This is the first in a two-part story focused on combating fentanyl addiction in Minneapolis.
On a Monday night in July, when asked why he’s giving out sandwiches in parking lots of north Minneapolis, Howard Dotson said, “To save one life is to save all of humanity.”
“Are you hungry?” he asked a group of people. “I got PB&J and a sausage sandwich. I also have some clothes.”
Dotson spends many of his days doing service work.
“You got Narcan on you? You know where you can get some?” he asked a woman who he gave a sandwich to from the back of his Chevy Cruze.
She didn’t know where she could find Narcan, also known as Naloxone, an injectable or nasal treatment that can reverse the effects of a fentanyl overdose. So Dotson gave the woman directions to the Twin Cities Recovery Project, an organization with a branch on Broadway in north Minneapolis that offers services for people seeking help with substance use, mental health and criminal justice.
Dotson drives around the community three to five times a week offering food, clothing and — when the supply is there — Narcan to people who don’t have any. Fatal opioid overdoses in the city increased by 130% from 2017 to 2021.
Dotson believes helping people meet their needs and doing outreach to get more Narcan out in the community can curb some of the deaths in the city. Since September, Dotson has done around 155 food runs, giving out around 4,000 meals, he estimated.
Creating community among those affected
Dotson has seen Narcan save lives. But on this Monday, he didn’t have any on him. When that happens, he tries to equip the people in the community to help each other stop overdose deaths.
“I encourage them to look out for each other,” Dotson said.
When he sees that someone who doesn’t have Narcan on them and is using drugs alone, he then tells the next people he sees in the area to check in on them and give them Narcan if they have extra.
“Can you go over to that green station and give her a Narcan if you have an extra one?” he asked a woman.
“Yeah, I can do that,” she responded.
The next Monday, he received more Narcan from the Twin Cities Recovery Project. He set out to begin his drive around the community, this time with a homemade multigrain casserole and 12 Narcan packets.
Dotson is building trust with the people he feeds.
“They trust me because I feed them so much. They all know me, so they’re like, ‘That’s the church guy who feeds us,’” he said.
“All I ask is that you carry Narcan. That’s the agreement. I feed you, you carry Narcan,” he told one man.
Dotson has been doing humanitarian work for more than two decades. He’s gone to Ukraine three times as a military liaison and previously worked a similar role in Lebanon. After seeing the number of opioid overdoses in north Minneapolis this past summer, he shifted his attention closer to home.
With opioid overdose deaths in Minneapolis surging, the city also has stark racial disparities in opioid deaths, with the rates for American Indian residents being 29.4 times higher and 3.9 times higher for Black residents compared to white residents.
Dotson said the number of overdoses have gone down this summer compared to the previous year. He attributes some of that to the Minneapolis Police Department’s Operation Endeavor.
“Last summer was a wild, Wild West. We had six dealers in the entryway [to Merwin Liquors on West Broadway Avenue]. It looked like a flea market,” Dotson said.
What are the needs?
Dotson and other advocates, like Christopher Burks, a recovery coach at the Twin Cities Recovery Project, have a sense of what people who use are needing.
“Do you need any socks or underwear?” Dotson asked of a woman.
“Yeah, I need everything,” one woman responded to him.
“Do you have any water?” another person asked him.
Once he’s served most of the food, he stopped at a Holiday gas station on Washington Avenue, where he leaves food at the counter for people who might hang around there. As soon as he stepped in, one of the employees asked him, “What do you got today?”
“He brings all types of food up in here all the time. He helps out the community the best way he can, to my knowledge,” said Davante Donaldson, a security guard at the Holiday. “I live in the area and I (see) him riding around on Broadway, stopping at the bus stops, seeing if homeless people want food.”
[image_credit]MinnPost photo by Ava Kian[/image_credit][image_caption]Dotson handing out envelopes with Narcan supplies to a staff member at the Holiday gas station on Washington Ave in north Minneapolis.[/image_caption]
“We introduce ourselves, let them know who we are. Sometimes it’s just me passing out a card telling them ‘I’m here when you’re ready.’ We’ve had a number of people that come through the door months later, a year later,” he said.
In his time doing that, he learned a lot about what people need.
“It’s supposed to be all these wonderful housing programs out there, but it seems like none of them (are) working or they’re not getting the people in the houses,” Burks said. “A lot of (homeless people) don’t know where they can get housing, don’t know how to go about getting the housing. And then a lot of times they have exerted all their strength to get the housing, and then the housing falls through.”
During one of Dotson’s food runs, he served the multigrain casserole to a woman named Coco. She was unhoused, and passing through a Franklin/Hiawatha encampment in south Minneapolis. Coco has been unhoused for a few years, she said. She wants stable housing, but hasn’t been able to find it. While she has case workers, she feels that they are not helping her much.
[image_credit]MinnPost photo by Ava Kian[/image_credit][image_caption]Howard Dotson filling a plate with a homemade multigrain casserole to give people outside of the Cub Foods in north Minneapolis on July 31.[/image_caption]
The Twin Cities Recovery Project has offices in both south and north Minneapolis. As a whole, Burks feels the Northside receives less support and resources.
“North Minneapolis doesn’t get nearly the help south Minneapolis gets,” he said. “Every time we do outreach over south we always see another outreach program doing outreach. I think we’ve been over north just as much as we’ve been over south and I think we’ve only seen one other organization doing outreach over north. That was just one time.”
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Younger people are increasingly using fentanyl in north Minneapolis, said Marilyn Jackson, a lifelong north Minneapolis resident, who lost her husband to a fentanyl overdose three years ago.
The pill has become increasingly cheaper, offering greater access to younger people, with buyers saying you can find it for as low as $5.
[image_credit]MinnPost photo by Ava Kian[/image_credit][image_caption]Marilyn Jackson lost her husband to a fentanyl overdose three years ago.[/image_caption]
“It’s so sad,” Jackson said. “When I see this, it just relives the nightmare because I believe everybody (has) been hit with it in some type of way. It just brings back what I experienced. And it’s sad because I don’t wish it on nobody; and it don’t matter what age it is. It’s a life.”
That nightmare is becoming more of the reality.
“North Minneapolis [has] definitely been hit real hard within the last two to three years,” Jackson said. “Unbelievable, the stuff that you see now.”
Frustration over city’s response
Burks, the recovery coach, knows Narcan saves lives. He has overdosed around six times. Because of his relationship with the life-saving drug, he’s made it a mission to teach others about what it can do.
“I’ve had Narcan administered to me myself. So I do understand it works,” he said.
Just last week someone overdosed at the 4th Street Saloon on West Broadway.
“We knew something was more than just the drinks he had. He just went totally cold and blue. First thing I could think of was to go grab Howard [Dotson],” said Mike Oker, the Saloon’s general manager.
Dotson came and began CPR. About 20 minutes later, the ambulance arrived and then administered Narcan. Dotson wants bars to be equipped with Narcan, so that it doesn’t take 20 minutes to stop an overdose.
Right now, people in the community say there’s not enough Narcan available. Dotson thinks the city should have invested in Narcan years ago.
[image_credit]MinnPost photo by Ava Kian[/image_credit][image_caption]Vials of intramuscular naloxone (Narcan) and injection supplies on the bar at the 4th Street Saloon.[/image_caption]
A public health specialist will also be hired. The specialist will implement the strategic plan created by the consultant, which the city estimates will happen in 2024.
That timeline enrages Dotson.
“I don’t hear a sense of urgency,” he said. “I’ve been giving [the city] a free consultancy for 10 months. You don’t need a consultant to get the answer I’ve been giving you for 10 months. Harm reduction is what this settlement’s supposed to be about. It’s like rearranging the chairs on the Titanic to sit on this money waiting for a consultant to give you an answer that I’ve been giving you.”
“We need that Narcan now,” Dotson said. “Some will say, ‘Oh there’s enough Narcan out there.’ Well, are you doing the public health outreach? Are you doing the surveys? Do you really have the data? Some officers say they all have it, and I’m like, ‘That’s not what I see. I’m out there five nights a week.’”
Burks wants to know why this plan doesn’t already exist.
“They should have had a plan by 2024. It’s like how many more people got to die for you to get a plan?” he said.
In March, MinnPost talked to Damon Chaplin, who at the time was just about to begin his role as Minneapolis public health commissioner. When asked about how he would approach the opioid crisis, he mentioned the need to develop relationships with people in the city who are already doing work around prevention, intervention, treatment and recovery.
Some members of the City Council are working to make sure the city lives up to its promises. On Wednesday, the Minneapolis Public Health and Safety Committee approved a legislative directive authored by council members Robin Wonsley and Elliott Payne that aims to establish accountability for the city’s plans regarding opioid intervention.
Wonsley said the directive originated from a presentation by the city’s health department to the committee in June, addressing the opioid epidemic.
“The presentation very clearly laid out the enormous, tragic and incredibly inequitable impacts that the opioid crisis is having on our communities,” Wonsley said at the meeting. “This legislative directive is intended to structure additional conversations around the way this body, the city of Minneapolis can show up to meet the need of that urgency and what are some best practices to respond, to provide support to the communities that are disproportionately impacted by this crisis.”
The directive requests the mayor’s assistance in supporting a needs assessment of staff, funding and other resources required to fully implement a comprehensive opioid response program. Additionally, it calls for a follow-up report on the actions taken by the health department. The deadline for these reports is set for March and September of 2024.
A grant is said to be in the works to put Narcan dispensers at Minneapolis fire stations near encampments. Dotson likes that idea as a solution – he wants it to happen before more lives are lost. And Burks thinks it can be expanded even further.
[image_credit]MinnPost photo by Ava Kian[/image_credit][image_caption]Christopher Burks, a recovery coach at the Twin Cities Recovery Project, at the project’s south Minneapolis location.[/image_caption]
Advocates emphasize that Narcan is not the solution to addiction, however. It must be accompanied by medications for addiction treatment (MAT), meaning treating of the withdrawal symptoms.
Only 10% of people with substance use disorder in the U.S. receive treatment for their condition, according to the American Medical Association. Getting that access to treatment – meaning having beds available in recovery centers and hospitals, is crucial for survival.
When someone is sent to the ER for an overdose and there are no available beds to treat psychiatric conditions, what happens?
“They Humpty Dumpty them back out in the community, and eventually they’re going to O.D. (overdose),” Dotson said. “It’s Humpty Dumpty ‘til they die.”
Dotson and Burks believe keeping people alive and expanding recovery services can be life changing and dramatically improve health outcomes in the city. In addition to giving Narcan to places like gas stations and bars near areas where he’s noticed fentanyl use, Dotson has also taught many, like the staff of the Moose Bar and Grill in Minneapolis, how to administer the drug.
Dotson is trying to do as much of this work as he can before September, when he will be leaving for Ukraine for other humanitarian work.
Part II focusing on addiction runs Aug. 11.
There is housing, but it often comes with rules and then there is the issue of maintaining it. Shelters do have a pretty messy system–call at this time, show up at this time, no pets, sometimes share a room, etc.. What people will often say is why should we subsidize housing if we are not sure the person can maintain it. There are lots of chemical dependency programs, but they are voluntary. You also hear people say, why should someone who is using get preference over someone not using. It becomes complicated.
Lisa, damn straight there are rules to public housing for the unhoused! Would there be another way preferable to rules-based housing? I live in a home where there are rules and regulations and taxes and city and community expectations and neighborhood expectations. Why wouldn’t a homeless person agree to rules in order to have safe, clean housing? I need some education here…thanks, in advance.
We have a big problem on the West Bank, too, among Somali youth.
Very well-written article – I sincerely look forward to part 2. I appreciate Burks’ compassionate perspective on the challenge of actually finding AND securing housing when you are experiencing homelessness. As Lisa mentioned, it is also not as simple as some people may think. You also have to worry about things like protecting what little property you may have or things like medication from others, and there is the possibility of being exposed to violence in some poorly managed shelters. It is not as simple as just “choosing not to be homeless.”
Dotson’s frustration with the city’s lack of urgency also resonated with me. I know I can be a cynic sometimes, but the idea of bringing in a consultant just reeks of unnecessary bureaucratic nonsense that is probably meant to insulate decision-makers more than it is meant to make sure the city takes the right approach. We know the right approach! We’ve known for years. Housing first, harm reduction, and community engagement. Yes, all of these are extremely complex initiatives unto themselves, but you don’t need to blow money on a consultant to tell you this a year from now while those doing the actual work in the streets are watching people die every day.
I can’t disagree more with the “if we have more consultants, we get better results” approach to city governance. The mayor and council so far don’t get this. We’ve had consultants doing public service work for as long as I’ve been on the planet — now 71 years. It’s time to stop hiding behind studies and consulting, and really DO the work on the ground that our Minneapolis citizens expect. I want to hear from readers what their reactions are…
It’s well past time Minnesotans realize what public consultant work really is… graft.
I don’t think they will though, because too many here make their living this way.
Agree- well done article. I don’t know the solution to get them into housing and drug rehab, but not trying is worse IMHO.
I know a lot of them won’t try housing or drug rehab adding to the frustration.
Yesterday I read an excellent article by David Brooks on reducing polarization. He commented on terms like “unhousing” as the new invented word to replace homeless. Why distract from the issue with a made up word? His point is that making up words like that alienates a lot of people. It is like our St Paul city council person who champions rent control, but uses really old derogatory terms like tenant and landlord. Who does that in 2023? Next we will have “unapartmented” or “uncondoed.” Please stop making up words! It is not helpful in so many ways.
I do think we get pretty hung up on using the correct language sometimes, but I think with good intentions. For example, I have always struggled with the term “latinx” because I don’t actually know anyone, personally, that identifies by that term – though, if someone asked me to use the term, I would do so out of respect. More specific to your point, though, one of the things I was trained on early in my career is “person-first language”, where you separate the descriptor from the individual. So, for example, you would say “an individual with a disability” instead of referring to someone as disabled or a disabled person. Because of this, and from talking with others, I have shifted to using the expression “experiencing homelessness.” Referring to someone as a “homeless person” just sounds demeaning and alienating to me. Just my two cents.
Ah yes, its a Minneapolis problem, what next, Minneapolis is failing because we don’t provide asthma relief services, or immediate within micro-seconds 311 emergency services for gun shots, auto accidents, bike collisions, pedestrian collisions, heart attacks, etc. etc. etc. etc. Yeah lets keep blaming the city and the government for not being 100% on the job, everywhere and at any time 100% of the time! It isn’t the problem of the irresponsible for being irresponsible, its the problem of the responsible for not being more responsible for the irresponsible so the irresponsible can be more irresponsible!
This is really sad. We have unchecked flow of fentanyl into the country from the Southern Border. Not one word of that in this story. No Supply = No Demand. Narcan is a bandaid and doesn’t solve anybodies long term use/addiction. It is a roll of the dice every time somebody takes fentanyl, you never know what you are getting.
“unchecked flow of fentanyl into the country from the Southern Border” I would be very interested where this information came from?
“The United States and Mexico are working together in this fight, promoting historic cooperation on both sides of the border to stop fentanyl trafficking. We recognize the Government of Mexico’s announcement about the seizure of more than 1,700 kilograms of fentanyl in the first half of 2023.” That’s 3,740 lbs American speak.
https://www.google.com/search?client=firefox-b-1-d&q=Fentanl+busts+iin+US+and+mexico+
Are you serious?? Absolutely unchecked. When we seize just a tiny fraction and that tiny fraction is 1,700 kg, we have a problem. The drug cartels are moving it across the border daily. The smoke and mirrors of look we caught some, meaning we are doing a great job. We are not doing a great job. Despite the narrative. If we were doing a great job we wouldn’t be losing Thousand of people a year to this epidemic, these pills are floating around in a grade schools for goodness sakes.
Show your work! Where are you getting your “Absolutely unchecked” from? You were provided a link to a resource that says you are pimping us with humongous unchecked levels of bombast!
“Coast Guard offloads more than $186 million in illegal narcotics” guess that is “unchecked” coast guard BS?
https://www.news.uscg.mil/Press-Releases/article/3431687/coast-guard-offloads-more-than-186-million-in-illegal-narcotics/
1000 deaths against what, 26,000+ gun deaths a year are we doing a good job there?
What world are you getting your stats from. Unchecked. Yes. Thousands of pounds is coming across the southern border every month. Of course that’s a guess. We don’t know. CDC says there is 210 fentanyl overdose deaths per million people. That equates to over 70,ooo/year that has more than doubled since 2019. 1000?? Maybe five years ago. The overdose deaths are on a huge upward slope. Here is reference for you. https://abc7chicago.com/cook-county-illinois-opioid-deaths-drug-addiction-help/12629232/
Show your work. Just because it doesn’t fit your narrative doesn’t mean it isn’t true.
Way off the original topic but:
Haven’t heard anyone denying fentanyl is a social problem, just like guns, you are saying however “Absolutely unchecked”, read your own links! As before pimping folks with bombast.
https://abc7chicago.com/fentanyl-seized-drug-overdose/12595150/
Your saying the link you provided is BS, and the DEA really didn’t seize that fentanyl, because its coming in the country “Absolutely unchecked”? You do know what the word absolute means?
Well since you are the one who compared it to guns. I did not. Unchecked. Yes. As soon as it becomes difficult to acquire I will consider it checked.
We as a society have made drug addiction acceptable, we even pander to it. We have become the great enablers.
Read your own comments; “Absolutely unchecked.”
“We as a society have made drug addiction acceptable” Meaning what? We recognize it as a problem, if it is acceptable, its not a problem now is it?
it isn’t healthy for cities to just push the issue down the road to someone else. someone else is us — right now. when words don’t get translated into concrete actionable efforts, people get really angry. it’s hard to govern, but it’s also the job our elected were chosen to do.
Which concrete actions do you suggest? And who should perform them, and how should we pay for them? It’s easy to say “Somebody do something!” but not so easy when you’re dealing with the specifics.
We don’t have unlimited resources, they need to be prioritized. Self inflicted drug overdoses are not at the top of the list. We have many people in crisis for no fault of thier own.
True, we do need to prioritize. But “self inflicted” drug overdoses are pretty important. In any case, how many addictions do you think are the “fault of their own?” I’m having trouble finding more recent data, but 75% of those addicted to heroin started that addiction via a LEGAL opioid prescription. Opioids are incredibly addicting… there’s a reason that the Sackler family would like to simply pay a few billion dollars and otherwise get off scott free. They knew. And getting sober isn’t just a decision you make. You can literally DIE getting sober due to withdrawal. Frankly, if we stopped letting some people make money off the government (and I’m talking about people who are rich, not poor – look up “tax loss harvesting” for starters), we probably would be able to prioritize a little more broadly.