More than 33,000 Americans died with opioids—such as prescription painkillers, heroin, or fentanyl—in their systems in 2015. But many of those deaths may have been preventable. There's a prescription medicine that can reverse nearly all opioid overdoses, so long as patients get it quickly enough and in high enough doses: Naloxone, a generic drug that even non-professionals can learn to administer. So the critical question is: When someone overdoses, what's the likelihood he'll get naloxone in time?
There are state policies that can improve his chances. One example is allowing family members and friends of opioid users to carry naloxone; that way, if they find their loved one overdosed, they can administer the treatment themselves. Some states have also enacted policies offering protection from drug charges to those who call 911 in the event that they witness an overdose, the logic being that people often overdose while in the company of fellow users.
In the map below, we've scored how each state and Washington, D.C., fares in six categories of laws that make naloxone more likely to be administered to overdose victims. These aren’t the only policies that could increase naloxone access; for example, none of these laws address the prices of naloxone injections and nasal sprays, which have risen sharply in the last few years. We chose to map the laws we did in part because the Prescription Drug Abuse Policy System, a database maintained by the National Institute of Drug Abuse, tracks them carefully.
The shading of yellow corresponds to a state's provision of naloxone; the darker the shade, the better the access. You can click on any state to learn more. Here are the types of laws we looked at:
- General naloxone access laws. This includes any law that addresses naloxone access, as determined by researchers at the Prescription Drug Abuse Policy System. As of August of 2016, only Montana, Wyoming, Arizona, Kansas, and Missouri have had no such laws.
- Laws protecting health-care professionals who prescribe or distribute naloxone to laypeople. Studies show that many doctors think they'll be open to criminal liability if they prescribe naloxone, even though that's not true. Laws in this category assure them they won't. Laws like this may also allow prescribers to write naloxone scripts for drug users' family members and friends, which isn't legal for most medicines.
- Laws allowing standing orders for naloxone. These laws allow doctors to write a prescription in such a way that many other health-care workers, such as the staff of a community health center, can get and give out naloxone as needed, without ever meeting the doctor. Some states have a standing order written by their surgeon generals, which applies to the whole state.
- General Good Samaritan laws that protect people who call for help for an overdose victim. This encompasses anything that encourages drug users to call for emergency services for each other, including the two law types below.
- Laws that protect people who call for help from punishment for drug possession specifically. Depending on the state, a law that fits in this category may reduce possession penalties for Good Samaritans, scrap them altogether, or only scrap them for small amounts of drugs.
- A law that considers calling for help a mitigating factor in prosecution for drug crimes.