Medical Amnesty Research Articles

Content comparison of campus medical amnesty policies

Objective: To describe common components of medical amnesty (MA) policies and examine how MA policies differ across institutions. Participants: 50 U.S. colleges and universities with current MA policies. Methods: A checklist was developed to compare and assess the campus MA policies of 50 institutions. Descriptive statistics, chi-square, and regression analyses were used to examine common policy components and differences across types of institutions. Results: 40% of policies did not include a purpose statement. 42% of policies had no mention about how to use the policy. 48% did not mention restrictions on amnesty. 32% did not mention follow-up actions. 24% of policies mentioned extending amnesty for additional person(s) present. There were no significant differences in policy components across school characteristics. Conclusions: Many policies lacked detail, highlighting the need for guidelines and best practices to develop MA policies. Future research could examine the effects of these policy components on help seeking intentions.

Student Perceptions of a University Medical Amnesty Policy Are Impacted by Race and Racism: A Qualitative Study

Student Perceptions of a University Medical Amnesty Policy Are Impacted by Race and Racism: A Qualitative Study

Variations in Protection Provisions Among State Medical Amnesty Laws

Background Studies indicate that a leading reason young people do not seek medical assistance for alcohol-related emergencies is worry of “getting in trouble”. To assuage these fears, over 30 states and numerous universities have passed medical amnesty laws. However, there are variations in protections between states. Objectives: This study aimed to (1) assess students’ knowledge of Nevada’s medical amnesty law; (2) knowledge of alcohol poisoning indicators; (3) whether variations in the law’s coverage relates to differences in intention to seek medical attention; (4) whether knowledge of the law is associated with intent to seek medical attention; and (5) whether attitudes, perceived norms, and personal agency are associated with intent to seek medical attention for an alcohol-related emergency, specifically alcohol poisoning. Method: This study surveyed 564 graduate and undergraduate students aged 18 and older from the University of Nevada, Reno. Results: The results suggest that that students were severely undereducated about the state’s medical amnesty law. Having a medical amnesty law at all is related to increased intent to call for medical attention in an alcohol poisoning situation. Further, components of the integrated behavior model (i.e. attitudes, perceived norms, and perceived personal agency) are associated with increased intent to call for medical attention. Conclusions: The presence of medical amnesty laws versus a law providing no protections for underage drinkers is positively related to an individual’s intention to seek medical attention in an alcohol-related emergency. Educational implications and recommendations for policy implementation are discussed.

Student Perceptions of a University Medical Amnesty Policy Are Impacted by Race and Racism: A Qualitative Study

Background Alcohol consumption on college and university campuses is a public health concern. Some universities have instituted medical amnesty policies (MAPs) to encourage calling first responders to the scene of an alcohol-related emergency. This study describes perceptions of a university MAP and the perceived risks of calling first responders among a sample of undergraduate students at a mid-sized, private, residential university. Methods: This is an exploratory, peer-led study, in which student-researchers worked under faculty supervision to devise the aims of the study, recruit and conduct qualitative interviews with participants, analyze data, and organize major findings. Results: Participants in this convenience sample (N = 42) were majority female (n = 33, 78.67%) and white (n = 35, 83.3%). White students often reported risking disciplinary consequences (i.e. suspension) if found in violation of university alcohol policy. White students who were familiar with the MAP praised it as beneficial in improving student safety. Students of color (especially Black students) reported concerns for their safety in the presence of first responders (especially police officers). Awareness of the MAP among students of color was very low, and many reported low levels of institutional trust, suggesting the protections conferred by the MAP should be taken “with a grain of salt.” Conclusions: MAPs may alleviate concern about some perceived risks of calling first responders, but that benefit may not be experienced equitably among students of color. More research is needed to understand the complex relationship between alcohol policies, alcohol-related injuries, policing, and race on college and university campuses.

State-by-State Examination of Overdose Medical Amnesty Laws

Introduction Timely medical attention could decrease mortality following drug or alcohol overdose events, but overdose victims and witnesses often delay or fail to seek professional help because they fear police involvement. Statutes that provide immunity from criminal action can have an important impact on seeking timely treatment. Methods We systematically collected and reviewed medical amnesty laws (MALs; commonly known as “Good Samaritan laws”) that are designed to encourage bystanders and others to contact authorities for assistance during overdose emergencies. Each law was coded to analyze (1) who receives statutory protections and under what circumstances; (2) what factors undercut the credibility of statutory protections; and (3) whether statutory language is easily attainable and understandable. Results Forty-seven states plus the District of Columbia have MALs, but provisions differ widely in their scope of protection. Some laws may be less effective than others in prompting calls for professional assistance because they either lack protections, allow overly broad discretion, or prove difficult to research. Conclusions Some statutes may be ineffective in encouraging calls for professional assistance following overdose events. Narrow immunity provisions with complex language may not be easily understood by the general population.

Peer-Led Training to Reduce Alcohol Misuse and Related Harm among Greek-Affiliated Students

Background High-risk alcohol use on college campuses is a significant public health concern, especially among students in fraternities and sororities. Alcohol harm-reduction programs that include protective behavioral strategies (PBSs) provide a promising approach to curb drinking among students, yet results have been inconsistent among high-risk drinkers. Purpose: To evaluate the impact of a harm-reduction, peer-led training program called “Voice of Reason” (VOR) on alcohol knowledge and behaviors among students in Greek chapters. Methods: We conducted two studies with students directly trained in VOR (Study 1: N = 118; Study 2: N = 53) and with students in affiliated Greek chapters (Study 1: N = 1363; Study 2: N = 1446). Study 1 included 13 chapters and Study 2 included 15 chapters. Results: Results of analyses across both studies showed that among those directly trained in VOR, there were pre-post increases in alcohol knowledge, medical amnesty law awareness, talking with friends about PBS, use of PBS, and intentions to use PBS, as well as pre-post decreases in drinking and driving and riding with drinking drivers. In addition, VOR had an impact on students in affiliated chapters, indicating an increase in medical amnesty law awareness and a decrease in the number of drinks consumed on a typical day. Conclusions: Overall, results provide some early evidence of VOR impact, while also demonstrating the challenge of changing normative drinking behaviors among high-risk college students. Ongoing research is needed to assess the effectiveness of VOR, especially after successive implementations with the same chapters.

Student awareness of campus medical amnesty policies

Objective Examine students’ awareness of medical amnesty policies and the influence of policy awareness on the expected consequences of bystander help seeking in alcohol-related emergencies among student-athletes and non-athletes. Participants: 1,012 college students. Methods: Spearman’s correlation and chi-square tests were used to examine accuracy in awareness of amnesty policies. Nominal logistic regression was used to test the relationship between amnesty policy awareness and expected consequences of bystander help seeking. Results: About 25% of students were unsure if their school had an amnesty policy; of these students, 67% attended schools with such a policy. Students who were unsure about the presence of amnesty policies were more likely to expect serious negative consequences of calling for help for both non-athlete peers (B = 1.152 p < 0.001) and student-athlete peers (B = 0.887 p = 0.001). Conclusions: Greater attention is needed to how amnesty policies are implemented on college campuses, including how they are communicated to and interpreted by student-athletes.

A Classroom Activity to Increase Student Pharmacists Confidence in Dealing with the Opioid Epidemic

Objective. To implement and assess the impact of a hybrid flipped-classroom activity designed to increase the motivation and confidence of Doctor of Pharmacy (PharmD) students in addressing the opioid crisis. Methods. Third-professional year student pharmacists were provided with reading material developed by federal agencies and professional pharmacy organizations, as well as Georgia-specific information covering medical amnesty and local resources for opioid-overdose prevention prior to class. They then attended a four-hour classroom session that included hearing a lecture on opioid pharmacology and opioid overdose, viewing training videos, and engaging in extensive discussion. The students voluntarily completed pre- and post-intervention assessments regarding opioid abuse and opioid overdose prevention. Results. Seventy of the 107 third-year students enrolled in the course completed the pre-intervention assessment (65% response rate), and 33 of the 70 completed the post-intervention assessment (47% retention rate). The students exhibited a high baseline motivation to assist in combating the opioid crises, but less confidence in their ability to intervene. Significant increases were seen in areas related to student confidence on the post-intervention assessment. Fewer changes were seen in areas related to student motivation. Conclusion. A "hybrid" flipped classroom activity increased the confidence of student pharmacists in their understanding of the physical and adverse effects of opioids and the application of reversal agents. Increased confidence may support increased intervention.

What Affects College Students’ Decision to Intervene or Not Intervene When Someone Is Drinking Too Much?

Medical amnesty policies aim to encourage individuals to help their peers who have been drinking too much by providing immunity for alcohol policy violations. We examined college students' decisions to intervene or not intervene when someone was drinking too much and reasons for not intervening. We conducted secondary analyses using data from college students ages 18-25 who participated in the Healthy Minds Study, a national survey of mental health and substance use (N = 30,785; 65% female). We examined the prevalence of reasons for not intervening and estimated a multilevel multinomial logistic regression to answer our research questions. Nearly half (46.5%) of students reported being in at least one situation in the past year when someone was drinking too much. Among these students, 46.7% consistently intervened, 27.7% inconsistently intervened, and 25.6% did not intervene in these situations. The most common reasons for not intervening were: "I felt it was none of my business" and "I didn't know what to do." "I was afraid I'd get in trouble" was the least common reason for not intervening. Intervening differed by student characteristics, including age, gender, race/ethnicity, residence, international student status, and binge drinking. Fear of getting in trouble, the basis for amnesty policies, was not a major barrier preventing intervention behavior in our study. Our findings suggest that implementing amnesty policies may not lead to intervention behavior. Strategies that empower and compel students to help their peers and provide them with skills needed to help may lead to more intervention behavior.

Implementation of an Alcohol Medical Amnesty Policy at an Urban University With a Collegiate-Based Emergency Medical Services Agency

PurposeMedical amnesty policies (MAPs) at universities attempt to encourage students to seek emergency medical care by reducing disciplinary sanctions. This study analyzed how a MAP affected requests for emergency medical help to a collegiate-based emergency medical services (CBEMS) agency for alcohol-related issues. MethodsThis before-and-after study analyzed CBEMS call data for the 6 semesters prior to and after MAP implementation. Extracted data included patient demographics, dispatch time, and requests for advanced life support (ALS) resources. ResultsFollowing MAP introduction, increases were observed in alcohol-related calls/day in the fall semesters (0.84 vs. 0.93; p < 0.01). The median time of calls decreased; 1:20 a.m. versus 12:59 a.m. (median difference 21 minutes, p < 0.001). Finally, ALS was requested less often (9.0% vs. 3.7%; odds ratio 0.39; p < 0.01). ConclusionsMAP implementation at a university with a CBEMS is associated with a higher call volume, requests for service that occur earlier in the evening, and reduction in ALS requests for alcohol-related emergencies.

Evaluating the Effectiveness of a Medical Amnesty Policy Change on College Students’ Alcohol Consumption, Physiological Consequences, and Helping Behaviors

This study summarizes the association between medical amnesty policy (MAP) implementation and drinking behaviors at a 4-year university. First-year students (N = 1,246; 50.8% male) were assessed in the academic year pre- (2009-2010, n = 571) and post-implementation (2010-2011, n = 675). A cohort-sequential design was used. Students were assessed at college entry and end-of-year. Self-report measures assessed recent alcohol use, physiological consequences, and helping behaviors specific to alcohol-related medical emergencies. MAP implementation did not increase drinking, overall consumption, or the incidence of physiological consequences. Modest increases in contacting residence life staff in the event of an emergency were also found. This study provides empirical support that MAP policies do not increase consumption or problems and may reduce barriers to seeking help in the event of an emergency. Additional research is needed to establish the effectiveness of MAPs as an environmental-level strategy to reduce harmful drinking on campus.

Tackling Barriers to Seeking Emergency Care: The Campaign for a Medical Amnesty Policy at Washington University in St. Louis

Tackling Barriers to Seeking Emergency Care: The Campaign for a Medical Amnesty Policy at Washington University in St. Louis

Beyond punishment: the impacts of medical amnesty in a U.S. Residential college context

Despite its risks, heavy drinking is widespread at universities. Increasingly, colleges are integrating harm-reduction perspectives into traditional punishment/deterrence-based alcohol policy approaches. One such programme is the Medical Amnesty/Good Samaritan (MAGS) policy, which reduces or eliminates punishing consequences for students seeking alcohol-related emergency assistance. But beyond its specific utility of potentially saving lives, there is almost no empirical work to examine how MAGS might affect a college climate. To explore this important issue, we compared a cohort of n = 1006 pre-MAGS students to a cohort of n = 537 post-MAGS students (from the same institution), and also sub-samples of n = 448 pre-MAGS versus n = 195 post-MAGS freshmen. Findings showed fewer adverse events among post-MAGS freshmen. Furthermore, the full cohort of post-MAGS students appeared to have more positive perceptions of campus climate. Other results were mixed, inviting discussion. Nevertheless, the present work serves as a springboard for considering how harm-reduction measures can synthesise with deterrence measures to move youth policy initiatives “beyond punishment.”

Using the Health Belief Model to Predict Bystander Behavior Among College Students

This investigation used the Health Belief Model (HBM) to examine perceived barriers and benefits college students hold concerning medical amnesty. Researchers employed a cross-sectional research design with 369 students completing the survey (97% response rate). A path analysis revealed that college students are more likely to seek help during an alcohol overdose when they perceive the situation as life-threatening with few barriers. Results reveal that the HBM is useful in explaining intentions to utilize medical amnesty.

The Impact of an Online Educational Video and a Medical Amnesty Policy on College Students' Intentions to Seek Help in the Presence of Alcohol Poisoning Symptoms

This study analyzed the impact of a medical amnesty policy and an online alcohol poisoning video on college students’ intentions to seek help when witnessing alcohol poisoning symptoms. Students were randomly assigned to receive an amnesty policy, alcohol poisoning video, or both. The group that received both treatments was most likely to seek help. Females, abstainers, and those not previously exposed to an alcohol poisoning situation were more likely to seek help.

Alcohol Poisoning Among College Students Turning 21: Do They Recognize the Symptoms and How Do They Help?

The aims of this study were to (1) determine recognition of and self-reported concern regarding alcohol poisoning symptoms versus other alcohol-related behaviors among students turning 21 years old, (2) assess the frequency of helping behavior among students in situations where peers display alcohol poisoning symptoms, (3) assess sources from which students seek help, and (4) consider reasons why students report reluctance to seek help. Students (N = 306; 50% male) completed a Web-based self-report assessment during the week before their 21 st birthday focusing on drinking behavior, alcohol-related consequences, concern for symptoms of alcohol poisoning, and observations of and experience with helping behavior. Results indicated most students report having helped another student with symptoms of alcohol poisoning and show concern about the symptoms. Students most often seek help from other students and parents. When students do not help their peers, it is most often because of the perception that help is not needed. Heavier drinkers report a greater likelihood to help a peer showing symptoms of alcohol poisoning. Prevention professionals should incorporate students, friends, and parents in interventions that provide knowledge and helping strategies for alcohol poisoning symptoms. In addition, prevention efforts regarding alcohol poisoning should focus on heavy drinkers, as they are most likely to be in situations requiring help. Finally, administrators implementing medical amnesty policies should couple those policies with educational strategies aimed at recognition of alcohol poisoning symptoms.

Medical Amnesty Policies: Research is Needed

This article explores the issues surrounding medical amnesty policies in higher education beginning with the background of such policies, a summary of the current debate regarding the policies, and a discussion of research related to helping behaviors among college students. Due to the negative consequences of alcohol misuse, many student affairs administrators have implemented medical amnesty or Good Samaritan policies. These policies usually consist of an educational campaign in which students are assured that they will not be sanctioned by the university if they seek help for a peer who is intoxicated. The current discussion regarding medical amnesty policies focuses on the debate between harm reduction and enabling. Understanding why students do not seek help is crucial to designing policies or other interventions to increase help seeking. The article reviews the arguments for and against medical amnesty policies and gives specific recommendations for further research on this topic.

Medical Amnesty Policies: Research is Needed

This article explores the issues surrounding medical amnesty policies in higher education beginning with the background of such policies, a summary of the current debate regarding the policies, and a discussion of research related to helping behaviors among college students. Due to the negative consequences of alcohol misuse, many student affairs administrators have implemented medical amnesty or Good Samaritan policies. These policies usually consist of an educational campaign in which students are assured that they will not be sanctioned by the university if they seek help for a peer who is intoxicated. The current discussion regarding medical amnesty policies focuses on the debate between harm reduction and enabling. Understanding why students do not seek help is crucial to designing policies or other interventions to increase help seeking. The article reviews the arguments for and against medical amnesty policies and gives specific recommendations for further research on this topic.

Safety first: A medical amnesty approach to alcohol poisoning at a U.S. university

Despite the minimum legal drinking age of 21 in the United States, alcohol consumption among underage college students is widespread. Patterns of consumption among students often include episodes of heavy drinking that contribute to a range of negative consequences, including alcohol poisoning. Although failure to seek medical assistance in cases of alcohol poisoning can lead to fatal outcomes, evidence suggests that the threat of judicial consequences resulting from enforcement of the minimum drinking age or other law or policy violations leads some students to refrain from calling for emergency medical services. Beginning in the fall of 2002, Cornell University attempted to address this dilemma by implementing a Medical Amnesty Protocol (MAP) designed to: (1) increase the likelihood that students will call for help in alcohol-related medical emergencies; and (2) increase the likelihood that students treated for alcohol-related medical emergencies will receive a brief psycho-educational intervention at the university health centre as a follow-up to their medical treatment. This article provides a case study of the MAP at Cornell University and reviews data from emergency room and health centre records, calls to emergency medical services, and student self-report survey data to evaluate the extent to which the protocol's goals were achieved during the first two years of implementation. Results include consecutive increases in alcohol-related calls for assistance to emergency medical services during the two-year period. Survey results suggest that, following initiation of the MAP, students were less likely to report fear of getting an intoxicated person in trouble as a barrier to calling for help. Furthermore, the percentage of students seen by health centre staff for a brief psycho-educational intervention after an alcohol-related emergency more than doubled (from 22% to 52%) by the end of the second year. In their discussion, the authors explore the inherent tension between the responsibility of colleges and universities to enforce the minimum legal drinking age of 21 as well as other laws and university policies versus the need to motivate underage students to call for assistance when alcohol-related medical emergencies occur. Recommendations to other colleges and universities considering a medical amnesty approach are provided.