Substance Abuse and Mental Health Services Administration, Rockville, MD, United States.
RTI International, San Francisco, CA, United States; University of California-San Francisco, San Francisco, CA, United States; University of Washington, Seattle, WA, United States.
Addict Behav. 2018 Nov;86:90-95. doi: 10.1016/j.addbeh.2018.03.014. Epub 2018 Mar 19.
Since the 1990's, governmental and non-governmental organizations have adopted several measures to increase access to the opioid overdose reversal medication naloxone. These include the implementation of laws that increase layperson naloxone access and overdose-specific Good Samaritan laws that protect those reporting overdoses from criminal sanction. The association of these legal changes with overdose mortality and non-medical opioid use is unknown. We assess the relationship of (1) naloxone access laws and (2) overdose Good Samaritan laws with opioid-overdose mortality and non-medical opioid use in the United States.
We used 2000-2014 National Vital Statistics System data, 2002-2014 National Survey on Drug Use and Health data, and primary datasets of the location and timing of naloxone access laws and overdose Good Samaritan laws.
By 2014, 30 states had a naloxone access and/or Good Samaritan law. States with naloxone access laws or Good Samaritan laws had a 14% (p = 0.033) and 15% (p = 0.050) lower incidence of opioid-overdose mortality, respectively. Both law types exhibit differential association with opioid-overdose mortality by race and age. No significant relationships were observed between any of the examined laws and non-medical opioid use.
Laws designed to increase layperson engagement in opioid-overdose reversal were associated with reduced opioid-overdose mortality. We found no evidence that these measures were associated with increased non-medical opioid use.
自 20 世纪 90 年代以来,政府和非政府组织采取了多种措施来增加阿片类药物过量逆转药物纳洛酮的可及性。这些措施包括实施增加非专业人员纳洛酮获取途径的法律以及针对特定药物过量的“好撒玛利亚人法”,这些法律保护报告药物过量的人免受刑事处罚。这些法律变化与药物过量死亡率和非医疗用阿片类药物使用之间的关联尚不清楚。我们评估了(1)纳洛酮获取法律和(2)药物过量“好撒玛利亚人法”与美国阿片类药物过量死亡率和非医疗用阿片类药物使用之间的关系。
我们使用了 2000-2014 年国家生命统计系统数据、2002-2014 年全国药物使用和健康调查数据以及纳洛酮获取法律和药物过量“好撒玛利亚人法”地点和时间的主要数据集。
到 2014 年,30 个州制定了纳洛酮获取和/或“好撒玛利亚人法”。有纳洛酮获取法律或“好撒玛利亚人法”的州,阿片类药物过量死亡率分别降低了 14%(p=0.033)和 15%(p=0.050)。这两种法律类型与阿片类药物过量死亡率的关联在种族和年龄上存在差异。没有观察到任何被检查的法律与非医疗用阿片类药物使用之间存在显著关系。
旨在增加非专业人员参与阿片类药物过量逆转的法律与降低阿片类药物过量死亡率有关。我们没有发现这些措施与非医疗用阿片类药物使用增加有关的证据。