Opioid Response Initiative

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine and many others. These drugs impact parts of the brain that regulate pain and emotions and can pose significant health risks if they are misused.

The misuse and addiction to opioids became a national public health crisis in the late 1990s, when the number of opioid-involved deaths in the United States skyrocketed. Since then, there have been three distinct increases in opioid overdose deaths that were each linked to different types of opioids. Learn more about the opioid crisis by using one of the following resources:

• The Opioid Crisis: A Timeline –  Johns Hopkins University
• The Opioid Crisis in the United States: A Brief History  –  The Library of Congress

Data about the opioid epidemic in Minnesota

• Opioid crisis in Ramsey County dashboard - Ramsey County
• Drug overdose dashboard - Minnesota Department of Health

The opioid settlements

In 2021, the state of Minnesota was part of a $26 billion multi-state winning lawsuit against multiple opioid pharmaceutical companies and an opioid manufacturer. In 2022, Minnesota joined five additional multistate settlements worth $20.4 billion with two more manufacturers and three pharmacy chains. Three years later, Minnesota joined several more settlements. Settlement money is divided between the state, counties and some cities, and payments are sent on a yearly basis until 2038.

The Minnesota Memorandum of Agreement (MOA) governs how opioid settlement funds are distributed, how they can be used and who should lead the work being funded. The MOA also offers strategies for responding to the crisis including prevention, treatment and harm reduction. All opioid settlement funding must be used in accordance with the MN MOA, Appendix A, and include effective, evidence-based interventions. Find more information about the opioid settlements in Minnesota:

• Fighting the Opioid Epidemic in Minnesota  – Minnesota Attorney General
• Local public health guide to spending opioid settlement funds – MDH
• State-level guides about opioid settlement funds for community advocates.

In 2026, the county embarked on a realignment and reorganization of priorities after a change in program staff and leadership. Working across county departments and with partners, the county has been reassessing the best uses of these one-time settlement funds. Together, we take on the responsibility responding to the ongoing opioid crisis. 

During this transition, opioid settlement funding has been used to develop and implement the following projects.

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Contact us

Rae Eden Frank
Saint Paul — Ramsey County Public Health Deputy Director
[email protected]