Good Samaritan. State with this law in place: New Mexico, Washington, New York, Connecticut, Illinois (to be enforced June 1, 2012)

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1 Good Samaritan Immunity Laws that provide protection from prosecution for calling 911 if seeking medical attention for self or another experiencing an overdose The US Conference of Mayors 2008 unanimously adopted a resolution supporting 911 Good Samaritan policies Pennsylvania Good Samaritan (S.B.448) (September 2011) - A new law provides immunity to underage drinkers who call 911 because someone else needs medical attention. The law eliminates a disincentive for underage drinkers to call for help. This law does not protect individuals from opioid prosecution. State with this law in place: New Mexico, Washington, New York, Connecticut, Illinois (to be enforced June 1, 2012) States considering the law: New Jersey, California, Hawaii, Minnesota, Massachusetts (currently a House Bill), Rhode Island, Florida (passed legislation 2/8/12), Pennsylvania, and potentially others.

2 National 2011 National Drug Control Strategy Epidemic: Responding to America s Prescription Drug Abuse Crisis. Expansion of state-based prescription drug monitoring programs Mandatory additional education for physicians prescribing opioid medications Reduction of pill mills and doctor shopping through law enforcement efforts ( In September 2011, the American Society of Addiction Medicine wrote the Commissioner of the FDA asking the administration to add Tramadol to Schedule III, and elevate Hydrocodone to Schedule II.

3 International Internationally an Overdose Awareness Day began 10 years ago to provide an educational platform and of equal importance to give individuals an opportunity to mourn without shame or guilt Drug Policy Alliance initiated a nationwide campaign: Purple Ribbons for Overdose Prevention An effort to raise awareness began with a Facebook Cause that hosted over 17,000 international members. March 2011: WHO Model List of Essential Medicines Expert Committee requested the review of the comparative effectiveness and safety of codeine for possible deletion at their next meeting. Naloxone Projects Worldwide As of November 2010 programs distributing Naloxone to drug users their peers, family members and others operated in: The UK, US, Canada, Germany, Russia, Spain, Norway, Afghanistan, China, Kazakhstan, Tajikistan, Vietnam It has been available across the counter in Italy since (Eurasian Harm Reduction Network, November 2010) DPMP (Drug Policy Modeling Program)

4 California Drug Overdose Prevention and Education Project (DOPE) Overdose education in shelters, jails, treatment programs Collaborates with the San Francisco Department of Health to implement a Naloxone Distribution Program. Working toward passing a Good Samaritan Law

5 Connecticut 2011 Passed 911 Good Samaritan Law A Better Way Foundation One of their missions is to allow trained professionals to carry and administer Narcan. Started in 2008 with multifold purpose including: Policy reforms, research, and public education. Affiliations with: Drug Policy Alliance and Connecticut Harm Reduction Coalition

6 Florida NOPE Task Force Narcotics Overdose Prevention and Education Middle & High School and University Presentations Community and Parent Forums Support Groups and Treatment Media Campaign and Information Dissemination 911 Good Samaritan legislation passed on February 8, 2012

7 Illinois Chicago Recovery Alliance Cook County Illinois operated by the Chicago Recovery Alliance was the first Naloxone distribution program in the US. The Chicago Recovery Alliance has been assisting opiate overdose prevention with naloxone training and distribution since 1996 through their harm reduction outreach in Chicago. Through June of 2011 they have received 2,601 reports of peer opiate-involved overdose reversal. They have a 911 Good Samaritan Law to be enforced June 1, 2012.

8 Massachusetts Overdose Prevention Strategy Good Samaritan House Bill MA has three-fold strategy including: 1) Reduce the incidence of fatal and non-fatal OD-prevent OD from occurring 2) Improve the management of OD if it occurs and 3) Reduce the amount of misused, abused and diverted prescription opioids. Since 2007 Massachusetts Department of Public Health, has been sponsoring a pilot program and has been distributing intra-nasal Naloxone (Narcan ), along with opioid overdose prevention education, to opioid users and to trusted people in their lives such as family, friends, and staff of human services programs. 8 community-based settings. Training is 15 to 30 minutes and each participant receives an overdose prevention kit.

9 New Mexico In 2007 New Mexico was the first state to respond to the growing problem of fatal overdoses in the form of the 911 Good Samaritan Legislation Naloxone distribution immunity to non-healthcare providers Drug possession immunity New Mexico Department of Health established guidelines for overdose Prevention Training and Naloxone distribution Educates on harm reduction Informs on overdose recognition and response Trains on administration of Naloxone

10 New York Department of Health in 2005 defined the use of Naloxone as first aid April 2006 became authorized to approve Opioid Prevention Programs July 2011 passed Good Samaritan Law Skills and Knowledge on Overdose Prevention Project (SKOOP) Well defined guidelines Expansive programs Training and required refresher course every two years Naloxone Kits - two pre-filled syringes and instructions, a face mask for mouth-to-mouth resuscitation, two alcohol swabs and a pair of surgical gloves.

11 North Carolina Project Lazarus Naloxone distribution Educational video at doctors offices Project Lazarus Naloxone Rescue Kit (2) needle free syringes of Naloxone rescue medication Two nasal adaptors Refrigerator magnet DVD of the instructional video Guides on how to talk to your family about overdose

12 Ohio The Ohio Department of Health s Violence and Injury Prevention Program launched: Stop the Epidemic A Comprehensive Education and Awareness Campaign; Multi-level social marketing campaign. It began 2010 through 2011 in 5 counties and now coalitions and pro bono work allows outreach to four additional counties through June 2012 January 31, 2012 Ohio Department of Alcohol and Drug Addiction Services (ODADAS), announced the launch of Don t Get Me Started, a statewide public service campaign that speaks to young adults and their friends and family. Don t Get Me Started website includes 5 videos of Ohioans who share a unique story; features an interactive map of local Alcohol, Drug Addiction and Mental Health Boards; a link to treatment options; information about opiate abuse; links to other partners in the war on drugs.

13 Rhode Island Preventing Overdose and Naloxone Intervention (PONI) A pilot overdose prevention program began in 2006 Training and Education at fixed-site needle exchanges, drug abuse treatment centers, and homeless shelters. Interactive training that includes how to administer intramuscular Naloxone and a quiz.

14 Washington State Passed the 911 Good Samaritan Law in Taking 5 years, Washington was the second state to pass this law. Keys to passage: Framing the law as a public health issue and not primarily as a legal issue. The emergence of prescription OD and deaths statistics. And keeping the scope of the immunity narrow. Naloxone distribution program provides kits to people who use as well as family and others who may be in a position to help in the case of an OD. This site includes news stories, sources for help and resources, Narcan facts and a Good Samaritan Law Quiz.

15 Naloxone - Narcan (Brand Name) Naloxone is an opioid antagonist - it temporarily displaces opioids from their brain receptors. It is an unscheduled drug with no abuse potential (Practical Pain Management). Approved by the FDA and utilized by emergency medical professionals for 40 years. Around the world and throughout the US, Naloxone distribution programs in various ways are educating and training people on overdose and proper response - including administering Naloxone (Drug Policy Alliance). Ongoing research reports that over 10,000 lives have been saved by overdose reversals utilizing Naloxone by non-medical people and the programs do not increase drug use.

16 Some Areas with Naloxone Distribution Programs Illinois Massachusetts Washington State Rhode Island California New York New Mexico Connecticut Wisconsin 48 Naloxone Programs across the US have unique characteristics in their programs: Variety of settings, durations and formats Many protocols, materials, videos, most available on-line Often pre-post evaluation Typical components include: Review of the causes and how to prevent overdose Assessment of an overdose Necessity of calling an ambulance Airway maintenance and rescue breathing Naloxone and its administration Post Naloxone monitoring and support Communication with ambulance and police services Procedures for returns, new Naloxone and reporting back

17 States with the Good Samaritan law in place States considering the Good Samaritan law Interstate Opiate Task Force States with Naloxone Programs

18 State References (New York) (Pittsburgh) (Ohio) (Florida) (Massachusetts) (Massachusetts) (Washington) (North Carolina) (Illinois)

19 References ncadd.org/ harmreduction.org/

20 It used to be, overdose, you always talked about it in past tense: I HAD a friend who OD d. Now, overdose is in the present tense: I HAVE a friend, he OD d last week. Naloxone did that. -Anonymous

21 Bucks County January 1, 2012 February 27, Deaths With Toxicology Involved In Some Manner 3 Directly Drug Related 2 Motor Vehicle Incidents With Drugs Involved 1 Pending Investigation

22 Bucks County 2011 Of all the deaths reported by the coroner s office that involved toxicology, 65.8% were directly related to drugs. 37.2% of those deaths were age 30 and under Drugs Most Often Cited: Oxycodone, Xanax, Heroin, Codeine and Morphine

23 What is an Opioid Overdose?

24 Narcan Reversing an Overdose