Ramsey County and St. Paul brief council on opioid response: settlement funds, naloxone distribution and Suboxone pilot

Ramsey County Public Health Director Amy Kieran and Deputy Director Ray Eden Frank told the Saint Paul City Council Policy Committee about local opioid overdose trends, settlement funds and current county programs. St. Paul Fire Department Assistant Chief Steve Samson and regional Medical Director Dr. Aaron Burnett briefed the committee on an EMS Suboxone pilot and other prehospital responses.

Kieran said the national and state opioid overdose death counts decreased in 2023 and that provisional 2024 data showed a continuation of that trend, but cautioned that nonfatal overdoses can still rise. "Drug overdose is the leading cause of accidental death in The United States with opioids being the most common classification of drugs responsible for those overdoses," she said. Kieran and Ray Eden Frank flagged persistent racial disparities in overdose mortality: Minnesota data cited by the presenters showed American Indian Minnesotans had substantially higher age‑adjusted overdose mortality and Black Minnesotans had higher rates than white Minnesotans; provisional 2024 figures the presenters cited showed a decline in American Indian deaths and an increase in Black deaths.

Frank summarized opioid settlement distributions: he said state agreements with manufacturers and distributors produced funds that are allocated to states, counties and qualifying cities. He said Ramsey County was projected to receive more than $26 million (across rounds referenced in the settlements) and that the City of Saint Paul was set to receive about $14 million (figures as reported by Ramsey County staff). Frank said some settlement dollars already received by the county — about $8.8 million as of a February disbursement referenced in the presentation — have been used to fund a naloxone distribution pilot and the first round of county opioid response community grants.

Ramsey County described actions already funded by settlement and other grants: the county awarded roughly $1 million in June 2024 to 17 community organizations across five priority areas (pregnancy/parents/babies; culturally specific approaches; prevention/education/outreach; treatment/support for justice‑involved people; youth engagement). The county reported distributing 1,592 naloxone kits through an online ordering portal and direct community trainings, funding enhanced pretrial case management through JusticePoint, operating a syringe‑services site (listed at 555 Cedar) with testing strips and wound care, and deploying a mobile clinic van for testing and harm‑reduction outreach.

Frank said the county had also received federal grants (SAMHSA and MDH infrastructure grants) to support work in correctional facilities, services for people who are unhoused, and feasibility planning for safer‑recovery/safe‑use sites in collaboration with Minneapolis. He said the county planned to release a new opioid response RFP for community grants during the year, to form a county opioid advisory council and to hire consultants for strategic planning.

At the committee meeting, Council members urged focus on high‑use transit corridors, particularly the METRO Green Line. Council Member Provosky and others urged more on‑train staffing and outreach; Frank and Kieran said county teams were participating in the Safe & Strong corridor initiative with Metro Transit PD and community partners and that pilot staffing and outreach on trains were underway.

St. Paul Fire Department officials described prehospital care and a Suboxone pilot: Assistant Chief Steve Samson said paramedics responded to roughly 4–5 suspected overdoses per day during the current reporting period and described a heat map of overdoses concentrated along the Green Line and downtown. Dr. Aaron Burnett, the department's regional medical director, said the department launched a Suboxone program late in the prior year and had administered three Suboxone doses in the field while assessing about 60 patients who qualified for the medication. "Narcan is the treatment for respiratory arrest for not breathing. It is not a treatment for substance use disorders. Suboxone is the treatment, the cure for opioid use disorder," Burnett said. Fire officials said they planned to expand Suboxone availability from supervisor vehicles to ambulances that most frequently respond along high‑use corridors and will collect program data in real time to guide further expansion.

Council members pressed for timely follow up and for coordination between city and county settlement dollars; committee members asked for ward‑level maps and for information about referral pathways and treatment capacity. County and fire officials said they would provide more detailed data and follow up on funding timelines, the RFP schedule, and the referral sheet the fire department uses for patients who decline transport to hospitals.

Ending: Committee members thanked county and city responders for the briefing and asked for further updates on settlement allocations, the community‑grants timeline and outcomes from the Suboxone pilot as data accrue.