Legal changes to increase access to naloxone for opioid overdose reversal in the United States.
BACKGROUND
Opioid overdose, which has reached epidemic levels in the United States, is reversible by administration of the medication naloxone. Naloxone requires a prescription but is not a controlled substance and has no abuse potential. In the last half-decade, the majority of states have modified their laws to increase layperson access to the medication.


METHODS
We utilized a structured legal research protocol to systematically identify and review all statutes and regulations related to layperson naloxone access in the United States that had been adopted as of September, 2015. Each law discovered via this process was reviewed and coded by two trained legal researchers.


RESULTS
As of September, 2015, 43 states and the District of Columbia have passed laws intended to increase layperson naloxone access. We categorized these laws into three domains: (1) laws intended to increase naloxone prescribing and distribution, (2) laws intended to increase pharmacy naloxone access, and (3) laws intended to encourage overdose witnesses to summon emergency responders. These laws vary greatly across states in such characteristics as the types of individuals who can receive a prescription for naloxone, whether laypeople can dispense the medication, and immunity provided to those who prescribe, dispense and administer naloxone or report an overdose emergency.


CONCLUSIONS
Most states have now passed laws intended to increase layperson access to naloxone. While these laws will likely reduce overdose morbidity and mortality, the cost of naloxone and its prescription status remain barriers to more widespread access.
Network for Public Health Law, 3701 Wilshire Blvd. #750, Los Angeles, CA 90010, United States. Electronic address: cdavis@networkforphl.org.
Corey S
CS
Davis
Network for Public Health Law, 101 E. Weaver St. #G-07, Carrboro, NC 27510, United States. Electronic address: carr@healthlaw.org.
Derek
D
Carr
D000701:Analgesics, Opioid / Q000009:adverse effects; D062787:Drug Overdose / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000592:standards; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D009270:Naloxone / Q000600:supply & distribution* / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000600:supply & distribution* / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010594:Pharmacies / Q000331:legislation & jurisprudence; D014481:United States
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone
Law; Naloxone; Opioids; Overdose; Public health