Minnesota Drug Overdose and Substance Use Surveillance Activity (MNDOSA)

In 2017, the Minnesota Department of Health (MDH) launched the Minnesota Drug Overdose and Substance Use Surveillance Activity (MNDOSA) project to track cases of substance misuse that resulted in hospitalization in near real time. (Note: MNDOSA does not collect data on cases of intentional overdose or solely alcohol misuse.) Toxicology testing is rarely performed for overdoses that are treated in hospitals. MNDOSA provides hospitals with the opportunity to send biological samples to the MDH Public Health Laboratory for more detailed toxicology testing. This helps to identify substances used in severe or unusual cases. In these cases, MDH collects data on the circumstances and risk factors involved in the reported case.

MNDOSA currently operates in five Essentia Health sites in Northeast Minnesota and in the Hennepin County Medical Center in the Twin Cities Metro area.

Learn more about the MNDOSA program with the MNDOSA Fact Sheet (PDF). You can find out more about the program's latest findings in the 2023 MNDOSA Report. 

This new system helps:

• Measure the impact of overdoses and visits to emergency departments or hospitals related to substance misuse treated in Minnesota.
• Identify clusters of drug overdoses and what substances they involve.
• Identify substances causing severe or unusual illness through comprehensive testing at the MDH Public Health Laboratory. This includes new substances, those that do not cause typical signs and symptoms of the drug reported or suspected to be used, and those causing death.
• Identify who is most at-risk for overdose and substance use to focus and guide prevention efforts.

Collecting and using MNDOSA information

Data collected from MNDOSA are being used to identify patterns of drug overdose and substance use in Minnesota. This information includes what substances are contributing to overdoses. A subset of patients with severe or unusual symptoms have blood and/or urine samples taken in a hospital. These samples are then submitted to the MDH Public Health Laboratory for further testing. The results from these samples are used only for public health surveillance purposes and cannot be used for any other purposes. The toxicology results help identify and track what drugs are being used in Minnesota. The MDH Public Health Laboratory is able to test a wider range of substances than most hospital and clinical laboratories, using an advanced instrument capable of identifying over 900 substances.

Comprehensive testing can identify what combinations of drugs (such as opioid and stimulants) are present at the time a person is treated at a hospital. Results reflect a snapshot of the substances in a person’s system at the time they were hospitalized. These findings may not show which substances were directly involved in the person’s overdose. This testing provides accurate information on what substances people are using. This is compared to what they believe they are using.

The most common substances detected through MNDOSA are amphetamines.

Download an accessible version of this data: MNDOSA substances detected (PDF).

SOURCE: Minnesota Drug Overdose and Substance Use Surveillance Activity, Injury and Violence Prevention Section, Minnesota Department of Health, 2017-2022.

Two or more substances are often detected in MNDOSA cases; opioids and amphetamines are frequently detected together.

Download an accessible version of this data: MNDOSA samples by type (PDF).

SOURCE: Minnesota Drug Overdose and Substance Use Surveillance Activity, Injury and Violence Prevention Section, Minnesota Department of Health, 2017-2022.

Most substances were detected in samples more frequently than were suspected, either by the clinician or the patient.

Download an accessible version of this data: MNDOSA samples suspected and detected (PDF).

SOURCE: Minnesota Drug Overdose and Substance Use Surveillance Activity, Injury and Violence Prevention Section, Minnesota Department of Health, 2017-2022.

Get Involved

Please contact the Drug Overdose Epidemiology Unit at health.drugodepi@state.mn.us if you would like to learn more or participate in the program.

Additional Resources and Reports

Drug Overdose Dashboard – a one-stop shop for opioid-related data and information.

MNDOSA Report: Homelessness and Substance Misuse in Northeast Minnesota

MNDOSA Report: Hospital – Treated Overdose and Acute Substance Misuse in MNDOSA (PDF)