Good Samaritan Proposal in Missouri Legislature Will Save Lives, Reduce Law Enforcement Burden

I was pleasantly surprised to see then St. Louis Post-Dispatch reporting today about a proposed Good Samaritan law (HB 296) that’s been filed in the Missouri legislature:

Kathie Kane-Willis, director of the Illinois Consortium on Drug Policy at Roosevelt University, in Chicago, studies addiction-related legislation. Illinois adopted its good Samaritan drug law in 2009.

“We know from research that the biggest fear for calling 911 was fear of police involvement,” she explained.

Kane-Willis said the phenomenon of “body dumping,” with overdose victims dropped off at hospital doorsteps or abandoned in trash bins, “is a reaction of fear and disregard.”

“When someone dies, we cannot get them into treatment, and we can’t prosecute them,” she said. “… (I)t’s about redirecting people to the services they need and making sure people do not continue to die.”

She said the law would provide immunity only from a drug possession charge. “If there is a perception that this is going to be going easy on drug users or sellers, it only provides limited immunity for the one person who calls 911 and the one person who is experiencing the overdose, and that is it.”

McCulloch said he generally opposes granting immunity in any case, but he is open to exploring the legislation.

Missouri’s proposal, based on the Illinois model, is sponsored by Rep. Bryan Spencer, a Republican who represents parts of St. Charles and Warren counties. He did not return a call seeking comment.

Some states, including Illinois, allow doctors to provide a prescription to addicts, or those who are close to them, for naloxone. The injectable drug, commonly known by the trademark name Narcan, can quickly reverse life-threatening effects of an opiate overdose. The prescription option is not included in the Missouri proposal.

Excerpted from Christine Byars, “Proposed Missouri law aimed at saving lives after drug overdoses“, Stltoday.com, 05 March 2013.

Though I would like to see the issue of naxalone access addressed, HB 296 sounds like a great start.

The organization Students for Sensible Drug Policy has advocated for Good Samaritan policies and legislation for years. Here are their bullet points:

  • Good Samaritan Policies have been proven to be effective at saving lives. A 2006 study in the International Journal of Drug Policy found that emergency calls increased after Cornell University’s Good Samaritan Policy was enacted in 2002, although alcohol abuse rates have remained relatively constant.
  • Good Samaritan Policies are not a violation of federal law. The Drug-Free Schools and Communities Act explicitly states that “a disciplinary sanction may include the completion of an appropriate rehabilitation program.” Follow-up evaluations and counseling are fundamental components of any Good Samaritan Policy. The key is that these followups be nonpunitive so that they don’t serve as a deterrent to calling for help.
  • Good Samaritan Policies shouldn’t be viewed as “get out of jail free cards” or rewards for binge drinking. Rather, they provide students with the clarity they need in order to make responsible, life-saving decisions during confusing and stressful party situations. Every minute spent worrying about judicial consequences is another minute it will take for help to arrive. That minute can very literally be the difference between life and death.
  • Campus administrators are correct in wanting to send the right message. And a Good Samaritan Policy would send the message that campus officials care more about keeping students alive than punishing them. A message against the dangers of binge drinking or drug abuse should never have to come in the form of a student’s obituary.
  • More than half of the schools with Good Samaritan Policies provide coverage for situations involving all drugs, not just alcohol. This is logical, since marijuana is often involved in party situations and can serve as a deterrent to calling for help, whether or not the drug was involved in the overdose. We should also remember that the abuse of other illegal drugs and prescription medications can have dire consequences, which we should seek to mitigate by enacting all-inclusive Good Samaritan Policies.
  • The primary intention of a Good Samaritan Policy isn’t to reward those who make the decision to call for help when a friend is in trouble. Rather, the policy enables and empowers students to make that decision when they would otherwise hesitate. It is a preemptive policy that promotes responsible behavior rather than a reactive policy that rewards responsible behavior after the fact.
  • Good Samaritan Policies are only effective if they guarantee amnesty in writing (usually in the student code of conduct) and the policy is widely publicized. If a school has the unwritten practice of excusing students from punitive consequences during emergency situations, but students don’t know about it, then it is like having no such policy at all.
  • In 2008,  drug overdoses caused 36,450 deaths in the United States.  Drug overdose is now second only to motor vehicle crashes among the leading causes of unintentional injury deaths.
    Centers for Disease Control. (2011). Vital Signs: Overdoses of Prescription Opioid Pain Relievers – United States, 1999-2008. Morbidity and Mortality Weekly Report, 60, 1487-1492.
  • Rates of hospitalizations for alcohol overdoses, drug overdoses, and their combination all increased from 1999 to 2008 among 18- to 24-year-olds.  More specifically, hospitalization rates for alcohol overdoses alone increased 25%, reaching 29,412 cases in 2008. Hospitalization rates for drug overdoses alone increased 55% (totaling 113,907 cases in 2008) and hospitalization rates for combined alcohol and drug overdoses increased 76% (with 29,202 cases in 2008).
    White, A. M., Hingson, R. W., Pan, I., & Yi, H. (2011). Hospitalizations for Alcohol and Drug Overdoses in Young Adults Ages 18-24 in the United States, 1999-2008: Results from the Nationwide Inpatient Sample. Journal of Studies on Alcohol and Drugs, 72, 774–786.
  • When someone in America overdoses, a call for help occurs less than 50% of the time.
    Tobin, K. E., Davey, M. A., & Latkin, C. A. (2005). Calling Emergency Medical Services During Drug Overdose: An Examination of Individual, Social, and Setting Correlates. Addiction, 100(3), 397-404; Baca, C. T., & Grant, K. J. (2007). What Heroin Users Tell Us About Overdose.  Journal of Addictive Diseases, 26(4), 63-68; Sherman, S. G., Gann, D. S., Scott, G., et al. (2008). A Qualitative Study of Overdose Responses Among Chicago IDUs. Harm Reduction Journal, 5(1), 2; Smart, A. T. & Porucznik, C. (n. d.). Drug Overdose Prevention and Education Study. Retrieved from http://www.dsamh.utah.gov/docs/dope_u_of_uschool_20060621.pdf; Tracy, M., Piper, T. M., Ompad, D., et al. (2005). Circumstances of Witnessed Drug Overdose in New York City: Implications for Intervention. Drug and Alcohol Dependence, 79, 181-190.
  • Fear of police involvement is the most common reason for not calling 911 during an overdose.  
    Seal, K. H., Downing, M., Kral, A. H., et al. (2003). Attitudes about prescribing take-home naloxone to injection drug users for the management of heroin overdose: A survey of street-recruited injectors in the San Francisco Bay Area. Journal of Urban Health, 80(2), 291-301; Tracy, M., Piper, T. M., Ompad, D., et al. (2005). Circumstances of witnessed drug overdose in New York City: Implications for intervention. Drug and Alcohol Dependence, 79, 181-190; Baca, C. T., & Grant, K. J. (2007). What heroin users tell us about overdose.  Journal of Addictive Diseases, 26(4), 63-68; Sherman, S. G., Gann, D. S., Scott, G., et al. (2008). A qualitative study of overdose responses among Chicago IDUs. Harm Reduction Journal, 5(1), 2.
  • Students who are aware that a medical amnesty policy is in effect are 2.5 times more likely than students who expect to face disciplinary actions to call for help when witnessing the signs of alcohol poisoning.
     Oster-Aaland, L., Thompson, K., & Eighmy, M. (2011). 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. Journal of Student Affairs Research and Practice, 48(2), 147-164.
  • After Cornell University implemented a Medical Amnesty Protocol, students were less likely to report fear of getting an intoxicated student in trouble as a barrier to calling for help and alcohol-related calls for assistance to emergency medical services increased.
    Lewis, D. K. & Marchell, T. C. (2006). Safety First: A Medical Amnesty Approach to Alcohol Poisoning at a U.S. University. International Journal of Drug Policy, 17, 329-338.
  • A survey of 355 opiate users found that once they became aware of Washington’s Good Samaritan law, 88% indicated that they were more likely to call 911 during future overdoses.  
    Banta-Green, C. J., Kuszler, P. C., Coffin, P. O., Schoeppe, J. A. (2011). Washington’s 911 Good Samaritan Drug Overdose Law – Initial Evaluation Results.  Alcohol & Drug Abuse Institute, University of Washington. Available at http://adai.uw.edu/pubs/infobriefs/ADAI-IB-2011-05.pdf.

With Republican Sponsors for HB 296, Are the Political Winds Changing?

Interestingly, HB 296 is sponsored by Representatives Bryan Spencer (Republican, 63) and Mike Kelley (Republican, 126). Hopefully this session will allow their bill to advance to committee and perhaps beyond. Interested parties should contact their Missouri representative to express support for this legislation.

If you are interested in organizing further on drug policy issues in Missouri, follow Missourians for Drug Policy Reform.

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