. He works as a producer and specializes...