Interest is growing in Good Samaritan laws aimed at saving lives by encouraging people who witness drug overdoses to call 911. The laws provide legal immunity from drug possession prosecution both for the person who overdoses and his or her companion who calls for help. But much is not yet known about the laws’ impact on drug users, bystanders, paramedics and police.
A research team at the University of Washington is studying the impact of Washington State’s Good Samaritan law, which not only provides this legal immunity, but also allows the prescribing of an opioid antidote medicine, naloxone (Narcan), to drug users and their partners. The law states a person acting in good faith may receive a naloxone prescription, possess naloxone and administer naloxone to an individual suffering from an apparent opiate-related overdose.
New Mexico and New York have similar laws and others are currently working on passing such legislation. About 15 other states also have programs to distribute naloxone, which can help a person who has stopped breathing because of an opiate drug overdose (heroin or prescription-type opiates) to breathe more normally.
With a grant from the Robert Wood Johnson Foundation’s Public Health Law Research Program, Caleb Banta-Green, of the Alcohol and Drug Abuse Institute, with University of Washington colleagues Patricia Kuszler and Phillip Coffin, are investigating how the law is affecting heroin overdoses in Seattle. The study examines the legal intent, implementation and outcomes of the law. Ultimately they will report on how the law is impacting overdoses and 911 calls. In the meantime, they are releasing initial results about how the law was developed and implemented and how it impacts stakeholders’ behaviors.
Under the law, passed in 2010, immunity does not extend to outstanding warrants, probation or parole violations, drug manufacture or delivery, controlled substances homicide or crimes other than drug possession.
One of the challenges so far has been funding, since responsibility for implementing the law was not assigned to any state agency, Banta-Green noted. So far, most of the implementation has focused on publicizing the website stopoverdose.org, which explains the law, distributing wallet cards at needle exchanges and putting up posters about the law at drug treatment programs.
Law enforcement and prosecutors’ associations initially opposed the law, thinking it was unnecessary because people are rarely arrested or prosecuted for drug possession during overdoses. However, as they heard from their constituents, such as campus police supportive of alcohol Good Samaritan laws, and learned about the dramatic increase in the use and abuse of pharmaceuticals by people across the age spectrum, they became supportive. “The law gives legal cover to what’s been standard practice for a long time,” Banta-Green says. Legislators and organizational stakeholders agreed that framing the law as a public health issue, not as a legal issue, was also key to its passage.
As part of Banta-Green’s research, drug users, police officers and paramedics were asked about the frequency with which they encounter overdoses. They were also questioned about whether they’d heard of the law, whether they had a correct understanding of it and how they thought it would change their future actions during an overdose.
A survey conducted this year by Public Health-Seattle and King County found that 42 percent of heroin users had witnessed an opiate overdose in the prior year and 911 was called in half of the cases. Police responded along with medics 62 percent of the time, but just one person was reported to have been arrested at the scene of an overdose. Only one-third of heroin users had heard of the Good Samaritan law. According to the survey, 88 percent indicated that now that they were aware of the law, they would be more likely to call 911 during future overdoses.
Seattle paramedics reported that police are usually at the scene of overdoses, but that arrests of overdose victims or bystanders rarely occur. The majority of police, 62 percent, say they have been at an overdose scene in the past year, yet few are familiar with either the Good Samaritan or the Narcan provisions in the law. Sixty-two percent 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 percent were unsure what they would do, and 14 percent said they would be less likely to make such an arrest.
“These findings indicate we need to make sure we’re getting information into the hands of police and the community at large,” Banta-Green says. To that end, leaders from the local police, prosecutors’ offices and public health departments are collaborating on educational and training efforts.