In recent years, local, state, and federal government agencies have responded to the epidemic of fatal and non-fatal opioid related overdoses in the U.S. One response was enacting Good Samaritan and Naloxone Access laws. These laws were motivated by a reluctance of people to come to the aid of others out of fear of being involved with litigation. In almost every state Good Samaritan and Naloxone Access laws have been enacted. According to the Government Accountability Office (GAO), 47 states have enacted both laws.
The purpose of this article is to highlight research related to the impact of these laws on overdose deaths and non-fatal events.
Good Samaritan laws protect individuals who call for medical assistance for an overdose victim. These laws encourage individuals at the scene of an overdose to seek medical assistance for an overdose victim by protecting that individual from criminal penalties for certain drug offenses. For example, an individual who calls 911 for an overdose might be exempt from prosecution for unlawfully possessing opioids.This protection may also extend to the victim of the overdose. In addition, some states have established specific requirements that individuals must meet to be covered under the law, such as the individual must be the first person to seek medical assistance, provide their name and contact information, remain at the scene until assistance arrives, and cooperate with the authorities.
Good Samaritan laws state that if the victim is unconscious or cannot respond, a person who discovers or witnesses an emergency incident can act on the grounds of “implied consent.”
Good Samaritan laws do not apply to individuals giving aid in a reckless or careless manner; this is considered “gross negligence” and the negligent party may be liable to the victim for worsening their injuries.
No person is obligated by law to assist or carry out first aid in most states. However, the Good Samaritan laws of Vermont, Minnesota, and Rhode Island require bystanders to act in some limited capacity.
Naloxone Access laws protect individuals who administer the opioid-reversal drug naloxone. The goal is to reduce overdose deaths by broadening the pool of individuals who are authorized to possess t naloxone to include first responders, family members, friends, and those who interact with opioid users and may be in a position to assist during an overdose event. Naloxone Access laws may also authorize a pharmacist to dispense naloxone based on a Standing Order.
These laws offer some level of protection to those who administer naloxone from civil, criminal, or professional penalties if their actions result in accidental injuries to the overdose victim, such as breaking of the victim’s nose during the administration of nasal naloxone. These laws provide criminal immunity to individuals who call for medical assistance and some cover drug possession offenses. Good Samaritan laws define immunity based on specific drug offenses; Naloxone Access laws generally define immunity based on the type of proceedings, civil, criminal, or professional disciplinary,to which the immunities applied. The laws vary as to which of the three immunities they offer for naloxone administration.
These two laws vary from state to state and the level of protection to the individuals. Therefore, a review of the status within each state's jurisdiction when traveling is recommended.
Impact of Good Samaritan and Naloxone Access Laws
The GAO conducted a review that examined the association between the enactment of a Good Samaritan law and rates of reported opioid-related overdose deaths across states. Based on the results of five studies, the laws were associated with an overall lowering of the rates of opioid-related overdose deaths controlling for confounders. One study showed a statistically significant decrease of 15% in opioid-related overdose deaths associated with enactment of a Good Samaritan law. Two other studies also showed a decrease in opioid-related deaths; however, they were not statistically significant. One study reported a 14% decrease in the rate of opioid-related overdose deaths while another reported an 11 to 14% decrease. One study reported mixed findings of statistical significance within their analyses, with a decrease in overdose deaths ranging from 1 to 16% among the five states studied pre- and post-enactment of their Good Samaritan law.
Public Awareness of Good Samaritan Laws
The impact of these two laws is dramatically affected by the level of the public awareness of the law, which in turn affects an individual’s willingness to call 911 or provide overdose victims with emergency care on scene. While the research on public awareness of Good Samaritan laws has limitations, a review of a number of studies suggests that public awareness of these laws varies widely. Studies assessed public awareness of Good Samaritan laws among different types of individuals who were at high risk of being at the scene of an overdose (individuals who use drugs or requested naloxone) and found that knowledge of the laws varied widely ranging from 15 to 77%.
Public Willingness to Call 911
Three studies found a positive association between knowledge of the law and increased likelihood of calling 911. One qualitative study reported that some respondents with knowledge of their Good Samaritan law had reported a general sense that calling 911 had increased after enactment of the law, although others had expressed a more cautious view of its effect. Two studies quantitatively examined the association between knowledge of the Good Samaritan law and the likelihood of making 911 calls; both found a significant positive association, suggesting that individuals who are aware of these laws are more likely to call 911 in the case of an overdose.
While there are few studies on the effect of Good Samaritan laws on overdose hospitalization rates, one study reported a significant association between enactment of a law and an increase in hospitalization rates. The study compared rates of hospitalizations before and after New York enacted its law to hospitalization rates in New Jersey, without a Good Samaritan law during the study time period. The study found a significant association between enactment of New York’s law and an overall increase in accidental opioid overdose emergency department visits and inpatient hospital admissions, suggesting that more overdose victims may have received medical assistance at a hospital.
Law Enforcement Knowledge
The level of law enforcement knowledge of Good Samaritan laws can impact the extent to which the laws will be carried out and, consequently, may also influence individuals’ willingness to call 911. Studies on law enforcement knowledge of Good Samaritan laws suggest that law enforcement understanding of these laws may vary widely after passage and may be improved through targeted guidance and training. A number of studies examining law enforcement officers’ knowledge of Good Samaritan laws in their jurisdiction reported the following: One study reported that less than a quarter of officers surveyed reported being aware of the Good Samaritan law in their state over a year after its enactment. Of those officers who were aware of the law, many were unclear about the exact protections it afforded and almost none reported receiving clear guidance on the law from their department. One study showed that knowledge of the Good Samaritan law enacted over 2 years previously in their state among officers was almost 100% after receiving specific training on the topic. One study that included a sample of officers from law enforcement agencies that participated in the Office of National Drug Control Policy’s High Intensity Drug Trafficking Areas (HIDTA) program across 20 states, all of which had enacted Good Samaritan laws, reported more than 90% of the officers were aware of their state’s Good Samaritan law; however, many were not able to accurately describe the exact protections their state offered and to whom. Officers who had responded to the scene of an overdose within the last 6 months were significantly more likely to be aware of the Good Samaritan law overall and to correctly describe these protections. These and other studies stress the need for training of law enforcement officers related to their state’s Good Samaritan laws as one of the most useful training topics related to responding to an overdose scene.
Table 1. Type of protection under the Good Samaritan and Naloxone Access Laws by State
Immunity from Drug Possession Offenses
Immunity from Drug Delivery Offenses
Immunity from Arrest, Charges, and Prosecution
Immunity from Prosecution
Mitigating Factors at Sentencing
W.Va. Code Ann 16-47.4
W. Va. Code Ann 16-46-3 to -5,-7
35 Pa. Stat and Cons. Stat. Ann. 780.113.7
35 Pa. Stat and Cons. Stat. Ann. 780.113.8
Rev. Code. Ann 2925.11
Ohio Rev. Code Ann. 2925.61,3707.56, 4723.488, 4729.44, 4730.431, 4731.94, 942
Rev. Stat. Ann 218A.133
Rev. Stat. Ann. 217.186
Va. Code Ann. 18.2251.03
Va. Code Ann 8.01-225, 54.1-3408 (X)-(Y)
Drug Misuse: Most states have Good Samaritan Laws and research indicated they may have positive effects. United States Government Accountability Office Report to Congressional Committees. March 2021. (GAO-21-248).
What is the purpose of Good Samaritan Laws? Available at https://valientemott.com/legal-terminology/good-samaritan-act-laws/
Good Samaritan Laws: What exactly do they protect? J.L. Rathner. Jan 2019. Available at https://www.lhsfna.org/good-samaritan-laws-what-exactly-do-they-protect/
Nicole Adams, Ellen Gundlach, Ching-Wei Cheng, “An analysis of state-level policies and opioid overdose deaths,” Western Journal of Nursing Research, vol. 42, no. 7 (2020): p. 535-542.
Danielle N. Atkins, Christins Piette Durrance, Yuna Kim, “Good Samaritan harm reduction policy and drug overdose deaths,” Health Services Research, vol. 54, no. 2 (2019): p. 407-417.
Caleb J. Banta-Green, Leo Beletsky, Jennifer A. Schoeppe, Phillip O. Coffin, Patricia C. Kuszler, “Police officers’ and paramedics’ experiences with overdose and their knowledge and opinions of Washington state’s drug overdose-naloxone-good Samaritan law,” Journal of Urban Health: Bulletin of the New York Academy of Medicine, vol. 90, no. 6 (2013): p. 1102-1111.
Tristan I. Evans, Scott E. Hadland, Melissa A. Clark, Traci C. Green, Brandon D.L. Marshall, “Factors associated with knowledge of a Good Samaritan Law among young adults who use prescription opioids non-medically,” Harm Reduction Journal, vol. 13, no. 24 (2016): p. 1-6.
Andrea Jakubowski MD, Hillary V. Kunins MD, MPH, Zina Huxley-Reicher BA, Anne Siegler DrPH, “Knowledge of the 911 Good Samaritan law and 911-calling behavior of overdose witnesses,” Substance Abuse, vol. 39, no. 2 (2018): p. 233-238.
Stephen Koester, Shane R. Mueller, Lisa Raville, Sig Langegger, Ingrid A. Binswanger, “Why are some people who have received overdose education and naloxone reluctant to call emergency medical services in the event of an overdose?” International Journal of Drug Policy, vol. 48 (2017): p. 115-124.
Amanda D. Latimore, Rachel S. Bergstein, “Caught with a body yet protected by law? Calling 911 for opioid overdose in the context of the Good Samaritan Law,” International Journal of Drug Policy, vol. 50 (2017): p. 82-89.
Chandler McClellan, Barrot H. Lambdin, Mir M. Ali, Ryan Mutter, Corey S. Davis, Eliza Wheeler, Michael Pemberton, Alex H. Kral, “Opioid-overdose laws association with opioid use and overdose mortality” Addictive Behaviors, vol. 86 (2018): p. 90-95.
Holly Nguyen, Brandy R. Parker, “Assessing the effectiveness of New York’s 911 Good Samaritan Law – evidence from a natural experiment,” International Journal of Drug Policy, vol. 58 (2018): p. 149-156.
Daniel I. Reese, Joseph J. Sabia, Laura M. Argys, Dhaval Dave, Joshua Latshaw, “With a little help from my friends: The effects of Good Samaritan and Naloxone Access Laws on opioid-related deaths,” Journal of Law and Economics, vol. 62 (2019): p. 1-28.
Kristin E. Schneider PhD, Ju Nyeong Park PhD, Sean T. Allen DrPH, Brian W. Weir PhD, Susan G. Sherman PhD, “Knowledge of Good Samaritan Laws and beliefs about arrests among persons who inject drugs a year after policy change in Baltimore, Maryland,” Public Health Reports, vol. 0, no. 0 (2020): p. 1-7.
Dennis P. Watson, Bradley Ray, Lisa Robison, Philip Huynh, Emily Sightes, La Shea Walker, Krista Brucker, Joan Duwve, “Lay responder naloxone access and Good Samaritan law compliance: postcard survey results from 20 Indiana counties,” Harm Reduction Journal, vol. 15, no. 18 (2018): p. 1-8.
Cathy Zadoretsky, Courtney McKnight, Heidi Bramson, Don Des Jarlais, Maxine Phillips, Mark Hammer, Mary Ellen Cala, “The New York 911 Good Samaritan Law and opioid overdose prevention among people who inject drugs,” World Medical and Health Policy, vol. 9, no. 3 (2017): p. 318-340.
Cory D. Saucier, Nickolas Zaller, Alexandria MacMadu, Traci C. Green, “An initial evaluation of Law Enforcement Overdose Training in Rhode Island” Drug and Alcohol Dependence, vol. 162 (2016): p. 211-218.
Jennifer J. Carroll, Sasha Mital, Jessica Wolff, Rita K. Noonan, Pedro Martinez, Melissa C. Podolsky, John C. Killorin, Traci C. Green, “Knowledge, preparedness, and compassion fatigue among law enforcement officers who respond to opioid overdose,” Drug and Alcohol Dependence, vol. 217 (2020): pp. 1-8.