Executive Order 22-07

Establishing the Opioids, Substance Use, and Addiction Subcabinet and the
Governor’s Advisory Council on Opioids, Substance Use, and Addiction

I, Tim Walz, Governor of the State of Minnesota, by the authority vested in me by the
Constitution and applicable statutes, issue the following Executive Order:

Opioid overdose deaths, along other substance-related deaths, have increased significantly in
Minnesota and across the country over the past two decades—and they continue to increase year
after year. Although Minnesota has one of the lowest drug overdose mortality rates in the
country, we have seen that rate trend upward. Since 2000, nearly 5,400 Minnesotans have lost
their lives due to opioids. The Minnesota Department of Health reported 54 overdose deaths in
2000, and 678 in 2020. Increases in Minnesota’s overdose mortality rates have been especially
dramatic among people of color and Native Americans, leading to some of the worst racial
disparities in drug overdose mortality in the nation. In Minnesota, Native Americans are seven
times more likely, and African Americans are twice as likely, to die from opioid-related
overdoses than white people.

There are many reasons for the tragic rise in opioid-related deaths. To start, opioids can be easy
to obtain. Most common prescription opioid painkillers are Schedule II drugs. This means that
any physician may prescribe an opioid painkiller in the course of pain treatment. Opioids are also
highly addictive. They activate the brain’s reward systems that trigger the release of dopamine,
leading to feelings of intense pleasure. The early stages of opioid abuse are primarily driven by
this stimulation of the brain’s reward systems.

Fentanyl—a synthetic opioid—has also fueled the opioid crisis. Fentanyl is 50 times stronger
than heroin and 100 times stronger than morphine. Since fentanyl is so potent, even a very small
amount can be lethal. It is widely available and often mixed intentionally or unintentionally with
other drugs. People who use drugs are often unaware that they are taking fentanyl, leading to
deadly results. Synthetic opioids were responsible for more than 80 percent of the opioid-related
overdose deaths in 2020.

In addition to increased overdoses from opioids and other drugs, we have also witnessed an
increase in alcohol sales and excessive consumption. This increase is concerning, because
alcohol is the third-leading preventable cause of death in the United States. Alcohol is the

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leading substance driving admission to substance use disorder treatment for adults in Minnesota.
In 2020, 992 Minnesotans' deaths were solely attributable to alcohol. Even more Minnesotans
died from alcohol in combination with other factors.

Despite the deadly consequences of substance use, only one in ten people with a substance use
disorder receives treatment. To prevent more tragic deaths, we must do more to combat
substance use and educate and provide treatment to all those who need it.

In 2019, I signed the Opiate Epidemic Response bill into law. Through that bill, Minnesota now
raises funds from prescribers, drug manufacturers, and distributors to fight the opioid crisis. The
bill also established the Opioid Epidemic Response Advisory Council (“OERAC”) to oversee the
funding. OERAC is responsible for developing and implementing a comprehensive and effective
statewide effort to address the opioid addiction and overdose epidemic in Minnesota.

Minnesota Attorney General Keith Ellison leads key aspects of Minnesota’s response to the
opioid epidemic, including ensuring Minnesota’s participation in national lawsuits against opioid
distributors and manufacturers. In the coming years, Minnesota will receive almost $300 million
from settlements in several of those suits. Attorney General Ellison led efforts to reach an
agreement between cities, counties, and the State on the allocation and distribution of these
funds, which includes distribution of 75 percent of the proceeds to local governments (including
all counties and 33 cities). The State’s portion of these settlement funds will be overseen and
distributed by OERAC. These funds will support programs and strategies to help communities
and Tribal Nations address the opioid epidemic, including grants for traditional healing programs
and grants to communities for overdose prevention. This important work will help Minnesota
address the opioid crisis and will save lives.

As the grim reports of overdose deaths plainly show, more work remains to be done to address
opioids, substance use, and addiction issues. Coordination and leadership among state agencies,
with input from the public, is vital to ensuring that resources are aligned to meet these challenges
most effectively. A subcabinet can assist with coordination and strategy development across our
enterprise, and an advisory council can provide much-needed external input from affected
communities. An Addiction and Recovery Director in the Office of the Governor and Lieutenant
Governor will help lead and facilitate this critical interagency and public engagement.

For these reasons, I order as follows:

1. To more effectively coordinate and marshal state resources, the Opioids, Substance
Use, and Addiction Subcabinet (“Subcabinet”) is established.

2. The purpose of the Subcabinet is to:

a. Identify challenges that exist within state government that create silos around
addiction, treatment, and recovery and that limit access to treatment options or
addiction-related services.

b. Identify opportunities that exist within state government that support access to
treatment options or addiction-related services.

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 c. Identify barriers and gaps in service for Native Americans, African
Americans, other communities of color, and other communities—including
but not limited to the LGBTQ+ community—seeking treatment from opioid
or substance use addiction and propose solutions.

d. Identify how the State can address addiction as a chronic disease, emphasizing
that there are multiple ways to enter sobriety.

e. Identify policies and strategies that address prevention efforts, including

addressing underlying causes and public awareness and education around the
dangers of issues including, but not limited to, opioid abuse, use of fentanyl
and other synthetic opioids, other substance use, excessive alcohol
consumption, and addiction.

3. The members of the Subcabinet are the Commissioner, Executive Director, or Chair
of the following agencies and council:

a. Department of Human Services

b. Department of Health

c. Department of Education

d. Department of Public Safety

e. Department of Corrections

f. Minnesota Management and Budget

g. Office of Higher Education

h. Interagency Council on Homelessness

4. The Governor’s Addiction and Recovery Director will serve as Chair of the
Subcabinet.

5. The duties of the Subcabinet are as follows:

a. Opioids, Substance Use, and Addiction Policy and Strategy Development.

i. Identify challenges and opportunities that exist with accessing

treatment and support services and develop recommendations to
overcome these barriers.

ii. With input from affected communities, develop policies and strategies
that will reduce barriers and gaps in service for Native Americans,
African Americans, other communities of color, and other
communities—including but not limited to the LGBTQ+
community—seeking treatment for opioid or substance use addiction.

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 iii. Develop policies and strategies that the State may adopt to expand
Minnesota’s recovery infrastructure, including detox facilities,
treatment facilities, and sober housing.

iv. Develop policies and strategies to expand services and support for
people in Minnesota suffering from opioid or substance use addiction
through partnerships with the Office of the Attorney General and
OERAC.

v. Develop policies and strategies for agencies to manage addiction and

the relationship it has with co-occurring conditions.

vi. Identify policies and strategies that the State could adopt to address
opioid or substance use addiction among Minnesotans experiencing
homelessness.

vii. Submit legislative recommendations addressing opioids, substance

use, and addiction in Minnesota by December 31, 2022. The
legislative recommendations must also include the establishment of a
permanent Opioid, Substance Use, and Addiction Council, as well as
statutory language and goals for that Council.

b. Public Engagement. Successful policy and strategy development requires

that those affected by addiction, including members of Native American
communities, communities of color, and other Minnesota communities, have a
voice and the opportunity to participate in the process. The Subcabinet will
develop and implement a public engagement framework to ensure meaningful
public engagement is conducted by the Subcabinet’s agencies and boards. The
purpose of the engagement framework is to:

i. Engage with, and seek feedback from, the eleven Tribal Nations within
Minnesota.

ii. Build partnerships and shared understanding across urban Indian

communities, communities of color, local communities, and industries,
including but not limited to the health and business sectors.

iii. Provide a platform for dialogue about the needs and challenges of
those in active addiction or in recovery, and to identify solutions and
how those solutions will impact the lives of people in Minnesota,
including those who have been underrepresented in policy discussions
or are disproportionately impacted by addiction, including opioid
addiction.

iv. Gather and share ideas for how Minnesotans can get involved with,
and stay informed about, addiction issues that matter to them.

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 6. The Governor’s Advisory Council on Opioids, Substance Use, and Addiction
(“Advisory Council”) is established to advise the Subcabinet in its duties.

7. The Advisory Council will be comprised of up to 15 members appointed by the

Governor. The Governor will seek representation from community leaders,
individuals with direct experience with addiction, individuals providing treatment
services, and other relevant stakeholders.

8. The duties of the Advisory Council are as follows:

a. Meet up to four times per year to identify opportunities for, and barriers to, the
development and effective implementation of policies and strategies to expand
access to services for people in Minnesota suffering from addiction.

b. Promote equity by examining what services and supports are needed in

communities that are disproportionally impacted by the opioid epidemic,
including but not limited to Native American communities, African American
communities, and other communities of color.

c. Provide opportunities for Minnesotans who have directly experienced

addiction to address needs, challenges, and solutions.

9. The Department of Human Services, in coordination with other state agencies and
boards, will provide staffing and administrative support to the Subcabinet and the
Advisory Council.

This Executive Order is effective fifteen days after publication in the State Register and filing
with the Secretary of State. It will remain in effect until rescinded by proper authority or until it
expires in accordance with Minnesota Statutes 2021, section 4.035, subdivision 3.

A determination that any provision of this Executive Order is invalid will not affect the
enforceability of any other provision of this Executive Order. Rather, the invalid provision will
be modified to the extent necessary so that it is enforceable.

Signed on April 7, 2022.

_____________________________________
Tim Walz
Governor

Filed According to Law:

Filed on April 7, 2022
Office of the Minnesota
Secretary of State,
_____________________________________ Steve Simon
Steve Simon
Secretary of State