Drug overdose deaths soared in Minnesota last year, following a nationwide trend, but there are signs prescription opioid deaths are falling and better access to lifesaving naloxone is making a difference.

Overdose fatalities reached 1,286 in 2021, up 22% — the highest recorded in at least the last decade, according to a preliminary Minnesota Department of Health report.

That's an average of four Minnesotans a day dying from a drug overdose last year.

Much of the increase was driven by synthetic opioids such as fentanyl, psychostimulants like meth, and cocaine. Fentanyl, a synthetic opioid developed as a painkiller more powerful than morphine, is now being mixed in with many street drugs, leaving users unaware of what they are taking.

"We're assuming that the increase is due to the amount of fentanyl around," said Mary DeLaquil, epidemiologist at the Minnesota Department of Health.

"It's cheap," DeLaquil continued. "A lot of people don't seem to know what it is they are buying — in other words, they might not have any idea there is fentanyl in there."

Increased drug use may be linked to the pandemic, but even before it, America was in the throes of a drug overdose crisis, including an increasing and more dangerous illicit drug supply and a lack of mental health treatment and supportive services.

Preliminary data shows there was a 35% increase from 2020 for opioid deaths, from 685 to 924. Specifically, synthetic opioids deaths increased by nearly 50% and were involved in 90% of opioid deaths.

However, deaths with prescription opioids decreased 11%. Heroin deaths also decreased by 20%.

Deaths from cocaine spiked — up 81% — and psychostimulant-involved deaths increased 35%.

Hospital-treated drug overdoses that did not result in a death also decreased 10% from 14,545 to 13,081, much of it due to increased naloxone awareness and availability that resulted in more people being treated at home, according to the report.

Researchers say 62% of nonfatal overdoses were treated in hospitals, and for every overdose death, there are 10 nonfatal overdoses.

The increase in drug overdose deaths is widespread across the state. In the seven-county metro area, drug overdose deaths increased by 20% and for the first time since 2014, greater Minnesota outpaced the metro area with a greater increase at 23%.

The Minnesota Department of Health's research also found racial inequities in that Black and American Indian people who overdose are more likely to die than white people, DeLaquil said. Racial data was not included in the preliminary report and more will be released later this year.

In the metro area, nonfatal overdoses decreased 16% and in greater Minnesota it decreased by 6%. Across the state, drug overdoses have been rapidly increasing since 2018.

The Centers for Disease Control and Prevention estimates more than 107,000 people died from drug overdoses — a new high for the country, according to its data. More than 1 million have died from drug overdoses since 2001.

For information on where to get fentanyl test strips or for more information on supportive services e-mail health.drugodprev@state.mn.us.