How can public health law support intervention in drug overdoses?

Drug overdose deaths have surpassed traffic fatalities in Washington State and 15 other states. This study will examine the legal intent, implementation and outcomes of a new Washington state law to support intervening in drug overdoses. The law includes a Good Samaritan component that provides legal immunity from drug possession charges for people who overdose or seek aid for another person’s overdose. It also allows the prescribing of an opioid antidote medicine (Naloxone) to drug users and their partners. Evaluation will be conducted on the development of the legislation and the impact of the law on Seattle area heroin users, bystanders, and police during overdoses as well as the impacts on community health outcomes.

Grant Number: 68396

Funding Date: Mon, 11/15/2010

Researching Institution: University of Washington

Researcher: Caleb Banta-Green, Ph.D. M.P.H. M.S.W.; Patrica Kuszler, M.D., J.D.

Results

Summary of Initial Findings

Passage of the “911 Good Samaritan Overdose Law” took five years, keys to passage included:

  • Framing the law as a public health issue, not primarily as a legal issue.
  • The emergence of prescription medicines (e.g. opiate pain medicines) as the drugs involved in a  majority of drug overdoses. This increased the perceived public health risks of overdose and broadened the populations, demographically and geographically, that could be helped by legislative action.
  • Keeping the scope of immunity narrow, just drug possession, was the only way to get support of law enforcement, prosecutors, and some legislators.

First responders’ and opiate users’ experience with overdose included:

  • Opiate overdoses are common---42% of opiate users and 62% of Seattle police reported being present at the scene of a serious opiate overdose in the prior year.  (Almost all opiate users surveyed at syringe exchange used heroin.)
  • Most paramedics had been at an overdose in the prior year and approximately 45 serious opiate  overdose victims (heroin or pharmaceutical) are transported by Seattle medics each month.
  • Police were at the scene of most overdoses for which 911 was called according to drug users and paramedics.
  • Arrests of overdose victims and bystanders were very rare according to drug users, paramedics, and police.

Impacts of Good Samaritan Law on planned behaviors:

  • 88% of opiate users indicated that now that they were aware of the law they would be more likely to call 911 during future overdoses. 
  • 62% of police surveyed said the law would not change their behavior during a future overdose because they would not have made an arrest for possession anyway, 20% were unsure what they would do, and 14% said they would be less likely to make such an arrest.

Information dissemination:

  • Funding for implementation of the law was not included in the legislation and no state agency was assigned responsibility for implementing the law.
  • Information dissemination has involved the limited distribution of written educational materials.
  • The website http://stopoverdose.org appears to be a frequently accessed source of information.

Caleb Banta-Green at the University of Washington

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