My name is Allie Carey. I’m the Director of Programs here, which is a big title for a somewhat loosely defined role. We’re a small nonprofit so we all wear a lot of hats, but generally speaking I work as the program organizer. I set up a lot of our internal management systems and work to coordinate all of our program activity, a lot of which is grant-funded. So by proxy, I’m also our grant manager and grant applicant/grant writer most times. I’m also involved organizationally with other things like research and content generation. I work collaboratively with Alicia Haugh, formerly our Communications Coordinator and now our Education Director. In a pinch, I host Naloxone trainings and I work with volunteers on kit assembly. I do a lot of the more top level supervision of the technical aspects of our partner relationships, expecting people to respond to inventory requests and things like that. I really enjoy my role and it’s great to be part of so many different things daily.

Our organization has been around for over a decade now. We were founded in 2011 after the untimely passing of Steven Rummler. His parents, fiancee at the time, and some of his close friends and family started a memorial foundation in his memory that hit the ground running in terms of advocating for naloxone access and Good Samaritan protections for opioid overdose situations in our state. That ended up coming to fruition as the Good Samaritan and Steve’s Law Provision, which still currently holds in the state of Minnesota. It expanded opportunities for Naloxone access, codified the expectation that certain professional groups were expected to become trained in Naloxone and administer it within the capacity of their role. First responders were a big one there, and establishing the Good Samaritan and criminal liability protections surrounding the opioid overdose crisis specifically. These provide protections for people who have low level charges that would oftentimes face discrimination that discouraged them from seeking out emergency assistance. Good Samaritan laws prevent people from facing civil liability for anything that might occur as a result of providing assistance in an emergency situation. CPR is a big one that is regularly protected. For example, if someone were to choke and in good faith you offer them CPR, and you were to crack a rib or cause any unintended damage, even if you aren’t able to revive them you won’t face civil liability charges down the line because this was a protected intervention. The same thing goes for Naloxone administration, anybody who’s going to be administering Naloxone in a personal or community level capacity won’t face any civil liability issues regarding acts or omissions around the intervention when it took place. In 2014, that was huge at the time. Immediately after that, we established our Overdose Prevention Program, which has since been providing education and distributing naloxone around the state of Minnesota. It has grown continuously year after year and this year the growth is almost overwhelming- between 30% and 60% across all metrics in terms of the activities that we’ve been doing statewide. This is supported by a pretty robust Community Trainer network that we have now. When the program first started, we had a single staff person hosting every training on our behalf. We now have many more who have joined us either personally and professionally and are trained to utilize our materials in the community. About a third of our trainings this year have been hosted by our community trainers which helps to amplify our impact. As a five person staff, there are only so many places we can be at any given point in time. Minnesota is a big state, and during COVID it was especially challenging for us to have a physical presence everywhere we were needed. Seeing things really take off and blossom over the past few years has been incredible.

On Overdose Awareness day we launched our fentanyl awareness campaign called “If You’re Going to Use, Know.” It is specifically targeted at building a level of awareness and education around the risks of fentanyl contamination. There are a lot of stories, messages, and narratives that have been swirling around about fentanyl over the past few years, some of them can tend to be pretty alarmist or have certain messaging strategies that immediately turn people off. While there are a lot of awareness campaigns around the issue of fentanyl contamination/exposure risk, and rightfully so, oftentimes the morbid tactics turn audiences away. The federal DEA “One Pill Can Kill” campaign I do think is impactful, but won’t resonate with everyone. As a local group that serves a variety of different people, we have a unique opportunity to reach a different audience than some of these larger campaigns may be reaching. 

We prioritize awareness focused on safer use and availability of resources for harm reduction, making sure that people are informed and have autonomy if they are choosing to use substances. While some people do opt into using fentanyl, many people we’ve seen do not. Unfortunately, it is a very real risk of the current drug landscape that almost everything has been contaminated at some point along the supply chain. Most people would prefer to know what they’re using because they have a preference for the desired outcomes. They have a substance of choice, something they feel comfortable with, very few people would use just any substance you put in front of them. 

Offering people the resources and tools to know what they’re using unilaterally causes a culture of caution and helps bring people into that mindset. If you offer people safety tools that are based on a very core need, you bring them into a conversation that encourages them to stay safe in other ways. In terms of different ways to approach this issue, I think that preparing, priming, and offering resources for people to take their drug cautiously and seriously can only be a good thing. Our fentanyl test strips, which allow people to test their substances for the presence of fentanyl, have a survey attached to them. Across the board we’ve seen time and time again that 95% of survey responses from people whose substances tested positive for fentanyl indicate major behavioral changes as a result. That might include making sure they weren’t using alone, doing test doses, and making sure they had Naloxone available. We’ve had several people who have reached out to our office to confirm a positive test result. That is a very real and immediate way in which these resources are keeping people safe by empowering them to be more aware of the immediate risks of the substances at their disposal. This past year we did a series called “HOPE Forums” where we went around Minnesota into spaces that we’ve never seen before in person, or hadn’t been in a long time, to connect with existing partners and host educational conferences and resources fairs. It was an incredible experience, and I know in the coming years we want to invest even further in the growth of our education programs.

The primary physical resources that we offer are naloxone and fentanyl test strip kits. We primarily provide injectable Naloxone kits, the nasal formal is still too expensive for us to distribute at scale as a nonprofit. So far this year we’ve distributed close to 37,000 Naloxone kits. To transition to fully nasal would cost multiple millions of dollars which we just don’t have, but is something we are always working on and hopeful for. 

As far as educational resources, the big ones this year have been our presentations on harm reduction and fentanyl, which bridges those two conversations, and stigma. Regarding stigma and substance use disorder, I think this continues to be such an important topic. Especially as we have more conversations about substance misuse, substance use disorder, and addiction in personal and professional spaces we’re being mindful of how stigma gets perpetuated and the small things we can do to dismantle it. 

We also have more static resources available on our website. We have an entire area dedicated to talking about substance use disorder with more narrative explanations- What does it look like as a medical condition? How is it diagnosed? What types of treatments can be effective for someone with substance use disorder? Steve suffered from both chronic pain and substance use, these were very interconnected in his experience. Because of this, we also have an area dedicated to understanding chronic pain. For individuals seeking alternative modes of treatment or therapeutic care, there are documents meant to help facilitate conversation with providers and pain diary templates that can be very helpful for people who have a dual diagnosis or may be struggling with both of these issues.

One of our big initiatives through our Overdose Prevention Program is Naloxone Access Points. These are sites across the state of Minnesota where our network partners have committed to maintaining our resources on-site and being publicly identified as a pickup spot for those resources. 10 years ago, I think a lot of these groups would not have felt comfortable doing so because it was a very different climate. I think that there was a lot of stigma and anger, especially in smaller communities, towards places that were trying to engage in this work. Currently, we are at ~145 sites across Minnesota, some of which are in very small or sparsely populated areas of the state. It’s been incredible to have them partner with us, and for them to proudly and publicly make sure that these resources are consistently and readily available in their area.