ST. PAUL — Opioid addictions typically end one of two ways — recovery or death.

Monica Rudolph is a survivor. She’s been sober almost a year.

Ryan Anderson didn’t make it. He died of an overdose in December.

Both became addicts by taking prescription opioids. Rudolph was prescribed the powerful painkillers after a car accident.

Anderson obtained them illicitly to experiment recreationally.

Both ended up hooked on heroin. Rudolph and Anderson sought treatment for their addictions and had different experiences.

Each day, Rudolph takes a prescription containing a low dose of opioids called Suboxone. The mix of buprenorphine and naloxone helps calm her cravings and keeps her from getting high.

“It allowed me to function normally and be a human being again,” Rudolph told the Pioneer Press . “Everything has turned around.”

Anderson, of Coon Rapids, tried a similar treatment, but it didn’t stick. He couldn’t get access to other medicines, such as naltrexone, an injection that provides a monthlong reduction in opioid cravings and protects against overdose.

“I wish he would have had the opportunity to try,” said Anne Emerson, Anderson’s fiancee, who shared his story. “I feel like he really wanted to (get sober), but he struggled with it.”

In the fight against opioid addiction, there are a growing number of tools for prevention and treatment. Too often, the help addicts need is inconsistent, out of reach or comes too late.

Minnesota is trying to change that.

Lawmakers have already committed nearly $25 million in state funding and federal grants to fight the opioid crisis through improved treatment and prevention efforts. Gov. Mark Dayton wants another $12 million for the coming fiscal year, and there is bipartisan support for legislation that would create a permanent revenue stream to fight addiction.

Opioid overdoses in Minnesota have skyrocketed.

In 2000, fewer than 200 residents overdosed on the drugs, according to state data. By 2016, overdoses had grown to more than 2,000 — an increase of more than 1,000 percent.

Not all overdoses are fatal, but the death toll is rising. In 2016, 395 people died from opioids, a more than 600 percent increase over the 54 deaths in 2000. By comparison, there were 392 traffic fatalities in 2016.

But there’s a glimmer of hope in the overdose data.

While overdoses and deaths continue to climb, the percentage of overdoses that are fatal have been falling. In 2016, one in five opioid overdoses was fatal, compared with a high point of more than one in three in 2008.

State health officials and addiction experts say the increased use of medical treatments for opioid addiction and overdoses are likely the reason. But they’re reluctant to say there’s a direct correlation.

Nevertheless, opioid antidotes like naloxone, or Narcan, that can reverse an overdose, and addiction medicines such as buprenorphine and naltrexone are becoming more widely available.

“I would hope the outcome we are seeing is from the wider availability of these treatments,” said Claire Wilson, an assistant commissioner with the state Department of Human Services.

The opioid crisis is changing the way addiction is treated.

Minnesota’s own Hazelden Betty Ford Foundation was a pioneer in addiction treatment, which has often focused on abstinence combined with peer support and psychological treatment.

Dr. Marvin Seppala, Hazelden’s chief medical officer, said it became clear in 2012 as the opioid epidemic was ramping up that they had to try something different. Not only were patients not getting better, they were dying of overdoses after leaving treatment.

“We’ve got to do whatever we can to keep people alive so they can get sober and stay sober,” Seppala said.

Medicines that ease withdrawal and prevent relapse, such as buprenorphine and naltrexone, improve recovery rates and help prevent fatalities, Seppala said. He added that Hazelden was compiling research on the success rates of the medications.

“Our biggest goal is to keep them involved long-term,” Seppala said. “The medicines do help them stick around.”