Opioid-overdose laws association with opioid use and overdose mortality

Addict Behav. 2018 Nov:86:90-95. doi: 10.1016/j.addbeh.2018.03.014. Epub 2018 Mar 19.


Introduction: Since the 1990's, governmental and non-governmental organizations have adopted several measures to increase access to the opioid overdose reversal medication naloxone. These include the implementation of laws that increase layperson naloxone access and overdose-specific Good Samaritan laws that protect those reporting overdoses from criminal sanction. The association of these legal changes with overdose mortality and non-medical opioid use is unknown. We assess the relationship of (1) naloxone access laws and (2) overdose Good Samaritan laws with opioid-overdose mortality and non-medical opioid use in the United States.

Methods: We used 2000-2014 National Vital Statistics System data, 2002-2014 National Survey on Drug Use and Health data, and primary datasets of the location and timing of naloxone access laws and overdose Good Samaritan laws.

Results: By 2014, 30 states had a naloxone access and/or Good Samaritan law. States with naloxone access laws or Good Samaritan laws had a 14% (p = 0.033) and 15% (p = 0.050) lower incidence of opioid-overdose mortality, respectively. Both law types exhibit differential association with opioid-overdose mortality by race and age. No significant relationships were observed between any of the examined laws and non-medical opioid use.

Conclusions: Laws designed to increase layperson engagement in opioid-overdose reversal were associated with reduced opioid-overdose mortality. We found no evidence that these measures were associated with increased non-medical opioid use.

Keywords: Good Samaritan Laws; Mortality; Naloxone; Opioids.

MeSH terms

  • Analgesics, Opioid / poisoning*
  • Drug Overdose / drug therapy
  • Drug Overdose / mortality*
  • Drug and Narcotic Control / legislation & jurisprudence*
  • Harm Reduction
  • Health Services Accessibility
  • Humans
  • Naloxone / therapeutic use*
  • Narcotic Antagonists / therapeutic use*
  • Opioid-Related Disorders
  • United States


  • Analgesics, Opioid
  • Narcotic Antagonists
  • Naloxone