British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
Int J Drug Policy. 2021 Apr;90:102773. doi: 10.1016/j.drugpo.2020.102773. Epub 2020 May 25.
The United States (US) and Canada are in the midst of an opioid overdose epidemic. Many people who use illicit drugs (PWUD) do not call an emergency number 911 at the scene of an overdose due to fear of arrest. In the US and Canada, when an individual calls 911, both emergency medical services (EMS) and police are notified to attend the overdose event. In response, many settings in North America have introduced drug-related 'Good Samaritan' laws (GSLs) that aim to encourage PWUD to call 911 by providing legal immunity (mainly protections from drugs possessed for personal use) to those at the scene of the overdose. However, little is known about the effectiveness of these laws in increasing calls to 911.
We conducted a literature review of the published literature between 2005 and 2019 to examine the effectiveness of GSLs. Searches were referenced using keywords that included: "good samaritan", "overdose", "emergency services", and "drug use".
Among 68 articles identified, after eligibility screening, 12 publications were deemed to meet the inclusion criteria. These publications were largely quantitative observational studies (9/12), with a minority (3/12) being qualitative in design. Two major themes emerged: "knowledge of GSLs and calling EMS" and "overdose-related hospital admissions and mortality assessment".
At this time, the current body of evidence regarding the effectiveness of GSLs in increasing calls to EMS and reducing drug-related harms is limited and mixed. Studies show that PWUD have low levels of knowledge regarding GSLs while some evidence suggests their effectiveness in increasing calls to EMS at the scene of an overdose. Given the current overdose crisis, further investigation is warranted to establish the effectiveness of these laws in reducing drug-related harms.
美国和加拿大正处于阿片类药物过量流行之中。许多使用非法药物的人(PWUD)由于担心被捕而不在现场拨打紧急电话号码 911。在美国和加拿大,当个人拨打 911 时,紧急医疗服务(EMS)和警察都会接到通知前往过量用药现场。为了应对这种情况,北美许多地方都出台了与毒品相关的“好心人”法律(GSL),旨在通过为现场过量用药者提供法律豁免(主要是对个人使用的毒品的保护)来鼓励 PWUD 拨打 911。然而,这些法律在增加拨打 911 电话方面的有效性知之甚少。
我们对 2005 年至 2019 年期间发表的文献进行了文献综述,以研究 GSL 的有效性。搜索参考了包括以下关键字的关键词:“好心人”、“过量”、“急救服务”和“药物使用”。
在确定的 68 篇文章中,经过资格筛选后,有 12 篇出版物被认为符合纳入标准。这些出版物主要是定量观察性研究(9/12),少数(3/12)是定性设计。出现了两个主要主题:“GSL 知识和呼叫 EMS”和“与过量用药相关的住院和死亡率评估”。
目前,关于 GSL 增加对 EMS 的呼叫并减少与毒品相关的危害的有效性的现有证据有限且不一致。研究表明,PWUD 对 GSL 的了解程度较低,而一些证据表明它们在增加现场过量用药时对 EMS 的呼叫有效性。鉴于目前的过量用药危机,有必要进一步调查以确定这些法律在减少与毒品相关的危害方面的有效性。