Overdose Good Samaritan laws are policies that provide legal protections for individuals who call for emergency assistance (such as 9-1-1) in the event of a drug overdose. This may include protection from arrest and/or prosecution for crimes related to drug possession, drug paraphernalia possession, and other crimes. These laws are designed to encourage people to summon emergency assistance if they experience or witness a drug overdose.
As of July 2017, 40 states and the District of Columbia have instituted Good Samaritan laws. Yet, lack of awareness and understanding of the protections these laws provide, as well as concerns about their limitations, may be limiting their effectiveness in encouraging overdose bystanders to call for help. These barriers may also prevent the criminal justice system from fully observing them.
Prevention practitioners can play an important role in maximizing awareness of these laws—which vary considerably across states—and educating relevant stakeholders on their strengths and limitations. This tool supports these efforts by providing an overview of this overdose prevention strategy, including the aims of Good Samaritan laws and types of protections they can offer. We also present some of the obstacles that prevent overdose bystanders and the criminal justice system from applying their state’s Good Samaritan laws, and steps prevention practitioners can take to raise awareness of these laws among various target populations.
WHY GOOD SAMARITAN LAWS?
In an opioid-related emergency, bystanders should—but often don’t—call for emergency assistance, which is recommended even when the opioid antidote naloxone is on hand.1-2 Fear of arrest or prosecution keep many from involving law enforcement or medical teams at the time of an overdose. This is particularly true for individuals who use opioids themselves, who may fear the unwanted attention, stigma, and negative consequences that might accompany a call, or who have had previous negative experiences with law enforcement officers or emergency medical personnel.1 Overdose Good Samaritan laws are designed to address these fears by protecting overdose victims and those who call for help from some of these potential consequences.
GOOD SAMARITAN LAWS VARY BY STATE
Depending on the state, individuals who seek care for themselves or others in the event of an overdose are eligible for a variety of legal protections.3 The table below describes the different types of legal protections that states offer in their Good Samaritan laws.
FACTORS LIMITING THE USE OF GOOD SAMARITIAN LAWS
Even if a state has a Good Samaritan law, various obstacles can prevent the law from being fully utilized by the public or criminal justice professionals (e.g., law enforcement, prosecutors). Lack of awareness Individuals who engage in the non-medical use of prescription drugs —particularly young people— may be less likely to be aware of Good Samaritan laws (compared with intravenous drug users).4-5
- Studies suggest that young adults, age 18 to 32, who engage in non-medical prescription drug use, but who do not have a history of heroin use, are less likely to be aware of their state’s Good Samaritan law. 4 Furthermore, they tend to see themselves as distinct from individuals who inject heroin, and are thus unlikely to interact with traditional harm reduction services that provide education on overdose prevention and Good Samaritan laws.5
Law enforcement officers may not be fully aware of their state’s Good Samaritan law or understand the extent of the protections that the law offers.
- In a survey of Seattle police officers one year after the passage of Washington State’s Good Samaritan law, only 16 percent had heard of the law, only 7 percent could correctly identify the law’s protections, and only 1 percent felt that they had received clear guidance on the law from the police department.6
Skepticism and lack of trust Even if they are aware of the Good Samaritan law, many individuals at risk for encountering an overdose often report a strong distrust of law enforcement and skepticism that the law will protect them. These are likely to be individuals with criminal histories, such as outstanding warrants or probation status.1 These individuals, particularly those who inject drugs, are more likely to delay or not call for help during an overdose.7
- Media reports of individuals being arrested after experiencing or intervening in an overdose despite the presence of a Good Samaritan law may contribute to this lack of trust.8-12
- Studies suggest these individuals may hesitate to call for help even if they know about Good Samaritan laws. They may fear arrest, withdrawal symptoms in jail, getting others in trouble, or hold the belief that they do not need professional help if they have naloxone on hand.1
As of July 15, 2014, 30 states and the District of Columbia enacted legislation to decrease overdose deaths. The infographic provides an at-a-glance view of which states have passed and enacted these laws as of July 15:
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Below is a summary of salient points in the infographic, with the corresponding colors.
Red: Twenty states (AK, CA, CO, CT, DE, FL, GA, IL, LA, MD, MA, MN, NJ, NM, NY, NC, RI, VT, WA, & WI) and the District of Columbia have statutes which prevent charge or prosecution for possession of a controlled substance and/or paraphernalia for persons who seek medical/emergency assistance for someone experiencing an opioid-induced overdose. Additionally, in UT and IN, evidence of providing assistance to someone experiencing an opioid overdose can be presented as a mitigating factor at sentencing to a conviction for possession of a controlled substance and/or paraphernalia. Utah allows evidence of providing assistance to someone experiencing an overdose to be used as an affirmative defense to an allegation of possession of a controlled substance and/or paraphernalia.
Purple: Twenty-one states (CA, CO, CT, GA, IL, KY, ME, MD, MA, MN, NJ, NM, NY, NC, OH, RI, TN, VT, VA, WA, & WI) and the District of Columbia have statutes which protect lay persons from criminal liability for administering naloxone to someone believed to be experiencing an opioid induced overdose. In Virginia, this protection applies to persons who are participating in the provisional pilot program. Two additional states (LA & MO) provide criminal liability protections to first responders.
Blue: Eighteen states (CA, CO, CT, GA, KY, MN, NJ, NM, NY, NC, OK, OR, RI, TN, UT, VT, VA, & WI) and the District of Columbia have statutes which protect lay persons from civil liability for administering naloxone to someone believed to be experiencing an opioid induced overdose. In Virginia, this protection applies only to persons participating in the provisional pilot program. Two additional states (IN & LA) provide civil liability protections to first responders.
Green: Fourteen states (CA, CO, CT, GA, MN, NJ, NM, NY, NC, OH, TN, UT, VT, & WI) have statutes which protect prescribers from criminal liability actions.
Orange: Thirteen states (CA, CO, CT, GA, MN, NJ, NM, NC, OH, TN, UT, VT, & WI) have statutes which protect prescribers from civil liability actions.
Yellow: Twenty-one states (CA, CO, DE, GA, IL, ME, MD, MA, MN, NJ, NY, NC, OH, OK, OR, TN, UT, VT, VA, WA, & WI) have statutes which allow for “third-party” prescriptions of naloxone (i.e., the prescription can be written to a friend, relative, or person in a position to assist a person at risk of experiencing an opioid overdose). Virginia allows third-party prescriptions only through a provisional pilot program. Three more states (IN, LA, & MO) allow prescriptions of naloxone to qualified first responders (e.g., law enforcement, EMTs, and firefighters).
1. Koester, S., Mueller, S. R., Raville, L., Langegger, S., & Binswanger, I. A. (2017). Why are some people who have received overdose education and naloxone reticent to call Emergency Medical Services in the event of overdose? International Journal of Drug Policy.
3. Davis, C., Chang, S., Carr, D., & Hernandez-Delgado, H. (2017). Legal interventions to reduce overdose mortality: Naloxone access and overdose Good Samaritan laws (pp. 1-13): The Network for Public Health Law
4. Evans, T. I., Hadland, S. E., Clark, M. A., Green, T. C., & Marshall, B. D. (2016). Factors associated with knowledge of a Good Samaritan Law among young adults who use prescription opioids non-medically. Harm Reduct J, 13(1), 24. doi: 10.1186/s12954-016-0113-2
5. Frank, D., Mateu-Gelabert, P., Guarino, H., Bennett, A., Wendel, T., Jessell, L., & Teper, A. (2015). High risk and little knowledge: overdose experiences and knowledge among young adult nonmedical prescription opioid users. International Journal of Drug Policy, 26(1), 84-91.
6. Banta-Green, C. J., Beletsky, L., Schoeppe, J. A., Coffin, P. O., & Kuszler, P. C. (2013). Police Officers’ and Paramedics’ Experiences with Overdose and Their Knowledge and Opinions of Washington State’s Drug Overdose–Naloxone–Good Samaritan Law. Journal of Urban Health, 90(6), 1102-1111. doi: 10.1007/s11524-013-9814-y
7. Mclure, W., & Kava, J. (2014). New York State trains law enforcement officers to combat overdoses from heroin, other opioids; provides overdose reversal medication at no cost [Press release]. Retrieved from http://www.criminaljustice.ny.gov/pio/press_releases/2014-06-26_pressrelease.html
8. Szalavitz, M. (2016, March 23). Calling the cops after your friend overdoses can still get you arrested, Vice. Retrieved from https://www.vice.com/en_us/article/3bj9ey/calling-the-cops-after-your-friend-overdosescan-still-get-you-arrested 9. Arditi, L. (2014, April
9). Despite the Good Samaritan Law, some addicts still punished for seeking help, Providence Journal. Retrieved from http://www.providencejournal.com/topics/special-reports/overdosed/20140409-despite-the-good-samaritan-law-some-addicts-still-punished-for-seekinghelp-video.ece
10. Olson, D. (2017, February 20). After cases of 911 overdose calls lead to charges, ND Good Samaritan law may see changes, Grand Forks Herald. Retrieved from http://www.grandforksherald.com/news/4221661-after-cases-911-overdose-calls-lead-charges-nd-goodsamaritan-law-may-see-changes
11. Sledge, M. (2015, May 2). West Jefferson hospital heroin arrest reveals holes in ‘Good Samaritan’ law The New Orleans Advocate Retrieved from http://www.theadvocate.com/new_orleans/news/article_8ee2484a-17a7-5f99-9bc7-cd60ce370174.html
12. Knopf, A. (2016, January 18). Good Samaritan laws undercut by prosecutions, Alcoholism & Drug Abuse Weekly Retrieved from http://www.alcoholismdrugabuseweekly.com/m-article-detail/good-samaritanlaws-undercut-by-prosecutions.aspx
Dr. Balta is the Medical Director at FCR for more than 10 years. Dr. Balta is Board Certified in Psychiatry and Addiction Medicine, Certified Psychoanalyst. As well, as having Psychiatric Training at The Albert Einstein School of Medicine Psychiatric Residency Program In New York City and Psychoanalytic Training at The William Alanson White Institute in New York City. While working in New York City, gained funding Grants for the treatment of Substance Abuse Disorders from SAMHSA , HRSA and the City of New York.