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Victoria Harris
Conversations About Life
Dr. John Martin
22 April 2014
Naloxone Legality and Good Samaritan Laws in Ohio
Currently in Ohio, lawmakers are considering implementing new laws regarding
naloxone legality and Good Samaritan policies. It is under consideration that our state makes
naloxone available, by prescription, to friends and family members of individuals who struggle
with opioid addiction. We are also currently looking into implementing more Good Samaritan
Laws in order to protect people who administer naloxone, or call for emergency services while
under the effects of drugs as well.
Naloxone works because it is an antagonist on the bodys opioid receptors. This means
that it competes for the same receptors and binds to them more strongly than the opioids, but it
does not produce any effects of its own. For this reason it is very successful at stopping
overdoses, without being a risk for addiction. Currently in Ohio, naloxone is available to opioid
addicts, with a prescription similar to that for an epi-pen, and medical professionals, such as
EMTs and nurses. However, since opioid overdoses are dangerous and fast acting, sometimes
this is not always sufficient. Overdose results in respiratory suppression, which causes cessation
of breathing and can result in death very rapidly. Many times its a family member or friend who
will encounter an addict during an overdose, and will need quick access to naloxone. Often this
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access can mean the difference between life and death. Also naloxone is commonly present in
prescription opioids in order to help discourage prescription drug abuse. In these drugs it is
inactive in its pill from, but as soon as it is crushed, the naloxone becomes activated in order to
render the opioids ineffective. Overall, naloxone is already being used in many different ways to
prevent overdose and abuse without negative consequence, but its positive reach can still be
extended.
Although there are many benefits to allowing wider access to naloxone, there are still
some individuals who are skeptical about this. Some people may argue that an increased
availability of naloxone will encourage non-users to try opioids because they would have access
to an easy fix, were they to overdose. However, this is not a major factor, as many people who
refrain from drug use do so not out of fear of overdose, but rather out of fear of addiction.
Naloxone does nothing to stop addiction, and therefore should not increase the incidence of new
users. Related to this fear is also the fear that readily available naloxone will promote increased
use of opioids among individuals already suffering from addiction. However, studies have shown
that 26.2% individuals who do overdose, and survive seek treatment within a month (Ohio
Department of Health) Dr. Judith Feinberg, a University of Cincinnati College of Medicine
professor has been quoted as saying that these efforts are prevention, not permission
explaining that they do not condone opioid abuse (Cornutte & Enquirer). Naloxone also causes
addicts to go into immediate withdrawals which can be very unpleasant. One firsthand account
of this experience, from a 19-year old Batavia man described it saying he felt electric static in
his legshad indescribable cramps and threw up. (He) woke up to a living hell (Cornutte &
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Enquirer). This adds more weight to the opinions of Dr. Feinberg and others who believe that
naloxone availability will not increase opioid abuse.
One of the more critical arguments against naloxone comes from individuals who believe
that individuals who believe that a consequence of drug use is death and those who abuse drugs
understand this and decide to use them anyways. While they may find this argument to be valid,
if there are any cases where it was not, it would be in the case of opiate addiction. Many cases of
opiate addiction start with the misuse of necessarily prescribed pain killers such as Vicodin,
OxyContin and Percocet after major events such as surgeries. In these cases, long-term proper
use can easily turn into addiction. Patients will get used to the effects and enjoy them, and can
easily begin to misuse them and other morphine derivatives such as heroin. Prescription opioids
are even responsible for more overdose deaths than both heroin and cocaine combined
(Tavemise). In many cases, opiate addiction starts out as a legitimate need, which eventually
turns to addiction. Another problem with this argument is the fact that addiction is considered a
medical disease and is classified under the DSM-V and treatment follows the disease model. If
we consider addiction a disease, we should not be sentencing addicts to death, but rather we
should devote our resources to helping them get better. Many addicts cannot get over addiction
on their own, but require medical attention, therapy, and additional outside help in order to
sufficiently kick their addiction. Even if someone is drug free, they are still considered a
recovering addict, and never an ex-addict.
Overall, I believe that allowing naloxone to be available to family members and friends
would be a smart choice for Ohio. The only things that could be negative consequences could all
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be solved through education to those who would be receiving the naloxone prescriptions.
Though the naloxone that would be widely distributed is fairly easy to administer, either through
a nasal spray or an intravenous pen similar to an Epi-pen, education would still be necessary.
One of the benefits of naloxone is that it is quick acting; this is also a downside, because it can
wear off before the opiates have a chance to completely lead the system, which can cause the
overdose to reappear. If properly educated, people who receive naloxone prescriptions would be
aware of this, and know that they should still contact medical professionals before or
immediately after the use of naloxone. According to statistics from Scioto Countys Poison
Death Review, 87% of people who died from an opiate overdose were not alone at the time of
their overdose, with adult family members being the most commonly present (Ohio Department
of Health). Also, 15,000 known deaths are caused annually, just from opiate overdose, and this
number represents close to half of known fatal drug overdose (The Network for Public Health
Law). If Scioto Countys Statistics are consistent with the rest of the country, this means that
making naloxone available to families could have the potential to save over 13,000 people a
year. In my opinion, this statistic should be enough to sway any persons views, simply out of
care for their fellow human being. However, this is not always the case. Some people require
monetary motivation in order for the reality of the benefits of naloxone legalization to truly set
in. In Ohio, drug overdose fatalities cost citizens 4.9 million dollars annually. The cost of an in-
patient hospital stay for an overdose is over 10,000. In comparison to these numbers, the cost of
naloxone administration kits is fairly cheap. Scioto Countys overdose reversal kit only costs $30
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(Ohio Department of Health). Considering the money and lives that allowing third-parties to
have access to naloxone could save, and argument against should.
One of the major legal problems with allowing third parties access to naloxone is simply
the fact that we would be supplying drugs to people who do not personally need it. However, we
know that naloxone is a fairly safe drug. It is non-addictive, and non-toxic, making it unpopular
for abuse. The only problems that it could cause are the results of non-medical professionals
the family and friends of the addicts, or any witness to the overdosepracticing medicine
without a license. This is where Good Samaritan laws could come into play. In Ohio, lawmakers
are looking into implementing Good Samaritan Laws that would protect not only the average
person administering naloxone, but they would also help protect drug users who contact
emergency medical services while under the influence. While these laws do not completely
absolve people from their actions, the do encourage people to do the right thing and be good
Samaritans. Current Ohio Good Samaritan laws protect first-aid and other life saving measures,
but do not currently cover naloxone administration (Huist Smith). If we were to legalize
naloxone for third-parties, adding naloxone to the existing laws would just be a minor extension.
The controversy then arises from the second part of the suggested law changes: protecting users
who call 911.
Currently, if you were to call 911 while under the influence or in possession of drugs, you
would face stiff penalties, which could include jail time. This is a provides discouragement for
those individuals who are face with a situation in which they either call 911 and save another
person who may be overdosing or having another bad reaction to drugs and face legal action, or
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they save themselves the trouble and the other person could possibly die. Even if they do call
emergency medical services, they may try to save the other person themselves first. According to
the Ohio Department of Health, qualitative research indicates that fear of police harassment is a
significant barrier to calling emergency services during an overdose event. Instead, witnesses
may try other methods (injecting saline, ice baths, etc.) to revive a person before finally calling
9-1-1, which can significantly reduce the time EMS providers have to reverse an overdose. If
given the option, people tend to look out for themselves first.
Implementing these new facets of the existing legislature could also lead to a decrease in death
from opiate overdose, especially when in conjunction with increased availability of naloxone.
However, some people may disagree with providing immunity to individuals involved with
illegal activities. While once again some may argue that people suffering from an overdose or
those using drugs deserve the ramifications of their actions, we must still acknowledge that
addiction is a disease. Immunity would allow those who need help to receive it, without causing
those around them to choose between their own safety and anothers. Also, these proposed
changes do not absolve drug users from all of the drug related crimes. They will still be held
responsible for serious drug offenses such as manufacturing, trafficking, and distributing
controlled substances. Individuals also have to take a specific course of action in order to receive
immunity. They must have reasonable belief that an overdose is occurring, report it in good
faith, remain on the scene, identify themselves, cooperate with officials and their offense must
have occurred during the course of the emergency. Officials also look at prior arrest and drug
records in order to determine if immunity should and will be granted (National Conference of
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State Legislatures).

In my opinion, these precautions take care of most of the doubts that people have about
the implementation of Good Samaritan laws. They allow drug users to seek medical attention
when necessary, but they do not completely absolve users from the more serious crimes that arise
from being more than just and addict. In my opinion, this protects people who are just suffering
from the disease of addiction, but not those who are benefitting from the exploitation of those
suffering from the disease.
Overall, it is my opinion that not only should naloxone be more widely available, but
there should be laws in place to protect individuals who are attempting to do the right thing. If
we continue to take measure to decrease the incidence of overdose, we may eventually be able to
turn around our nationwide opiate epidemic. Although the current measures do not accomplish
completely stopping opiate abuse, they do allow individuals to get the help they need, and come
back from experiences that could have previously killed them. For many that have to go through
these near-death experiences, it can be a wake-up call. By saving their lives, not only do we have
less overdose fatalities, but we can get more people into recovery. In recovery these individuals
can then turn their own experiences into lessons for others suffering from addiction. These first
person accounts of near-death and then recovery will do more to stop the opiate epidemic, than
the death of thousands of addicts a year.
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Failing to pass these laws is only going to harm our society even more. It will result in
more unnecessary deaths and the perpetuation of the belief that addiction is simply a personal
choice and problem not a disease. Allowing this idea to continue in our society will only
continue our ignorance, and love of blaming the victim. Addiction is a disease, and the sooner
we realize that as a whole, the sooner we can start to truly solve our problems. If we take the
effort now, we will not only save live and money now, but we have the potential to save the lives
and money of future generations.
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Bibliography
Curnutte, Mark, and Terry Enquirer. "Ohio, Ky. take steps to make naloxone available."USA
Today. Gannett, 7 Apr. 2013. Web. 22 Apr. 2014.
Davis, Corey. "LEGAL INTERVENTIONS TO REDUCE OVERDOSE MORTALITY:
NALOXONE ACCESS AND OVERDOSE GOOD SAMARITAN LAWS ." The
Network for Public Health Law. N.p., n.d. Web. 22 Apr. 2014.
"Drug Overdose Immunity "Good Samaritan" Laws." National Conference of State Legislatures.
N.p., 2014. Web. 22 Apr. 2014
Huist Smith, Joanne. "Ohio bill seeks 'Good Samaritan Law' to prevent overdose
deaths."Dayton, Ohio, News and Information. N.p., 24 Oct. 2013. Web. 22 Apr. 2014.
Levinthal, Charles F.. Drugs, behavior, and modern society. 8th ed. Boston: Allyn and Bacon,
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"Project D.A.W.N. (Deaths Avoided With Naloxone) Overdose Reversal Project." . Ohio
Department of Health, n.d. Web. 22 Apr. 2014.
Tavernise, Sabrina. "Hand-Held Treatment for Overdoses Is Approved." The New York Times.
The New York Times, 3 Apr. 2014. Web. 22 Apr. 2014.
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Trimble, Mandy. "Mom Wants Overdose Reversal Drug Available To Families of
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Wing, Nick. "This Drug Could Save Thousands Of Lives A Year, So Why Aren't We Using
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