The Minneapolis Health Department and M Health Fairview recently announced the successful outcomes of its First Step pilot program. The program offers rapid, free, same-day access to medication for opioid use disorder in the emergency department. This initiative provides critical support when and where it’s needed the most.
The communities served by M Health Fairview University of Minnesota Medical Center – West Bank are disproportionately impacted by the opioid crisis, with some of the highest overdose death rates in Minnesota. These communities also experience some of the worst racial disparities in overdose deaths nationwide, underscoring the urgent need for accessible and effective treatment.
“As frontline care providers, we see the devastating impact of addiction long before it is reflected in official statistics,” said Dr. Dziwe Ntaba, an emergency department provider at M Health Fairview. “Effective treatment is essential to overcoming this crisis. Ninety-four percent of patients with substance use disorder don't receive any treatment, yet many frequently visit the ER. The emergency department presents a unique opportunity to fill that gap.”
In partnership with the Minneapolis Health Department’s Opioid Response Team, the First Step program ensures patients with opioid use disorder receive immediate treatment upon arrival at the emergency department, breaking down barriers that often hinder recovery. The hospital is the only ER in Minnesota among 300 nationwide participating in the initiative.
The “medication first” treatment model, grounded in decades of research, leverages existing care systems and evidence-based treatments. It fosters collaboration between medical and psychosocial providers to retain patients in treatment and reduce opioid-related mortality.
“The First Step program allows us to adapt national best practices to our local context,” said Suzanne Young, Minneapolis Health Department senior project manager. “This includes rapidly stabilizing patients with the correct dose of buprenorphine, setting them on a path to long-term recovery.”
Positive outcomes
Since launching in June 2023, the First Step program has shown promising results:
- Over 500 patients connected with ongoing treatment and peer
- 75% of patients received buprenorphine or instructions for self-
- Over two-thirds of First Step encounters included consultation with a Substance Use Navigator, who assists with prescription access and referrals.
The Minneapolis Health Department provided $389,000 to fund the pilot.
“We are committed to helping those suffering from substance misuse,” said Deputy Commissioner Heidi Ritchie, Minneapolis Health Department. “With medications like Suboxone, we can help people move into recovery, but urgency is key.”
Key features of First Step
- Rapid stabilization: Patients receive Suboxone in the ER, offering immediate relief from withdrawal symptoms.
- Navigator support: Trained staff provide 1:1 support, education, and referrals for ongoing treatment. The ED is also partnering with the Recovery Clinic, M Health Fairview’s walk-in opioid use disorder clinic, to improve follow-up care further, offering medication management, peer support, therapy, and assistance in connecting patients to group-based
- InstyMed dispenser: A robotic dispenser in the hospital lobby provides up to a 30-day supply of Suboxone, enabling patients to start treatment upon discharge.
- Training and capacity building: All UMMC’s ER physicians receive ongoing training in harm reduction strategies, and how to tailor Suboxone doses to the potency of substances like
- Community outreach: Through regular outreach in neighborhoods like Cedar Riverside and at metro transit pop-ups, M Health Fairview’s Community Advancement team conducts regular outreach, informing residents about free addiction treatment available at the West Bank ER.