Good Samaritan Overdose Response Laws: Lessons Learned from Washington State
Drug overdoses persist as a major cause of preventable death. Calling 911 during an overdose can mean the difference between life and death, but witnesses sometimes do not call because they perceive that they may be arrested. Proponents of drug overdose Good Samaritan laws aim to address this concern by providing limited immunity to overdose witnesses and victims. Opponents argue that immunity will provide a “get-out-of-jail-free card” and interfere with the work of police and prosecutors.
Drug overdose Good Samaritan laws are in effect in 10 states and the District of Columbia and are being actively considered by at least a half-dozen state legislatures as of March 2013. In 2010, Washington State became the second state to pass a law incorporating a Good Samaritan provision providing immunity from drug possession charges; immunity applies to a person who seeks medical aid during an overdose (e.g., by calling 911 or taking someone to the ER), and to a person having an overdose.
I evaluated the development and implementation of the law and remain involved in spreading awareness of the law, providing overdose education, researching interventions, and encouraging broader availability of the opioid antidote naloxone (Narcan).
To date, there is no indication from police or prosecutors in Washington State that the Good Samaritan law is a serious impediment to the conduct of their work. This may be because arrests at overdose scenes are quite rare. In Seattle, we found that while police, paramedics, and heroin users all agreed police were usually at the scene of an overdose, they also all agreed that arrests were rare. This is in agreement with what we heard from representatives of statewide police/sheriffs and prosecutor associations during and subsequent to passage of the law.
We have not been able to determine if there is a positive impact directly related to the law either on increasing calls to 911 or decreasing overdose deaths. This is not because there is no effect, but rather because passage of the law facilitated the unfolding of a chain of events that was much broader than the simple legal immunity clause. Like other states’ legislation, no funding for implementation was included and no state agency was designated to implement (or evaluate) the law. However, during the course of our public health law research evaluation of the law, we surveyed Seattle police officers and found very low awareness of the law. Only 16 percent had heard of the law, and only 8 percent knew it applied to both overdose witnesses who sought aid and overdose victims. We shared these findings with police command staff, and they developed a training video that was shown to all patrol officers in the city. The video features the narcotics captain, a county prosecutor, and the medical director for Public Health - Seattle & King County. In my conversations with command staff and patrol officers, it appears that the video has dramatically increased awareness of the law among police in Seattle and has been shared with other Washington law enforcement agencies and at national conferences. The fact that police have been trained about the law has also been shared with those receiving overdose education. The video is publicly available and may be seen here:
Immunity from a broader set of charges is often a point of contention; in Washington State, the 2009 legislation covered a broader set of drug charges and did not pass. In 2010, the legislation was limited to drug possession, and it passed. Because of the social circumstances of substance use, there is interest by some in providing immunity for sharing controlled substances with others, and because of the personal histories of those with substance use, there is also interest in immunity for those on probation or parole. Immunity for these charges has not been implemented in Washington State but is under consideration in some other states.
In summary, Washington’s Good Samaritan overdose law has coincided with a great deal of progress on overdose education efforts throughout the state without any major negative consequences. We have found that collaboration among diverse stakeholders is critical to spreading the word about overdose prevention and response. The Good Samaritan law in Washington was an important catalyst for this progress, and we encourage other states to involve public health, law enforcement, medical and treatment professionals, and advocacy organizations in spreading the word about the need for overdose education and the protections provided by Good Samaritan overdose laws. Other states also may wish to consider cost-neutral ways of explicitly identifying an agency or standing work group to convene a multi-agency task force to help implement overdose-related laws in their legislation.
Dr. Caleb Banta-Green is a Research Scientist at the Alcohol & Drug Abuse Institute and served as a Senior Science Advisor at ONDCP in 2012. More information online at http://bit.ly/adaistaff_bantagreen