Good Samaritan Laws Research Articles

The Association of State Opioid Misuse Prevention Policies With Patient- and Provider-Related Outcomes: A Scoping Review.

In the midst of an opioid crisis in the United States, an influx of state opioid misuse prevention policies has provided new opportunities to generate evidence of policy effectiveness that can inform policy decisions.We conducted a scoping review to synthesize the available evidenceon the effectiveness of US state interventions to improve patient and provider outcomes related to opioid misuse and addiction. We searched six online databases to identify evaluations of state opioid policies. Eligible studies examined legislative and administrative policy interventions that evaluated (a) prescribing and dispensing, (b) patient behavior, or (c) patient health. Seventy-one articles met our inclusion criteria, including 41 studies published between 2016 and 2018. These articles evaluated nine types of state policies targeting opioid misuse. While prescription drug monitoring programs (PDMPs) have received considerable attention in the literature, far fewer studies addressed other types of state policy. Overall, evidence quality is very low for the majority of policies due to a small number of evaluations. Of interventions that have been the subject of considerable research, promising means of reducing the volume and dosages of opioids prescribed and dispensed include drug supply management policies and robust PDMPs. Due to low study number and quality, evidence is insufficient to draw conclusions regarding interventions targeting patient behavior and health outcomes, including naloxone access laws and Good Samaritan laws. Recent research has improved the evidence base on several state interventions targeting opioid misuse. Specifically, moderate evidence suggests that drug supply management policies and robust PDMPs reduce opioid prescribing. Despite the increase in rigorous evaluations, evidence remains limited for the majority of policies, particularly those targeting patient health-related outcomes.

Out-of-hospital cardiopulmonary resuscitation: a position statement of the Lebanese Society of Cardiology and the Lebanese Society of Emergency Medicine.

Out of hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Early cardiopulmonary resuscitation (CPR) and early defibrillation are key to improving outcomes of patients with OHCA including return of spontaneous circulation (ROSC) and survival to hospital discharge with good neurologic outcomes. Lebanon like other developing countries, suffers from absence of organized prehospital cardiac arrest care bundle and from absence of a legal framework for community involvement in cardiac arrest care. Scientific societies, involved non-governmental organizations (NGOs) and local governmental stakeholders organized a national meeting to launch a strategy aiming at improving OHCA outcomes in Lebanon. This article represents a position statement of the Lebanese Society of Cardiology and the Lebanese Society of Emergency Medicine summarizing the strategy to improve out-of-hospital CPR. Participating stakeholders developed and submitted a law proposal of a "Good Samaritan Law" to the Lebanese parliament. Several of activities were also launched aiming at establishing public access defibrillation programs and at training bystanders in different areas in Lebanon to perform bystander CPR and use automated external defibrillators (AEDs). Additional recommendations were proposed to local emergency medical system (EMS) agencies to improve prehospital care and introduce medical direction to prehospital activities.

중국 민사법 상 착한사마리아인법의 법적지위에 관한 고찰

중국 민사법 상 착한사마리아인법의 법적지위에 관한 고찰

Good Samaritan Law and bystander cardiopulmonary resuscitation: Cross-sectional study of 1223 first-aid learners in Hong Kong

Background:Similar to many Asian cities, there is no statutory provision for the determination of the duty borne by bystander first aiders when assisting victims in Hong Kong.Objectives:The aim of this study was to explore the views of a Good Samaritan Law by first-aid learners in Hong Kong.Methods:A cross-sectional survey was conducted among first-aid course participants from the two largest training providers in Hong Kong using a self-administered questionnaire.Results:In total, 1223 questionnaires were completed and returned. Only 12.1% (147/1211) of participants have ever heard of Good Samaritan Law. After a short description of Good Samaritan Law was provided, 71.4% (848/1188) agreed or strongly agreed on a Likert-type scale that a Good Samaritan Law is necessary; 95.2% (1148/1223) support the enactment of a Good Samaritan Law in Hong Kong.Conclusion:The majority of first-aid learners in Hong Kong supported the enactment of Good Samaritan Law. Overcoming the fear of litigation and improving bystander cardiopulmonary resuscitation rate is a priority for improving survival rates from sudden cardiac arrest in Hong Kong.

Opioid overdose knowledge among college students in a high overdose death state

ABSTRACTThe goal of this study was to investigate university students’ knowledge about the identification of opioid overdose and actions to take in an overdose emergency. A cross-sectional, anonymous, 36-item survey was developed and administered to West Virginia University (WVU) students. Overdose knowledge was assessed using the Opioid Overdose Knowledge Scale (OOKS). Demographic information, health insurance coverage status, previously receiving an opioid prescription, and knowledge about West Virginia Good Samaritan laws were also collected. Online survey responses were collected via REDCap. The study sample (n = 214) was 90% white, 72.5% female, had a mean age of 24.8 years, and over half previously received a prescription opioid (51.9%). Additionally, 6.5% reported witnessing an overdose in the past year, and 15.9% previously received naloxone training. Overall, our participants had an average score of 30.9 out of 45 on the OOKS. Participants who previously received naloxone training scored higher overall on the OOKS than participants who did not (p < .001). Similarly, participants who previously received a prescription for an opioid also scored higher than participants who had never had a previous prescription for an opioid (p < .001). University students’ knowledge suggests that previous exposure to opioid prescriptions and naloxone training increase a student’s knowledge about opioid overdose. This information is not surprising; however, this does make the case that students may benefit from brief overdose education programs that could be implemented across university health education curricula. However, a larger effort may need to be implemented to encourage students to participate in such programs.

The Chinese Model of the Good Samaritan Law

최근 난징(南京)의 펑우(彭宇)사건을 시작으로 구조자가 타인을 구조하고도 피구조 자가 구조자를 고소하는 일이 빈번이 발생함으로써 사회문제가 발생하고 있다. 중국은 전통적으로 타인의 어려움을 보고도 그냥 지나치지 않는 풍습을 자랑으로 삼고 있다. 하지만, 최근에 발생한 펑우 사건과 관련하여 타인이 위험에 처하여 도움을 청하는 경우에도 상호간의 불신임으로 인하여 도움을 주지 않고 그대로 지나치는 경우가 증가 하고 있다. 연구결과에 의하면 84.9%의 사람이 길거리에 쓰러진 노인을 보고도 직접 도움을 주지 않고, 국가에서 운영하는 전문구조요원에 연락하여야 한다고 응답하였다. 하지만 중국은 응급구조 시스템이 완전치 않아 응급구조팀이 도착하게 되면, 시간이 지체되어 더욱 위험한 사항에 처하게 된다. 이로 인해 착한사마리아인법의 중국법에의 적용에 관하여 논의가 새로이 되고 있다. 2017년에 시행된 민법총칙 제184조의 규정을 대표적인 법적 근거로 삼고 있는데, 구체 적으로 보면, “긴급구조행위로 인하여 피구조자에게 손해가 발생한 경우 구조자는 민 사책임을 부담하지 않는다.”라고 규정함으로써 구조자의 선량한 구조행위를 보호하고 있다. 또한 침권책임법 제23조에서도 타인의 위험을 방지 및 제거하기 위하여 어떤 조치를 취하다 구조자 자신에게 손해가 발생한 경우에도 구조자를 보호하고 있다. 본 연구에서는 현재 중국에서 사회적 문제로 되고 있는 이른바 ‘타인의 긴급구조요 청에 대한 무관심’에 대하여 착한사마리아인법과 연관하여 검토한다. 이럴 인정하고 있는 국가들의 입법과 중국의 현행법을 비교함으로써 중국법 상 적용에 있어 어떠한 문제가 있는지 고찰한다. 이를 통해 중국민법에서의 ‘사력구제’로 인한 민사책임실무 에 있어 참고자료로 활용할 수 있길 바란다.

Navigating social norms of injection initiation assistance during an overdose crisis: A qualitative study of the perspectives of people who inject drugs (PWID) in Vancouver, Canada

Despite the proliferation of fentanyl and fentanyl-adulterated opioids in North America, the impacts of this drug market change on injection initiation processes have not been examined. With the aim of informing structural interventions to address injection initiation and related harms, we explore how people who inject drugs (PWID) in Vancouver, Canada understand and navigate social norms of initiating others into injecting within the context of an overdose crisis. In-depth qualitative interviews were conducted with 19 PWID who reported helping someone inject for the first time. Participants were recruited from two cohort studies of PWID. Participants articulated moral dilemmas about assisting others with injecting. While participants described a 'moral code' prohibiting assisting injection-naïve individuals, this code was not the sole consideration shaping social action around injection initiation. Rather, PWID exercised agency about whether and how to assist novice injectors within the context of constraining and enabling social norms around practicing interpersonal responsibility. Changes to the drug market heightened feelings of moral culpability and criminal liability among PWID who assisted others into injection, given that injecting heightened initiates’ risk of overdose. These concerns operated in tension with the aim of protecting novice injectors from harms associated with an increasingly potent and unpredictable drug supply by providing them with injection assistance, education and supervision. Our analysis of how PWID practice interpersonal responsibility helps conceptualise how ‘moral codes’ prohibiting initiation assistance are managed and negotiated amidst structural vulnerability. Structural interventions reducing the vulnerability of novice injectors should be prioritized, including the implementation of supervised injection sites allowing for assisted injection, Good Samaritan laws, and policy changes conducive to a safer drug supply.

A Nurse Practitioner’s Guide to Airline Medicine

Several factors make commercial aircraft travel hazardous to passengers who may be sick or vulnerable to the strenuous environmental conditions of a modern jet airliner. These risk factors can expose a practitioner’s license if the practitioner volunteers to help a passenger who is having a medical emergency aboard an airliner. Understanding the history of medical emergencies during flight, the pathophysiology encountered by passengers, and, subsequently, the legal basis of medical emergencies aboard a commercial airline can be a very valuable process for any health care practitioner. A Good Samaritan law can be a useful piece of legislation for any practitioner.

C10 Opioid Reversal: Improving Access to Naloxone Can Save Lives

Improving public access to and knowledge of the opioid reversal agent naloxone are part of national, state, and community harm reduction recommendations to prevent death from overdose from prescription and illicit opioids. Naloxone is part of a comprehensive plan to address the opioid epidemic that includes prevention, treatment and recovery. The purpose of this presentation is to underscore the importance pain management nurses play in screening patients for risk for overdose and to provide options for obtaining naloxone. According to Substance Abuse and Mental Health Services Administration (SAMHSA) high risk individuals encompass more than those using illicit opioids or misusing prescription opioids and should also include those using opioids for treatment of chronic pain, opioid rotation, or reduced opioid tolerance. Since overdose often occurs at home and Emergency Medical Services response times vary, having naloxone available for those who would most likely be at the scene can save lives. The aim of the eight month pilot was to determine the feasibility of emergency department (ED) nurses and providers screening for and providing high risk ED patients with naloxone nasal spray (NNS) and harm reduction patient teaching at discharge. The setting included four EDs within one hospital system. Methods used included involving the ED staff in developing the protocol including workflow, order set, and patient teaching resources. Staff education was provided prior to implementation. Of the 154 patients in the pilot 140 (91%) took the provided NNS for home use, demonstrating the acceptability of the intervention and feasibility of the pilot protocol. The presentation will also include options for improving access to NNS for patients, families and communities; strategies to address stigma about and barriers to caring for patients with SUD and hospital-wide education on SUD. In addition, Good Samaritan laws, naloxone pharmacokinetics and resources for program implementation will be discussed.

착한 사마리아인 의사가 되어야 하는가?*

Good Samaritan laws are designed to encourage individuals, including physicians, to provide medical care in emergency situations. Such laws purport to protect physicians and others who volunteer to provide assistance during emergencies. However, whether Good Samaritan laws, such as the Korean Emergency Service Act article 5-2, really do protect physicians is uncertain and varies from case to case. When attempts at providing emergency medical care do not go as expected, and legal disputes arise, such disputes will inevitably affect how other physicians respond to future medical emergencies. In this article I argue that the current legislation needs to be revised and expanded to fully protect physicians who provide emergency medical care in good faith. In particular, the relevant laws must also protect physicians who render emergency aid hospital settings when they have no pre-existing duty to provide assistance.

PUBLIC POLICY Session 3: CONNECTING SURPLUS MEDICINE WITH PATIENTS: POLICY & TECHNOLOGY: Session 213

About 50 million people in the United States report skipping prescription drugs due to costs, which is detrimental to individual health outcomes and also increases costs for the entire healthcare system. Yet at the same time, over $5 billion of unexpired, unopened medicine from healthcare institutions goes to landfills, waterways and incinerators each year. Recognizing donation as a preferable alternative to destruction, states have passed Good Samaritan laws allowing and protecting the donation of still usable, safe medicine. The nonprofit SIRUM has leveraged these policy changes and built technology to convert the standard medicine destruction process into a donation process, seamlessly delivering medicine to charitable pharmacies serving patients in need.

With a Little Help from My Friends: The Effects of Good Samaritan and Naloxone Access Laws on Opioid-Related Deaths

AbstractIn an effort to address the opioid epidemic, a majority of states recently passed some version of a Good Samaritan law (GSL) and/or a naloxone access law (NAL). Good Samaritan laws provide ...

State variation in opioid treatment policies and opioid-related hospital readmissions

BackgroundState policy approaches designed to provide opioid treatment options have received significant attention in addressing the opioid epidemic in the United States. In particular, expanded availability of naloxone to reverse overdose, Good Samaritan laws intended to protect individuals who attempt to provide or obtain emergency services for someone experiencing an opioid overdose, and expanded coverage of medication-assisted treatment (MAT) for individuals with opioid abuse or dependence may help curtail hospital readmissions from opioids. The objective of this retrospective cohort study was to evaluate the association between the presence of state opioid treatment policies—naloxone standing orders, Good Samaritan laws, and Medicaid medication-assisted treatment (MAT) coverage—and opioid-related hospital readmissions.MethodsWe used 2013–2015 hospital inpatient discharge data from 13 states from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. We examined the relationship between state opioid treatment policies and 90-day opioid-related readmissions after a stay involving an opioid diagnosis.ResultsOur sample included 383,334 opioid-related index hospitalizations. Patients treated in states with naloxone standing-order policies at the time of the index stay had higher adjusted odds of an opioid-related readmission than did those treated in states without such policies; however, this relationship was not present in states with Good Samaritan laws. Medicaid methadone coverage was associated with higher odds of readmission among all insurance groups except Medicaid. Medicaid MAT coverage generosity was associated with higher odds of readmission among the Medicaid group but lower odds of readmission among the Medicare and privately insured groups. More comprehensive Medicaid coverage of substance use disorder treatment and a greater number of opioid treatment programs were associated with lower odds of readmission.ConclusionsDifferences in index hospitalization rates suggest that states with opioid treatment policies had a higher level of need for opioid-related intervention, which also may account for higher rates of readmission. More research is needed to understand how these policies can be most effective in influencing acute care use.

Public Awareness of the Emergency Medical Services in Maharashtra, India: A Questionnaire-based Survey.

Background and objectivesThe most widely used emergency medical services (EMS) model in India is the ‘108’ emergency service which primarily functions as an emergency response system to attend patients in need of critical care, trauma and accident victims. This is an observational cross-sectional study which was conducted using a questionnaire that asks the participants about their awareness and opinion of the current EMS system. The results of this study will enable us to ascertain the level of awareness of EMS among the population and address any misconceptions if they exist.Materials and methodsAll participants had to complete a 24-item self-administered questionnaire consisting of eight socio-demographic questions and 16 questions based on the EMS system. Questions regarding the development of the ‘112’ unified emergency service were also included. The convenient sampling method was used for data collection. The distribution of responses was examined using frequencies and percentages. Further analysis was done using the Chi-square test to compare responses between various subgroups based on the age, gender, profession, and level of education.ResultsA total of 1220 people from the state of Maharashtra responded to the survey and the maximum responses were from Mumbai. Majority of the respondents (59.2%) were from the age group of 15 to 30 years and, most of our responders had received education at the graduate level or above (78.2%). Only 17.5% of the respondents said that they will try to check for responsiveness if they saw a person lying unconscious by the side of the road with the scene being free of any danger. Interestingly, 78.9% of the healthcare professionals who participated in this survey would not check for responsiveness. Only 76.2% of the respondents knew that '108' is the number to dial in case of a medical emergency and about a quarter of them was not aware of it. It may seem that a good number of people are aware of the number. However, with the high number of fatalities occurring every day due to lack of medical facilities and a high current annual death toll on the roads, 100% of the population should know the emergency number. Only 20.2% of the respondents had called the EMS and asked for an ambulance. 68.5% of the respondents would immediately move out of the way and 27.5% of them would move out of their way if the ambulance’s lights and sirens were on. About two-thirds of the respondents were unaware of the development of a unified emergency number (112). However, a large majority (82.9%) were in favor of having a unified emergency number instead of a different number for each emergency. Only 43.8% of the respondents were of the opinion that the current EMS coverage was inadequate. 24.9% of the participants rated the current EMS as good, whereas 53.5% rated the EMS average and 16.9% rated it poor.ConclusionsAn effort should be made to make 100% of the population aware of this service. The first step for increasing awareness would be starting various advertisement campaigns. The next step would be to implement the unified emergency number (112) to address all kinds of distress calls such as police, fire, and ambulance. A very small proportion of the population is trained in first-aid or basic trauma life support. Awareness campaigns and training sessions for the general public should be conducted for the same. It is also necessary to spread awareness and help the populace know about the Good Samaritan law.

Good Samaritan Laws and Graduate Medical Education: A Tristate Survey.

ObjectiveTo assess the awareness of Good Samaritan laws among residents and fellows and the factors affecting the likelihood of a physician-in-training performing a Good Samaritan act.Participants and MethodsA survey was distributed via official e-mail to Mayo Clinic residents and fellows at Mayo Clinic’s 3 locations: Rochester, Minnesota; Scottsdale, Arizona; and Jacksonville, Florida. The survey was open from August 4 to 25, 2015, at the Arizona and Florida sites and from August 10 to 31, 2015, at the Minnesota site. Responses were collected anonymously and analyzed, using descriptive statistics and regression models.ResultsThe survey was sent to 1591 trainees and 19.7% (313) responded. Nearly half the respondents (49%) experienced a medical emergency that required assistance by a medically trained person and reported that increased medicolegal knowledge would increase their likelihood of helping (47%). Almost all (93.6%) felt that awareness of the Good Samaritan laws was essential for a medical professional and reported a need for further education to increase their knowledge (89.3%).ConclusionResidents and fellows asked for education about Good Samaritan laws and suggested that such education may increase their likelihood of helping in medical emergencies.

Risk Factors for Opioid Overdose

Opioid overdoses have risen starkly over the last two decades in the USA and are now among the leading causes of overall mortality. This review summarizes the current literature on risk factors for overdose as well as public health solutions. Although opioid overdose mortality is highest among men and non-Hispanic whites, the rate of death is rising more rapidly now among women and non-Hispanic blacks. Incarceration remains a significant risk factor for overdose death, especially in the first weeks upon reentry reflecting the absence of treatment in prisons and jails despite strong evidence for the benefits of pharmacotherapy integration into these settings. Pharmacotherapy with either methadone or buprenorphine greatly reduces the risk of overdose; however, treatment discontinuation leads to an increase risk of death. Naloxone distribution both through co-prescribing and community-based opioid overdose prevention programs remains the fundament of the public health response. Both are effective and cost-effective in reducing overdose; however, uptake is hampered due to variance in state naloxone access and Good Samaritan laws. Supervised injection facilities are a promising innovation to address overdose, especially in communities with high overdose rates.

Assessing the effectiveness of New York’s 911 Good Samaritan Law—Evidence from a natural experiment

BackgroundDrug overdose is the leading cause of accidental death in the United States. Nationally, opioids are the primary drugs associated with accidental overdoses. In response to increasing overdose deaths, 40 states and the District of Columbia have enacted Good Samaritan Laws (GSLs). Generally, these policies attempt to encourage witnesses or those experiencing an overdose to call 911 by providing limited immunity from arrest, charge and/or prosecution of possession of narcotics. The aim of the current study is to evaluate the effectiveness of New York State’s 911 GSL. MethodsWe exploit a difference in state law between New York State, where the policy was adopted in 2011, and New Jersey, where the policy was not adopted until 2013, to provide a reasonable comparison condition. We examine variation in accidental opioid overdose emergency department visits and inpatient admissions from 2010 to 2012 across 270 hospitals in New York and New Jersey at the quarterly level controlling for hospital fixed effects and time trends using State Emergency Department Databases (SEDD) and State Inpatient Databases (SID). ResultsAccidental opioid overdose emergency department visits and inpatient hospital admissions were increasing in both New York and New Jersey. After the enactment of New York’s 911 GSL, emergency department visits and inpatient hospital admissions for accidental heroin overdoses increased differently in New York and New Jersey, with an incident rate ratio (IRR) of 1.34 (95% CI = 1.00, 1.86). The results were inconclusive for accidental non-heroin opioid overdoses (IRR = 0.98, 95% CI = 0.86, 1.13). ConclusionsAccidental heroin overdose emergency department visits and inpatient hospital admissions increased in New York State after the enactment of the 911 GSL, consistent with the intended effect of the GSL. Preliminary evidence suggests that either persons who use heroin and/or those around them were impacted by the policy change.

Surgeon General Urges More Americans to Carry Naloxone

Surgeon General Urges More Americans to Carry Naloxone

Is the Good Samaritan Really Good? A Look into the Possible Harm Caused by Current Good Samaritan Laws

Is the Good Samaritan Really Good? A Look into the Possible Harm Caused by Current Good Samaritan Laws

Lay responder naloxone access and Good Samaritan law compliance: postcard survey results from 20 Indiana counties

BackgroundTo reduce fatal drug overdoses, two approaches many states have followed is to pass laws expanding naloxone access and Good Samaritan protections for lay persons with high likelihood to respond to an opioid overdose. Most prior research has examined attitudes and knowledge among lay responders in large metropolitan areas who actively use illicit substances. The present study addresses current gaps in knowledge related to this issue through an analysis of data collected from a broader group of lay responders who received naloxone kits from 20 local health departments across Indiana.MethodsPostcard surveys were included inside naloxone kits distributed in 20 Indiana counties, for which 217 returned cards indicated the person completing it was a lay responder. The survey captured demographic information and experiences with overdose, including the use of 911 and knowledge about Good Samaritan protections.ResultsFew respondents had administered naloxone before, but approximately one third had witnessed a prior overdose and the majority knew someone who had died from one. Those who knew someone who had overdosed were more likely to have obtained naloxone for someone other than themselves. Also, persons with knowledge of Good Samaritan protections or who had previously used naloxone were significantly more likely to have indicated calling 911 at the scene of a previously witnessed overdose. Primary reasons for not calling 911 included fear of the police and the person who overdosed waking up on their own.ConclusionsKnowing someone who has had a fatal or non-fatal overdose appears to be a strong motivating factor for obtaining naloxone. Clarifying and strengthening Good Samaritan protections, educating lay persons about these protections, and working to improve police interactions with the public when they are called to an overdose scene are likely to improve implementation and outcomes of naloxone distribution and opioid-related Good Samaritan laws.