Increased numbers of fatal opioid overdoses reflect a growing public health concern posed by nonmedical opioid use in the United States. The drug, naloxone, can quickly and effectively reverse opioid overdoses; recently, two formulations have been approved by the Food and Drug Administration and labeled specifically for layperson use.
Experts from RTI International, Dr. Barrot H. Lambdin and Dr. Alex H. Kral, served as contributing authors on a study recently published in the peer-reviewed medical journal Addictive Behaviors. The study reviewed two types of opioid overdose legislation: Naloxone access laws, which enable wider distribution of naloxone to laypeople, and overdose-specific Good Samaritan laws, which protect people from legal consequences when these individuals seek emergency services for an observed overdose.
According to this study, enacting naloxone access and Good Samaritan laws were associated with fewer opioid overdose deaths, especially among African American populations. Results further indicate that nonmedical opioid use did not increase after states enacted opioid overdose laws, refuting concerns that increased naloxone availability enables nonmedical opioid use. This study was the first to examine the influence of naloxone access and Good Samaritan laws on opioid-related mortality or nonmedical opioid use at the national level.
The study used National Vital Statistics data from 2000 through 2014 to determine opioid-overdose mortality, as well as National Survey on Drug Use and Health estimates of the number of individuals who use opioid pain relievers and heroin for nonmedical purposes. Opioid overdose deaths and nonmedical opioid use in states that had previously enacted naloxone access laws or Good Samaritan laws were compared (1) to states before and after they enacted legislation and (2) to states that did and did not enact legislation.
Findings showed that states that enacted naloxone access laws or Good Samaritan laws observed a 14% and 15% lower incidence of opioid-overdose deaths, respectively. Naloxone access laws were associated with larger reductions in overdose-related mortality among African Americans, while Good Samaritan laws were associated with larger reductions in overdose-related mortality among African American and Latinx populations. Several reasons could explain the stronger associations among these populations. First, many naloxone access laws make it easier to obtain naloxone without needing an established relationship with a prescriber; therefore, these laws could be increasing access among these communities that are more likely to be uninsured or underinsured. Secondly, many high-volume naloxone programs, implemented as a result of these laws, have been developed in urban areas that tend to have more residents who are people of color. Furthermore, the nation’s war on drugs has disproportionately impacted people of color, and providing more legal protections through these laws may result in a differential benefit for people of color.
These findings suggest that legal measures taken by states to improve naloxone access and encourage individuals to seek emergency services have helped the nation to address its opioid overdose crisis. States should continue to pass the full complement of naloxone access and Good Samaritan provisions so that their laws provide the most supportive and protective environment for reducing opioid-overdose deaths. These measures offer an opportunity to create a significant impact at a relatively low cost.