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Good Samaritan Laws and the Opioid Crisis: What You Need to Know

The nation’s on-going opioid crisis has led 45 states and the District of Columbia to expand and revise existing Good Samaritan laws to protect bystanders and victims of an overdose from being prosecuted for offenses related to drug possession. The state of Missouri passed a law in 2017, recognizing that time is often of the essence in treating overdoses, and fear of arrest for themselves or for the victim of the overdose may be a factor in preventing bystanders for calling for medical assistance in time. 

These changes in the law came after years of rising overdose deaths; over 1000 Missourians died as a result of overdose in 2015 alone. Over 70,000 people died nationwide in 2017 from overdose-related causes. Drug policy reform advocates and those directly affected by this crisis have worked for years at the state level in Missouri and around the country to persuade lawmakers to update the law to recognize that lives may have been lost out of fear of prosecution. Dr. Randall Williams, director of the Department of Health and Senior Services, had this to say at the time of the law’s expansion: 

"I want every Missourian to take this to heart: call 911 in the case of an overdose. Our first responders are ready and able to respond but time has to be on their side if they're going to be effective. Make the call and rest assured that our priority is to save lives, not pursue criminal charges. We think this is especially important for young people to remember” (MO Health and Senior Services press release, 2017).

Preliminary evidence suggests these steps and other similar efforts have already had an effect. According to the Centers for Disease Control, deaths resulting from overdoses last year fell for the first time since 1990, by an estimated 5.1 percent. However, concerns remain that overdose deaths go undercounted, and that most remain preventable. 

Due to the newness of these laws, it is possible that first responders may not be aware of these statutes, so it is crucial that you know your rights in such a situation. Further, some drug policy reform advocates believe that while these expansions of existing laws are necessary, they often do not go far enough to protect bystanders from prosecution. For example, the Drug Policy Alliance notes that as of 2017, New Mexico’s law does not protect an individual on probation or parole from being detained and re-incarcerated if found on the scene of an overdose. 

Thankfully, Missouri’s Good Samaritan law does provide protection for those found to be violating their probation or parole in such circumstances, but it is important to note the law does not provide blanket immunity. Missouri’s law protects both the Good Samaritan and the victim of an overdose from prosecution from these offenses: 

  • Possession of a Controlled Substance

  • Possession of Drug Paraphernalia 

  • Possession of An Imitation Controlled Substance

  • Keeping or Maintaining a Public Nuisance 

  • Sale of Alcohol to a Minor

  • Purchase or possession of alcohol by a minor

  • Possession of an altered ID

(Revisor of Missouri Statutes Chapter 195, effective Aug. 2017).

Again, it’s important to remember that this immunity does not protect against charges not specifically listed above, including offenses related to tampering with evidence, distribution of a controlled substance, and manufacturing a controlled substance. 

Good Samaritan Laws in Context

Expansions of Good Samaritan exceptions are only a piece of broader efforts to reform drug laws, but not all attempts are created equal. As we’ll see below, sometimes these efforts actually undermine other adopted reforms. 

Temple University’s Prescription Drug Abuse Policy System program has created an interactive map of each state’s Good Samaritan laws. The variation noted above is made all the more striking when overlaid upon a map of the United States. For example, only 18 states have codified factoring in a Good Samaritan call into sentencing mitigation for those arrested on other charges. The National Conference of State Legislatures notes that some states, including Missouri, “specify that immunity for covered offenses is not ground for suppression of evidence of other crimes.” It is important for citizens who may be affected by these laws to recognize this variation across states, as behavior that may be protected in one state might not be protected in a neighboring state. 

The opioid crisis in the United States took years to develop. Pharmaceutical companies and large retailers helped to drive demand for these synthetic drugs without regard to potential consequences. Evidence suggests that pharmaceutical companies downplayed the strength of these drugs, and thus the dangers of addiction to them, to doctors and the public in an effort to increase their profits. 

After being positioned by big business as a class of wonder drugs that would lead to less addiction, it has been suggested that increased opioid use has been a direct pipeline to the use of illegal and even more dangerous opiates like heroin. When people no longer have easy access to prescription opioids, they may turn to illegal drugs to continue their use. And even if users believe they are purchasing pharmaceutical-grade drugs, they may in fact be counterfeit and possibly adulterated with far more powerful drugs like fentanyl. 

Further, our nation’s punishment-focused criminal-legal system has often exacerbated rather than solved the street-level problems caused by decisions in board rooms. Some newly-enacted or revised drug-induced homicide laws work at cross-purposes with expansions of Good Samaritan laws. Currently twenty states have drug-induced homicide or manslaughter laws that may lead to arrest and prosecution for providing drugs that eventually caused an overdose-related death. More states are considering their adoption. Reform advocates have argued that this approach has little deterrent effect. In a comment to the Associated Press, Lindsay LaSalle, director of public health law and policy for the Drug Policy Alliance said, “Supply-side tactics really haven’t been proven to work over the past five decades they’ve been implemented…I think the focus needs to be on the demand.” Some of these laws, recently adopted or not, contain harsh mandatory minimum sentences that in effect cancel out the Good Samaritan laws mentioned above. 

Likewise, opposition to expanded access to naloxone, a drug that can reverse opiate overdoses, has been largely based on evidence-free claims.  Also known by its brand name Narcan, naloxone has been instrumental in preventing overdose deaths for decades and its use is simple enough for it to be administered by lay people without medical training. Many states have already recognized the importance of providing access to the drug, including the state of Missouri. At the same time Missouri updated its Good Samaritan law, the Department of Health and Senior Services also issued a standing order for the drug; this makes the drug accessible to the general public without a doctor’s prescription. 

It is clear that the opioid crisis will not solve itself. Thousands of lives have been lost, and thousands more lives have ruined by the wreckage of misguided anti-drug policies.  Common sense reforms like Missouri’s expansion of its good Samaritan laws, or the issuing of standing orders at pharmacies for live-saving medicines like naloxone, can help to ease these burdens on individuals and society.