Why Twin Cities Restaurants and Bars Are Carrying Narcan and Fentanyl Test Strips

Sarah Webster Norton’s hands are steady as she inverts the small glass vial and punctures its rubber seal with a needle. She draws the liquid — a clear, water-based solution of naloxone hydrochloride — into the syringe, angling the vial to take in every possible drop. From there, the process is fairly fast and intuitive: To treat a person experiencing an opioid overdose, she has to inject the needle into a muscular part of their body, like the shoulder or thigh, and push down on the plunger to empty the syringe. Then the naloxone goes to work: By attaching to opioid receptors in the body, it has the power to rapidly reverse an overdose and restore breathing. Sometimes, the first dose isn’t sufficient, so multiple doses are needed. Naloxone, once administered, remains effective for 30 to 90 minutes, so it’s not a permanent solution — rather a “Band-Aid solution” until paramedics arrive, Webster Norton says. But it can buy crucial, often life-saving time.

Webster Norton is a longtime Twin Cities server, bartender, and manager, and the executive director of the nonprofit Serving Those Serving. Much of her work has centered on mental health care access for restaurant and bar workers, but these days, she’s tackling another issue impacting the industry: As fentanyl continues to drive the American opioid crisis, workers face a heightened chance of having to respond to overdose incidents on the job. “We’re first responders whether we want to be or not,” Webster Norton says. She’s made it her mission to get naloxone, or Narcan, the brand-name nasal spray version of the medicine, stocked behind the bar at as many restaurants and bars as she can, as well as fentanyl test strips. Part of her goal is to prepare staff for emergencies; part is to get these resources into the community’s hands. At Northeast’s Spring Street Tavern, for example, where Webster Norton works every Sunday, she sets out Narcan canisters and fentanyl test strips on the bar for customers to take.

“I’m distributing constantly,” Webster Norton says. “I stop at bus stops and leave it. I like to call myself the Narcan fairy, because I just literally run around town with a bunch of shit in my car, and I pass it out to anybody who will take it.”

Webster Norton also offers opioid overdose training for restaurants and bars. Some staff are wary of the naloxone needles, which Webster Norton understands — they creeped her out at first, too, she says. “We just signed up to bring people food and beer. It’s a stretch for some people, and I get it.” Nasal Narcan is less intimidating; it’s simply sprayed into the nostrils, much like Flonase. But it’s more expensive than generic naloxone, which means that much of what’s available through local distributing organizations like the Steve Rummler HOPE Network and Southside Harm Reduction are intramuscular kits. (Recently, however, Webster Norton received a $5,000 Narcan grant from the State of Minnesota, so now most of the restaurants she works with have both versions.) As part of the training, Webster Norton also dispels prevalent myths about naloxone, like the common fear of injecting an air bubble into somebody’s bloodstream (emergency naloxone is typically administered into muscle, not a vein); or the false notion that it will harm someone who’s not actually overdosing (it won’t). Restaurant owners are often concerned about liability, Webster Norton says, but Minnesota’s Good Samaritan Overdose Prevention law empowers lay people to carry naloxone and legally protects those who administer it in good faith.

Asking restaurant and bar workers to prepare for potential overdoses may seem like a tall order. But for Meteor bartender Tyler Kleinow, it comes with the territory. Kleinow sees harm reduction as a key part of hospitality; for as long as bartenders have existed, he says, they’ve been responsible for staying aware of what’s happening at their bar, whether that means helping a customer to sober up with a bag of chips and water, keeping an eye on the couple arguing in the corner booth, or knowing what to do when somebody orders an “angel shot,” a coded drink that customers can use to discreetly tell a bartender they feel unsafe. “It’s healthy to remind yourself that you’re not performing brain surgery, but at the same time, you are responsible for other people’s lives to an extent,” he says. “Like, don’t be pretentious, don’t be an asshole. But also, you do have a job.”

Meteor’s staff started stocking naloxone kits behind the bar about two years ago, Kleinow says, as soon as they learned it was an option. They’re there in case of emergency, but are also available for customers to take, as are fentanyl test strips. (As Meteor put it in an Instagram PSA: “We don’t want you to do any nose stuff here, but you sneaky little shits are going to anyways so please be safe.”)

Nick Jeffrey has been a bartender at Spring Street Tavern for almost two decades. He’s observed a few ways that the opioid crisis has changed in the past several years, making it even more challenging for restaurant and bar workers to respond to. First is the rise of fentanyl, which has come to dominate the illicit American drug market in the past decade. Ultrapotent (a gram is about 50 times more powerful than heroin) and cheap to make, fentanyl has driven a staggering spike in overdose deaths, surpassing all-time peaks in American car deaths and gun deaths, though recent data shows a decline in overdose deaths in 2024. IThough it’s sold on its own, but fentanyl is also often mixed into other drugs like cocaine and heroin, or stamped into counterfeit Xanax, Percocet, Adderall, and other prescription pills. That contamination factor makes recreational use all the more unpredictable and dangerous. It used to be, Jeffrey says, that if somebody offered you a pill, the worst case was probably that you could get ripped off — now it’s that you could be poisoned with fentanyl.

Jeffrey also noticed that the crisis seemed to worsen during the pandemic — indeed it did, while also intersecting with nationwide mental health and housing crises. Those compounding factors have added complex layers to situations that staff have to respond to: In the past two or three years, Jeffrey says, Spring Street Tavern has had more incidents where a given customer was clearly in need of some kind of support, but he wasn’t able to ascertain what was happening — whether the issue was drugs or something else. “I’ve been doing this for 20-plus years; I understand the stages of drinking,” he says. But most bartenders haven’t been trained to recognize the stages of drug use and overdose, or to respond to mental health crises. “We might deal with some kooky people on a daily basis in the bar industry, but we’re sure not mental health professionals, as much as we sometimes play that role.”

Acting as de facto first responders can be scary for staff, he says. “None of us want somebody to die on our watch. Just the fact that it’s something that we may have to deal with — I think it terrifies a lot of people.” Spring Street staff haven’t yet had to administer naloxone to anyone at the bar, he says, but he assumes that it’s a matter of when, not if.

As the Minnesota state government takes its own approach to addressing the crisis, allocating more than $300 million in opioid settlement dollars over the next 18 years, bars and restaurants are emerging as part of the layered grassroots network working toward local harm reduction and overdose prevention. Damla Erten is the vice president of Sencha Tea Bar in Uptown, where she says she’s watched the opioid crisis escalate in real time over the past few years. Earlier this year, at the suggestion of an employee, she started stocking naloxone behind the counter and had her staff trained on how to administer it — just two weeks later, she says, a person overdosed on the steps behind the tea bar. One of Erten’s employees administered two successive doses of naloxone, she says, possibly saving that person’s life: Based on Sencha’s camera footage, Erten says, it took 12 minutes for paramedics to arrive. Erten now does outreach to neighboring businesses through her organization Uptown Community Coalition, encouraging them to carry naloxone. But it’s not always easy to get them on board.

Opioid use remains heavily stigmatized, and Erten says that some business owners are reticent because they feel they’d be encouraging people to use drugs in their business. She leads with a “human” approach — that stocking naloxone can save lives — but if she hits a wall, she’ll make a pragmatic argument, offering her own experience as a business owner whose own staff have already had to respond to an overdose. “To me, it’s just preparedness from a strictly business perspective,” she says

Webster Norton has also encountered pushback from certain restaurant owners and managers in her outreach work. Some, she says, seem to be in denial about the severity of the crisis; others express prejudice toward people who use drugs. Fentanyl test strips, in particular, prove to be a bridge too far for some because, of course, they precede drug use. But Webster Norton adheres to the first tenant of harm reduction: that drug use is a reality in our communities, whether we want it to be or not, and it’s better to reduce its harmful effects than to pretend like they don’t exist. “​​I don’t blame anybody or judge anybody for doing it — I don’t,” she says. She feels it’s essential to have test strips available, as they’re one of the most effective (though not foolproof) lines of defense against fentanyl poisoning. As she points out, restaurant and bar workers themselves are at a heightened risk, since the use of drugs like cocaine and prescription painkillers is relatively common in the industry.

Tim Evans/Eater Twin Cities

Alicia House, executive of the Steve Rummler HOPE Network, says that restaurants and bars have a unique role to play in community-level harm reduction. Rummler operates a network of “Naloxone access points,” or NAPs, where people can access naloxone and fentanyl test strips for free: This year, Minneapolis’s A Bar of Their Own became the organization’s first restaurant or bar NAP. A Bar of Their Own’s harm reduction power goes beyond the physical distribution of naloxone and test strips. House says — it lies in its ability to boost awareness and combat stigma. “Resources are great, harm reduction is amazing, but if nobody’s aware of them, and they can’t access them, they’re only doing so much,” House says. “One of the biggest grievances that I hear, unfortunately on a very regular basis, is people saying, ‘Why didn’t I know about all this before my loved one died? Or why was my daughter not able to find fentanyl testing strips when she was asking around for one?’” Many people affected by the crisis use drugs recreationally, she says — they’re not likely to find themselves in substance use disorder spaces where resources and information are readily available. That’s where everyday spaces like parks, restaurants, bars, and music venues can have an outsized impact. At A Bar of Their Own, staff have even made hand-drawn harm reduction zines, which are available in the bathrooms.

Restaurants and bars are finding other creative ways to support harm reduction in their neighborhoods. Kat Naden is the owner of Duck Duck Coffee in south Minneapolis, which hosts a weekly secular 12-step group and often offers its space up for donation drives, comedy hours, and book clubs. But Naden wanted to expand Duck Duck’s community resources even more, so she reached out to Southside Harm Reduction to have the organization give her and a neighboring business owner a full naloxone training. Now, Duck Duck hosts community trainings through Southside, which are free and open to anyone who wants to learn how to administer naloxone and Narcan. Naden estimates that 50-some people have cycled through the trainings so far. “All types of people are affected by the opioid crisis,” she says. “If it’s not affecting your family directly, it’s certainly affecting families of people you know and love.” Sencha also hosts community naloxone trainings through the Rummler HOPE Network.

Webster Norton says that ultimately, the power of a restaurant or bar to make a dent in the crisis boils down to its mission. For some, she says, it’s to serve food and drink; for others, it’s much deeper. She offers the example of Spring Street Tavern, which remains reliably open, every year, on Thanksgiving and Christmas. “They provide a safe space for people who don’t have families, who don’t have people that love them, who don’t have community,” she says. “We’re more than just a dive bar; we’re more than just a good breakfast spot. We’re a community that cares about the surrounding community.” Setting out canisters of Narcan and fentanyl test strips on the bar is an extension of that care, in Webster Norton’s eyes — and she knows it’s wanted, because they’re usually gone by the end of her shift. She hears stories from the restaurants she works with, too: an anecdote of a customer who slipped into the women’s bathroom and was found unconscious and blue-lipped, but staff revived her with Narcan; a server who grabbed fentanyl test strips before a bachelorette party and discovered that the Molly the group planned to take was, in fact, laced. Those are the stories that keep her going, she says, despite the exhaustion of the work and the hostility she sometimes encounters.

Jeffrey, who works those Sunday shifts with Webster Norton, says that as he’s watched the opioid crisis impact the community around him, he’s noticed changes within himself, too. Five years ago, he says, if he closed up the bar at 2 a.m. and found someone on the patio, he’d want them out of there. Now, he’s more inclined to leave them be, knowing that they may be having a mental health challenge, or may just need a safe place to rest. Sometimes, he sees posts on the Minneapolis Crime Watch Facebook page that mention overdose cases where naloxone was administered — inevitably, he says, there are comments blaming naloxone for enabling drug use in the first place. “There may have been a time in my life where I even felt the same way,” he says. “But it just blows my mind that people would bash somebody for having a thing that saves people’s lives, saying that these people deserve it.”

The reason Spring Street’s staff carries naloxone isn’t that they want people to be using drugs, he says — it’s that they’re trying to help where they can; to respond compassionately to a crisis that’s riddled and complex, and for many, devastating. “It’s tough to see the stigma around even making Narcan available,” Jeffrey says. “Once those people are impacted by it, all of a sudden, it opens their eyes.”