Good Samaritan harm reduction policy and drug overdose deaths

Abstract

Objective To examine the effects of a harm reduction policy, specifically Good Samaritan (GS) policy, on overdose deaths. Data Sources/Study Setting Secondary data from multiple cause of death, mortality records paired with state harm reduction and substance use prevention policy. Study Design We estimate fixed effects Poisson count models to model the effect of GS policy on overdose deaths for all, prescription, and illicit drugs, controlled substances, and opioids, while controlling for other harm reduction and substance use prevention policies. Data Collection/Extraction Methods We merge secondary data sources by state and year between 1999 and 2016. Principal findings We fail to identify a statistically significant effect of GS policy in reducing overdose deaths broadly. Conclusions While we are unable to identify an effect of GS policy on overdose deaths, GS policy may have important effects on first‐stage outcomes not investigated in this paper. Given recent state policy changes and rapid increase in many categories of overdose deaths, additional research should continue to examine the implementation and effects of harm reduction policy specifically and substance use prevention policy broadly.

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

“…68 However, a morerecentstudyonGoodSamaritanlawsfoundnosignificanteffectonopioid-relatedoverdosemortality. 102 Similarly, studies on pill-mill laws that we reviewed found an increase in the number of opioid prescriptions in Texas 58,59 and opioid-related mortality in Florida 57 ; however, a 2019 study foundnulleffectsofpill-milllawsonopioidprescriptionsin Ohio and Tennessee, despite robust enforcement of these laws. 103 Two additional studies in 2019 on medical marijuana policies found lower rates of opioid use in areas with legalized medical marijuana policy than in areas without such policy, consistent with our results.…”

Systematic review of the emerging literature on the effectiveness of naloxone access laws in the United States

“…Seven studies examined NALs dichotomously, and only one [19] did not also account for specific NAL components. Six studies dealt with potential issues of multicollinearity by collapsing components or running individual models for each component.…”

“…However, three studies that extended the study time‐frame to 2015 or 2016, just as the most recent fentanyl outbreak was unfolding in parts of the country, reported a null effect overall for NALs and overdose deaths [12,18,19], and one found an increase in overdose deaths following NAL adoption [20]. Using data from 1999 to 2016, Atkins et al .…”

“…Using data from 1999 to 2016, Atkins et al . [19] found a statistically insignificant relationship between NAL passage and state‐level opioid overdose mortality; based on a shorter time‐frame (2010–15) and county‐level data, Doleac & Mukherjee [12] also found small and insignificant effects of NALs that included third‐party or standing‐order provisions. Using a different categorization, Abouk et al .…”

“…Four studies [12,18,19,21] examined the relationship of NAL components with fatal overdoses involving different types of opioids. Two studies that considered NALs as a dichotomous variable found no statistical association between NALs and illicit opioid related mortality [19,21].…”