Minnesota's Opioid Deaths Fell Again. The Stimulant Deaths Don't Have an Antidote Waiting.

Dylan Ferguson runs Minnesota’s Office of Emergency Medical Services, and the people who work for him sit closest to where these numbers start: the back of an ambulance. Per the Medical Daily report on the state’s new data, Ferguson says EMS crews are often the first to notice when conditions in a community change. This year they noticed something the opioid scoreboard hides.

Minnesota can say “fewer opioid deaths” and “more overdose deaths” in the same breath, and both are true.

The Minnesota Department of Health’s Oct. 27 release puts 2025 at 1,025 overdose deaths, up 3% from 994 in 2024. Opioid-involved deaths slipped from 678 to 671, the third straight annual decline, and fentanyl-involved deaths fell 6%. Meanwhile the department’s preliminary 2025 data report shows deaths involving psychostimulants, mostly methamphetamine, up 11%, and cocaine deaths up 6%. Hospital-treated stimulant overdoses rose 11%, with methamphetamine cases up 17%. All of it is preliminary and can shift as death investigations close.

The part to sit with is the overlap. Opioid-and-stimulant deaths reached 371 in 2025, up from 154 in 2019, and made up 61% of multi-substance deaths. If you have ever mixed an upper with something to take the edge off, or been handed a bag with more in it than the person selling it knew, you already know the supply doesn’t respect the categories we use to count it.

Here is the gap. Naloxone reverses opioids and only opioids. The state’s own guidance says to keep it anyway, and to call 911, because you often can’t tell what someone took. But for a stimulant overdose with no opioid in it, there is no reversal drug and no approved medication for stimulant use disorder. What the CDC calls the most effective treatment is contingency management: small, real rewards for hitting recovery goals, like a negative drug test. It works, and it is underused.

For providers, this week: ask your intake team whether stimulant screening and a contingency-management referral path exist, and who owns them. Check whether patients on stimulants get screened for heart problems. Minnesota also launched MN-OD-ALERTS on Oct. 1, an ambulance-data system that flags overdose clusters, and 76 of 87 counties have signed up a contact. If your county isn’t one of them, that’s a phone call.

If you use, naloxone is still yours: carry it, and tell the people around you where it is. The state’s FastTrackerMN shows which treatment programs have openings today, and 988 or 211 answers at any hour.

Opioid deaths falling is real, hard-won, and not the finish line. People are still dying of the thing nobody built a rescue for.