The Effect of Naloxone Access Laws on Fatal Synthetic Opioid Overdose Fatality Rates

Area of Science:

• Public Health
• Epidemiology
• Health Policy

Background:

• Rising rates of fatal synthetic opioid overdoses necessitate effective state-level interventions.
• Many states have implemented policies and increased service capacity to combat synthetic opioid fatalities.
• Understanding the impact of policy interventions, such as naloxone access laws (NALs), is critical for reducing synthetic opioid deaths.

Purpose of the Study:

• To estimate the impact of naloxone access laws (NALs) on synthetic opioid overdose fatalities at the state level.
• To analyze the relationship between NALs and synthetic opioid overdose death rates while controlling for other relevant factors.

Main Methods:

• A multivariable longitudinal linear mixed-effects model with a random intercept was employed.
• The model assessed the relationship between NALs and synthetic opioid overdose death rates.
• Controlling variables included Good Samaritan laws, opioid prescription rates, and medication for opioid use disorder (MOUD) capacity, using a quadratic time trajectory. Data were sourced from the National Vital Statistics System.

Main Results:

• The presence of a naloxone access law (NAL) showed a significant negative relationship with fentanyl overdose death rates (multivariable P=.010).
• Other significant factors influencing overdose death rates included quadratic time (P<.001), MOUD capacity (P=.009), and Good Samaritan Laws (P=.018).

Conclusions:

• Naloxone standing orders are strongly associated with a reduction in fatal synthetic opioid overdoses.
• NALs, MOUD treatment capacity, and Good Samaritan laws significantly impact synthetic opioid overdose death rates.
• The utilization of naloxone should be a cornerstone of state strategies aimed at reducing overdose fatalities.