Amy Lieberman

Variations among jurisdictions in determining and reporting causes of death and delays in obtaining and reporting fatality data often result in an incomplete and out-of-date view of the overdose epidemic in the U.S. It is imperative that health departments, harm reduction organizations, and people who use drugs are provided with accurate, timely and actionable information on drug-related overdose. This fact sheet provides a snapshot of current laws, regulations, and sub-regulatory sources governing mandatory disease reporting and a description of the laws and regulations governing reporting of overdoses in the jurisdictions that require or explicitly permit it as of March 31, 2023.

This fact sheet details the state laws that require private insurers to cover at least one formulation of naloxone and those that reduce barriers to access naloxone where it is covered. Because these laws were written during a time when no over the counter (OTC) naloxone formulations were available, none explicitly require coverage for OTC naloxone.

Equipping people who use drugs, as well as their friends and family members, with the overdose reversal medication naloxone can significantly reduce the number of opioid overdose deaths. This fact sheet discusses laws in California that protect those who respond at the scene of an overdose emergency, including by administering naloxone to a person experiencing an overdose. These laws show a clear intention by the state to encourage laypersons to respond to overdose and increase access to and use of naloxone to reduce preventable overdose death and disability.

In 2021 drug overdose claimed the lives of nearly 108,000 people, and either by themselves or in combination with other drugs or alcohol, opioids were responsible for approximately 75 percent of these deaths. Many of these deaths could have been prevented with the administration of the opioid antagonist naloxone and, where needed, other emergency care. This fact sheet outlines modifications and other changes to laws in Tennessee to increase access to naloxone, including removal of some confusing language that previously limited the impact of state efforts to increase access to lifesaving opioid antagonist medications.

There are many reasons a person under the age of 18 may wish to obtain the life-saving overdose reversal medication naloxone or another opioid antagonist. Substance use disorders often develop in adolescence, and around 10 percent of overdoses nationally occur in youth and young adults below 26 years old.  In 2020, over 15 percent (874 out of 5,502) overdose deaths in California occurred in individuals under the age of 25.  Additionally, individuals under the age of 18 may be able to intervene in the overdose of an adult, such as a friend or family member. This fact sheet examines the legality of dispensing naloxone to minors in California.

All 50 states and the District of Columbia have modified their laws to increase access to naloxone, the standard first-line treatment for opioid overdose. While these laws have been successful in increasing access to this lifesaving medication, few explicitly address the legality of distributing and administering naloxone that is past its expiration date. This fact sheet discusses whether Tennessee laws forbid the prescription, dispensing, distribution, possession, or administration of expired naloxone and whether medical professionals and others who take such actions might be held liable.  

In 2021, nearly 108,000 people in the U.S. died of a drug overdose; around 75 percent of those overdoses involved an opioid, largely driven by the increased presence of synthetic opioids, like fentanyl and fentanyl analogues, in the nation’s illicit drug supply. While many jurisdictions are making moves toward evidence-based harm reduction measures to save lives, others are increasing penalties for those who possess and sell fentanyl.

National Minority Health Month was observed in April — which marked its 20th year — to emphasize and highlight initiatives aimed at improving health outcomes for racial and ethnic minority groups. This year, severe public health threats including the Covid-19 pandemic, opioid epidemic, high rates of substance abuse, and ongoing housing crises highlight the underlying disparities in U.S. health care and other policies, emphasizing the need to focus on these issues to achieve the best health outcomes for all.

In response to the ongoing opioid overdose crisis, all 50 states and the District of Columbia have modified their laws to increase access to naloxone, the standard first-line treatment for opioid overdose. While these laws have been successful in increasing access to this lifesaving medication, few explicitly address the legality of distributing and administering naloxone that is past its expiration date. These fact sheets discuss the efficacy of expired naloxone in Kentucky and Texas and whether the relative laws in each state permit the distribution and administration of such naloxone.

In response to the ongoing opioid overdose crisis, all 50 states and the District of Columbia have modified their laws to increase access to naloxone, the standard first-line treatment for opioid overdose. While these laws have been successful in increasing access to this lifesaving medication, few explicitly address the legality of distributing and administering naloxone that is past its expiration date. These fact sheets discuss the efficacy of expired naloxone in Kentucky and Texas and whether the relative laws in each state permit the distribution and administration of such naloxone.

Arnold Ventures has renewed funding support for the Network for Public Health Law’s Harm Reduction Legal Project, which works to address the legal and policy barriers that impede the establishment and expansion of evidence-based harm reduction measures such as naloxone distribution, syringe access programs, and access to evidence-based substance use disorder treatment.

Despite state efforts, disparities in access to the life-saving overdose reversal drug naloxone are widespread.  People of color and those experiencing homelessness face numerous barriers to obtaining naloxone, which is especially concerning given that from 2018 to 2019, overdose deaths for non-Hispanic Black individuals increased 40 percent, while deaths remained stable among individuals of other races and ethnicities. One innovative way to improve access is through the use of naloxone vending machines, an approach currently in use in a number of prisons and jails.