A record number of Hennepin County residents fatally overdosed from opioids or methamphetamines last year, with an alarming spike in deaths from fentanyl, a powerful synthetic painkiller that can be lethal even in tiny doses.

Hennepin County recorded 285 opioid-related deaths for the year, with nearly all involving at least trace amounts of fentanyl. That is up from 170 opioid deaths the year before. Methamphetamine overdoses reached a record 116 in the county last year.

"I do think 2020 was a blockbuster year in a really sad way," said Julie Bauch, Hennepin County opioid response coordinator. Bauch said the COVID-19 pandemic played a significant role in the rising number of deaths. "People are in crisis and they are being challenged."

The rising number of deaths in Hennepin County mirrors a broader trend statewide.

Opioid-related overdose deaths spiked statewide in 2020, killing 739 people, according to a Star Tribune analysis of death certificate data. The Minnesota Health Department has not released its 2020 numbers but reported 428 fatalities in that group the year before.

Health officials and street outreach workers across Minnesota said that the pandemic pushed residents struggling with addiction deeper into isolation. At the same time, county and law enforcement resources were redirected to tackle the spreading virus and away from programs to drive down opioid fatalities.

Jessie Saavedra witnesses the effects of drugs and the pandemic every day. Beyond the nearly 100 opioid deaths in Ramsey County last year, his work at a needle exchange and testing clinic in St. Paul brings him face-to-face with the problem.

When the pandemic hit last March, he visited the homeless encampments and met residents who had no idea that COVID-19 was a problem, he said. Over the months, he found more people buying drugs and shooting up alone.

He offers anybody he assists fentanyl testing strips to detect tainted drugs and Narcan, a nasal treatment used to help a suspected overdose victim.

"Eventually everybody started asking for Narcan, which has definitely prevented many more deaths," said Saavedra, who is a recovering drug addict.

Methamphetamine use surged during the pandemic because the drug is more accessible and cheaper to buy, said Dr. Tyler Winkelman, a physician who treats inmates with substance abuse issues at the Hennepin County jail. The drug was made in homemade labs in the early 2000s, but now production has shifted to an almost industrial scale outside the United States, he said.

With opioid and methamphetamine abuse worsening in Hennepin County, COVID-19 has scared people away from seeking treatment, he said. It is now crucial to aggressively push new strategies to curtail abuse disorders before they happen, he said.

"The drug issue has certainly fallen out of the public consciousness because of COVID," Winkelman said.

The virus forced social service and law enforcement agencies to shift some drug prevention efforts and handle COVID duties, said Bauch.

The Duluth Police Department postponed some criminal drug investigations and shifted those officers to patrol duty because they didn't know what would be needed to protect the public during the pandemic, said Lt. Jeff Kazel, who oversees the Lake Superior Drug and Violent Crimes Taskforce.

In St. Louis County, law enforcement saved 213 lives by using Narcan last year, and another 51 have already been rescued by the treatment so far this year, Kazel said.

Nicole Monette supervises a community health program in north Minneapolis that hands out an average of 1,000 doses of Narcan a month. The clinic now gives out double doses of Narcan to clients because of the abundance of fentanyl on the streets, she said. The clinic was also one of the first virus testing and vaccine locations in the county.

"We never stopped providing drug-related services during the pandemic," said Monette.

The Red Door syringe exchange and naloxone program in downtown Minneapolis served 20% more clients in 2020. The current overdose epidemic is "unlike anything we've ever seen," said Bobbi Gass, who coordinates the distribution of Narcan.

The pandemic created a "double whammy" for many people who may have been suffering with addiction and lost housing or a job, she said. Often a problem with drugs results from a traumatic life experience and the pandemic has retriggered those traumas, she said.

"It was probably a big step for that person to come to the clinic, and I might be the only person they talk to that day or week," said Gass.

As the pandemic eases its grip, Bauch and her community partners will carry on services and offer the resources that were available before coronavirus prevention became the new priority. Those range from outreach and education to clinics at homeless shelters and the jail.

She also wants to start up the longer term goals shelved by COVID. Some of those include working with families or pregnant mothers with substance abuse disorders. Another initiative would be conducting new research on resident drug use, especially people of color, who disproportionately suffer from addiction, she said.

"If it feels worse right now, it is," Bauch said. "If you need help, we are still here for you."

Data Editor MaryJo Webster contributed to this report.

David Chanen • 612-673-4465