Note: This is the first in a series of articles outlining the problem of opiod use in the region, a personal perspective and potential solutions.

NEW ULM — In October 2017 President Donald Trump declared the increasing rate of opioid-related deaths a public health emergency.

Commonly referred to as the opioid epidemic, overdosing on prescription painkillers, heroin and synthetic opiates has become one of the leading causes of injury-related deaths in the United States, according to the federal Department of Health and Human Services (HHS).

In 2016, over 42,000 people died from an opioid overdose, according to the HHS website. That year, 2.1 million people were reported to have an opioid-use disorder. The epidemic has cost the nation an estimated $504 billion.

Since 2000, the number of people dying due to opioid painkillers in Minnesota has increased in a virtually unbroken trend.

In 2016, the death count reached 395 people who died due to painkillers or heroin in Minnesota. That was an increase of almost 20 percent from 2015, according to data available on the Minnesota Department of Health’s website.

In Brown County and the surrounding six counties, deaths related to opioids have become more frequent since 2005.

Three people have died in Brown County between 2000 and 2015. In that time, Blue Earth County had the most deaths of any of the seven-county region, with eight total.

The worst year for overdose-deaths was 2011, when six deaths occurred in Brown, Nicollet, Cottonwood, Redwood and Renville counties.

According to data from the Minnesota Sentencing Guidelines Commission (MSGC), there have only been four opium or opium derivative-related convictions in Brown County since 2007.

Synthetic narcotic convictions are higher at 17 convictions since 2007. The most common drug is methamphetamine, with 57 in that same time frame. In the last three years, meth-related convictions have doubled per year, from six in 2014 to 24 in 2016.

Total drug-related crimes remained flat at 12 per year from 2011 to 2013 but have increased each year to 32 in 2016. However, those convictions do not tell the whole story.

For one, the MSGC’s data only covers adult felony offenders, when often drug-related crimes get pled down to misdemeanors, Director Les Schultz of the Brown County Probation Department said.

Addiction Manager Marie Larsen with the New Ulm Medical Center (NUMC) pointed out that the patients who end up in NUMC’s addiction treatment program often ask for help before they get arrested, or end up getting sent there after a non-drug crime.

In some cases, a person addicted to prescription painkillers may get caught in another crime that is on its face unrelated to drugs but is motivated by the offender’s addiction.

“Burglaries for (drugs), thefts, people will steal things in order to support their drug habit,” Assistant County Attorney Paul Gunderson said.

Another reason is the relative impact of a person’s addiction. If it does not prevent them from being able to work or go about their daily business, it is not usually diagnosed.

“That is a large reason why some of our opioid users are off the radar; because sometimes it is not diagnosable,” Jolene Hanson, a treatment director and mental health professional with Nova House, said.

That does not mean the addiction is not hurting the user. Luke Bresnan, a patient in NUMC’s addiction program who was willing to share his story, said one of the worst parts of his addiction — aside from withdrawal — was the facade he put on.

“Everyone thought I was doing great, but I was a mess inside,” Bresnan said.

He got addicted after an accident at work left his leg in a cast for over a year and him with a chronic pain disorder.

If drug-related convictions cannot paint the whole picture, there are a couple of other data sets to look at.

One is the Minnesota Student Survey (MSS), a voluntary, anonymous survey taken by students every three years.

County-wide, students using prescription drugs have been on the decline. In 2013, 5.2 percent of all grades reported using prescription drugs not prescribed for them. In 2016 that dropped to 4.4 percent.

Prescription pain relief numbers show a shift over the last decade. In 2007, 1.7 percent of students responding reported using painkillers not prescribed to them.

In 2010, that increased to 6.4 percent, and it dropped to 3.4 percent in 2016. Data for that question in 2013 was not available.

Heroin use is less uncommon, with 1 percent of boys in 2010 and 0.3 percent of boys in 2016 reporting having used it.

That fits with what the County Attorney’s Office sees. It is more common for someone to get caught with a couple of pills in their pockets than any heroin.

“The more common type of abuse, if it is going to be opioid-related or opiate related, is going to be prescription drugs,” Gunderson said.

To get a better idea of how many of these drugs may be in the community, the Minnesota Prescription Monitoring Program (PMP) releases annual reports on prescriptions by county.

The PMP’s 2016 report listed the state average for opioid prescriptions per 1,000 residents at 615.2. Brown County’s rate was slightly lower at 605.2.

Compared to adjacent counties, Brown County falls to the middle of the pack. The highest rate for opioid prescriptions is Cottonwood County with 729.9 prescriptions per 1,000 residents. The lowest is Nicollet with 488.3 prescriptions per 1,000 residents. The mean average of the seven counties including Brown is 618.1.

Despite Blue Earth having the highest population and total number of prescriptions for all three years, it shakes out near the bottom for opioid prescriptions per 1,000 people, with only Watonwan and Nicollet below it.

For the three yearly reports available, 2014-2016, virtually all counties show a consistent trend for total prescriptions per 1,000 people and opioid prescriptions per 1,000 people.

Almost all start lowest in 2014, with a spike in 2015 then dropping from that in 2016, though not as low as 2014.

The only exception is Renville’s total prescriptions per 1,000 which stays practically flat between 2014 and 2015 and drops somewhat in 2016.

Connor Cummiskey can be emailed at ccummiskey@nujournal.com.