Nonprofit fights opioid epidemic by giving away antidote doses

Anyone can now legally possess and administer naloxone, the powerful lifesaving antidote to a heroin or opioid overdose — even an addict.

The Steve Rummler Hope Network, a Minnesota nonprofit that lobbied for the 2014 law allowing for wider distribution of naloxone and immunity for those who use it to save a life, is giving away thousands of doses across the state to anyone who might need it. That includes police officers, first responders, college employees, drug rehab staffers and parents.

This summer, the Rummler network trained staffers and provided naloxone at Minneapolis Community and Technical College; Minnesota State University, Mankato, and even a big-box store after an overdose in a parking lot.

The nonprofit gave away 6,000 doses in 2016. This year, with the help of a $200,000 state grant, it wants to distribute up to 24,000 doses.

"It saves lives. I am down for anything that saves lives," said Dr. Anne Pylkas, the nonprofit's medical director and an addiction doctor at HealthPartners who writes the order for naloxone distribution.

With drug overdoses now killing more Americans than gun homicides and car crashes combined — more than 560,000 died from 1999 to 2015 — the Rummler network, founded in 2011, and a group of other nonprofits are doing the groundwork and advocacy that others are reticent to do.

The network is made up of a staff of four, a group of passionate volunteers often with personal ties to the crisis, and a team of 10 medical doctors who act as advisers and use their voices and expertise to combat the crisis within the medical community.

More than 500 died from an opioid overdose in Minnesota in 2015, a 600 percent increase since 2000, according to the state Health Department. Many people become hooked to prescription painkillers and resort to heroin when their prescriptions run out.

Providing access to naloxone is just part of the Rummler network's three-pronged strategy. It urges doctors to reduce opioid prescriptions, and seeks to make drug companies pay more for the problem created by their products.

"We are a country in crisis because of the prescribing practices to treat pain," said Lexi Reed Holtum, executive director of the Rummler network. "I feel frustration and anger about the fact that our country is not investing in the solutions to this epidemic that now kills more than at the height of the AIDS epidemic."

The nonprofit will be back at the State Capitol next year, this time lobbying for a one-cent fee on every morphine milligram equivalent sold in the state in the outpatient setting. The estimated $22 million collected annually by the Minnesota Board of Pharmacy would help pay some of the costs of the opioid epidemic, Reed Holtum said.

Pharmaceutical companies and some business groups oppose the fee. But Johnson said holding the industry accountable is a critical next step.

Johnson, an emergency and urgent care doctor, said he sees firsthand how long-term opioid prescriptions for chronic pain have created this problem. Opioids are an important tool for short-term acute pain relief, he said, but long-term use can have devastating side effects, said Johnson, who lectures widely on the topic.

"Use it for a couple of days, take an edge off the pain, but don't pretend it's something you can take for years without risk," he said.

Pylkas said the pharmaceutical companies pushed this class of drugs and people have come to expect them. "There is an expectation of zero pain. We have to reeducate people on that," she said.

The Pharmaceutical Research and Manufacturers of America, a Washington, D.C.-based trade group, said it's committed to preventing and deterring prescription drug abuse: "If we want to effectively tackle this challenge, we need to bring all relevant stakeholders — including providers, payers, and patients — together to craft a meaningful solution."

Steve Rummler's parents, William and Judy Rummler, founded the nonprofit after their son's overdose death in 2011. Rummler was a successful financial adviser in Eden Prairie in his 40s, engaged to be married to Reed Holtum, his high school sweetheart. He was a musician who ran marathons and played broom ball.

But he suffered from persistent back pain after an injury, and had been prescribed opioids to manage it. Realizing the pain pills were becoming an addiction, Rummler went through a chronic pain program to lessen his dependency. He later completed a 30-day inpatient rehab but was able to pick up prescription painkiller refills after treatment.

Disciplined in every other aspect of his life, he believed he could overcome the addiction himself, Reed Holtum said. "There was no amount of willpower that will rewire brain pathways established from prescription opioid use for years," she said.

Rummler, 43, was found dead of a heroin overdose at his home in July 2011.

In 2014, the Rummler network lobbied to help pass Steve's Law, which allowed for greater distribution of naloxone under a doctor's supervision and provides immunity for those who use it or call 911 to help someone who is overdosing — even if the caller possesses some illegal drugs.

Despite Health Department data showing that certain counties are facing a dramatic uptick in emergency room visits and deaths due to the opioids, local officials often initially decline training or naloxone kits. Pylkas said some incorrectly believe that having naloxone on hand may encourage drug use, because users know they can be revived.

The drug can be administered as a nasal spray, with an auto injector similar to an EpiPen, and by injection. The nonprofit, with a $180,000 annual budget, negotiates discounted rates with drug companies.

Volunteers gathered at the Rummler network's Minnetonka headquarters one morning in August to put together naloxone kits.

"I felt I could do something useful with my grief. I wanted to be able to support other people," said Star Selleck of Edina, whose 19-year-old son Ian overdosed and died in front of her on the kitchen floor eight years ago. The officer who responded to her call had a defibrillator but not naloxone.

"I am proud of the fact Minnesota has a nonprofit that is leading the way for other states to follow. I know hundreds of lives have been saved," she said.