The newspapers found that Minnesota ranks low when compared with the rest of the country when it comes to opioid prescriptions, but the impact of the drugs is devastating.
Prescription painkillers like oxycodone and hydrocodone are being prescribed in Minnesota in greater numbers than ever before, with legal distribution of all opioids increasing by 72 percent statewide from 2005 to 2011, according to a joint investigation by the St. Paul Pioneer Press and the Duluth News Tribune.
The largest increases were in Ramsey County and the northwestern corner of the state, the newspapers found. Last year, Duluth had the highest rate of opiate painkiller distribution in the state at more than 5,000 grams per 10,000 people. The southwestern corner of the state had the lowest rate at 1,600 grams per 10,000 people.
"Supply is a key ingredient in any drug epidemic," said Carol Falkowski, Minnesota's former drug-abuse strategy officer and a national expert on the issue. "You have to have an adequate supply in order to propel it into epidemic proportions."
This ease of access and a perception that prescription drugs are legal and "clean" make them attractive to teens and young adults, which experts say can lead to problems. Last year, 24 out of every 10,000 Minnesotans between ages 18 and 24 sought opiate addiction treatment. That's up 179 percent from four years earlier.
The newspapers found that Minnesota ranks low when compared with the rest of the country when it comes to opioid prescriptions, but the impact of the drugs is devastating: The increase of painkiller use brings an increase in rates of addiction, crime, arrests and overdose deaths. Addicts have also been switching to heroin.
"The misconception is that 'it'll never happen in their family,'" said Rich Clark, commander of the Ramsey County Violent Crime Enforcement Team. "I think the public doesn't understand it's a lot more prevalent than you think it is, and it's happening to good people, good, solid families. Kids raised well. Loving parents. (But) in the blink of an eye, they're a heroin addict."
Opioids include opiates, from the opium poppy, and synthetic drugs that work like opiates. These drugs include painkillers such as morphine, codeine, oxycodone and hydrocodone, and stimulants, such as Ritalin and Adderall to treat attention deficit hyperactivity disorder and narcolepsy.
Falkowski said opiate abuse is a problem on some of Minnesota's American Indian reservations. In the past two years, three reservations — Red Lake, White Earth and Leech Lake — have declared public health emergencies. The Leech Lake Band reported that about 80 percent of substance-abuse problems on its reservation stemmed from opiate addiction.
Dr. David Schultz, founder and medical director of Minneapolis-based MAPS Medical Pain Clinics, said drug companies push new products and it's "easy" for doctors to write prescriptions.
"Patients are happy when they get a prescription, and doctors' satisfaction ratings go up. ... If they say no to a patient, then they'll give them a bad rating," Schultz said. "There's a lot of perverse incentives to write a prescription, and that's an unfortunate situation."
Dr. Faris Keeling of Duluth, who specializes in chronic pain for Essentia Health, said when he was in medical school in the 1970s it was considered negligent to give opioid painkillers to any patient who wasn't near death. But over the next decade, a better understanding of addiction developed and doctors began prescribing opioids for cancer patients, finding most could use them without getting addicted.
"As time went on, we asked: Why are we withholding this from people who have chronic pain due to other things? What about people who have severe medical conditions causing chronic pain?" he said. "We started using it some for them."
There have been some sobering results.
The number of Minnesotans who died from prescription opiates was 191 in 2010, compared with 42 a decade earlier, according to the Centers for Disease Control. And the Department of Human Services says the number of Minnesotans seeking treatment for opiate addiction has more than doubled since 2007.
In addition, police say crimes such as burglaries and robberies — either to get drugs or to get items to sell to pay for drugs — are on the rise.
Last week, Cloquet Police Detective Darren Berg flipped through a stack of several dozen burglaries his small department has investigated in the past year. "When we get a burglary, nine times out of 10, people's prescriptions are taken," he said. "Often we're seeing people steal money, jewelry and turn around and buy narcotic drugs."