The United States is facing a fentanyl epidemic.[1] Fentanyl is a synthetic opioid that is fifty times stronger than heroin and one hundred times stronger than morphine.[2] While fentanyl is approved by the Food and Drug Administration (FDA) for pain relief and anesthetic used in controlled medical settings, most overdoses come from illegally manufactured fentanyl.[3] Drug dealers lace fentanyl into fake prescription pills and other illegal drugs.[4] Since fentanyl is a synthetic drug, it is cheaper to produce than other opioids that are grown from plants, and it therefore is more profitable for drug cartels to sell.[5] A lethal amount of fentanyl is only two milligrams—the equivalent to four grains of sand.[6] Many individuals who overdose from fentanyl often do so unknowingly; they are often unaware that they are both ingesting the drug and lethal amounts of it.[7] The most vulnerable population that is susceptible to fentanyl poisoning are teens and young adults.[8] Fentanyl overdose is the leading cause of death for Americans aged eighteen to forty-five.[9] Each week, about twenty-two teenagers aged fourteen to eighteen die from drug overdoses, primarily caused by fentanyl laced into counterfeit pills.[10]
One of the best ways for a bystander to intervene during a drug overdose is by calling 911.[11] However, bystanders who are also engaging in illegal drug use may hesitate to call for assistance due to fear of facing certain criminal penalties.[12] Good Samaritan laws address this concern and protect these individuals.[13]
Good Samaritan laws across the country have helped reduce overdoses in the United States;[14] however, the language set forth in these laws varies by state, which can cause confusion.[15] For example, Vermont, North Carolina, and New York all have different variations of a Good Samaritan law.[16] In Vermont, individuals who call emergency services are provided criminal immunity for drug possession and drug delivery offenses for the specific incident they are calling in for.[17] This means that if an individual could have been charged with selling, dispensing, or possessing drugs with intent to sell at the time they sought help, they would then be granted immunity.[18] Meanwhile, in New York and North Carolina, when an individual at the scene of an overdose calls for assistance, they only have criminal immunity for drug possession offenses.[19]
Another key difference involves the timing of when criminal immunity takes effect.[20] In Vermont and New York, the individual calling for help would have immunity from arrest, charge, and prosecution.[21] Police cannot take them into custody, file charges against them, or pursue any type of legal action, thereby eliminating the possibility of them being prosecuted in connection with the incident.[22] The policy behind this law is that the fear of prosecution alone will not deter an individual from seeking out emergency assistance.[23] In North Carolina, Good Samaritans only have immunity from prosecution.[24] Charges may also be dismissed before trial, but an individual still may be arrested and charged as a criminal defendant.[25] Even if their case is later dismissed, they may still be subject to a prior arrest.[26]
Another difference concerns trial or sentencing protections for individuals who do not have criminal immunity in their state.[27] In Vermont, individuals who are not afforded criminal immunity may seek a reduced sentence by proving that the evidence of the crime they are being prosecuted for was discovered while providing medical help to an overdose victim or during a medical assistance request.[28] In New York, an individual may seek acquittal by presenting proof that the evidence in relation to the crime they are being charged for was found during a medical assistance request.[29] As for North Carolina, there is no additional protection in this area.[30]
Good Samaritan laws that offer broader legal protections, when paired with a Naloxone Access Law, have been linked to a reduction in overdose fatalities compared to states with lesser protections.[31] The more knowledgeable people are on Good Samaritan laws, the more likely they are to call emergency services.[32] Therefore, the most proactive approach is to create a consistent, national Good Samaritan law that offers the broadest legal protections, as well as spreading public awareness.
If the primary goal of a Good Samaritan law is to save lives,[33] there should be no confusion as to what the law is in your jurisdiction. Spreading awareness and understanding of the specific provisions of a jurisdiction’s Good Samaritan law would increase the chance that people who witness an overdose will call for help.[34] However, the most effective strategy for addressing this national crisis is to reduce the demand for drugs. This can be best achieved through widespread education initiatives that inform teenagers and young adults about the fatal risks of drug use.[35] Equally important is raising awareness of legal protections that allow them to seek help during an overdose without fear of prosecution.[36] A universal Good Samaritan law that protects everyone from prosecution would make that easier, and help save lives.[37]
[1]Understanding the Opioid Overdose Epidemic, CDC, https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html (last visited Feb. 5, 2025) [https://perma.cc/4ZMQ-3PU6].
[2] Fentanyl, DEA, https://www.dea.gov/factsheets/fentanyl (last visited Feb. 5, 2025) [https://perma.cc/T6QG-2P8H].
[3] Id.; Fentanyl, CDC, https://www.cdc.gov/overdose-prevention/about/fentanyl.html (last visited Feb. 5, 2025) [https://perma.cc/SF38-T7TK].
[4] Caren Zucker, We must hear the warnings about fentanyl, Aᴛʟᴀɴᴛɪᴄ J. Cᴏɴsᴛ. (Jan. 21, 2025), https://www.ajc.com/opinion/opinion-we-must-hear-the-warnings-about-fentanyl/MTEKNULXY5BC7HO7DVEFVSH2S4/ [https://perma.cc/JH7Q-WHSD].
[5] Id.
[6] Can you spot the pill containing Fentanyl?, Sᴏʟᴀɴᴏ Cɴᴛʏ. (Oct. 24, 2022), https://www.solanocounty.com/news/displaynews.asp?NewsID=2468&TargetID=1 [https://perma.cc/CCQ9-QBKP].
[7] Fentanyl DrugFacts, NIH, https://nida.nih.gov/publications/drugfacts/fentanyl (last visited Feb. 5, 2025) [https://perma.cc/Y572-GRET].
[8] Fentanyl’s high potency increases the risk of overdose, especially for teens and young adults with low tolerance. Additionally, young people are unknowingly buying fentanyl-laced drugs online, putting them at greater risk. Ty Schepis, Dozens of US Adolescents are Dying From Drug Overdoses Every Month – An Expert on Substance Use Unpacks the Grim Numbers with 3 Charts, Tᴇx. Sᴛᴀᴛᴇ Uɴɪᴠ., https://news.txst.edu/the-conversation/2023/drug-overdose-deaths-in-us-adolescents.html (last visited Feb. 10, 2025) [https://perma.cc/M355-7Q3A]; DEA Administrator on Record Fentanyl Overdose Deaths, Gᴇᴛ Sᴍᴀʀᴛ Aʙᴏᴜᴛ Dʀᴜɢs, https://www.getsmartaboutdrugs.gov/media/dea-administrator-record-fentanyl-overdose-deaths (last visited Feb. 5, 2025) [https://perma.cc/G6WS-RUQB].
[9] DEA Administrator on Record Fentanyl Overdose Deaths, supra note 8.
[10] Enrique Rivero, About 22 high school age adolescents died each week from overdoses in 2022, driven by fentanyl-laced prescription pills, UCLA Hᴇᴀʟᴛʜ (Jan. 8, 2024), https://www.uclahealth.org/news/release/about-22-high-school-age-adolescents-died-each-week [https://perma.cc/3G7X-X4RM].
[11]Understanding an Overdose and How to Respond to One, NIH, https://nida.nih.gov/research-topics/parents-educators/lesson-plans/understanding-an-overdose-and-how-to-respond-to-one#:~:text=As%20a%20quick%20refresher%2C%20the,their%20side%20to%20prevent%20choking (last visited Feb. 5, 2025) [https://perma.cc/PCY6-PLRU].
[12]Andrea Jakubowski, Knowledge of the 911 Good Samaritan Law and 911-calling behavior of overdose witnesses, 39 Sᴜʙsᴛᴀɴᴄᴇ Usᴇ & Aᴅᴅɪᴄᴛɪᴏɴ J.233 (Nov. 2017).
[13] U.S. Gᴏᴠ’ᴛ Aᴄᴄᴏᴜɴᴛᴀʙɪʟɪᴛʏ Oғғ., GAO-21-248, Dʀᴜɢ Mɪsᴜsᴇ: Mᴏsᴛ Sᴛᴀᴛᴇs Hᴀᴠᴇ Gᴏᴏᴅ Sᴀᴍᴀʀɪᴛᴀɴ Lᴀᴡs ᴀɴᴅ Rᴇsᴇᴀʀᴄʜ Iɴᴅɪᴄᴀᴛᴇs Tʜᴇʏ Mᴀʏ Hᴀᴠᴇ Pᴏsɪᴛɪᴠᴇ Eғғᴇᴄᴛs (March 2021).
[14] Id.
[15] Good Samaritan Laws Summary Handout, Cᴏʀᴅᴇᴍ, https://www.cordem.org/siteassets/files/curricular-toolkit/good.samaritan/good.samaritan.laws.summary.handout.pdf [https://perma.cc/3T5P-CGEY].
[16] U.S. Gᴏᴠ’ᴛ Aᴄᴄᴏᴜɴᴛᴀʙɪʟɪᴛʏ Oғғ., supra note 13. See also Vᴛ. Sᴛᴀᴛ. Aɴɴ. tit. 18, § 4254 (2024)(Vermont’s Good Samaritan law); N.C. Gᴇɴ. Sᴛᴀᴛ. § 90-96 (2023)(North Carolina’s Good Samaritan law); N.Y. Pᴇɴᴀʟ Lᴀᴡ § 220.78 (2024) (New York’s Good Samaritan law). These three states reflect some of the key differences between Good Samaritan laws in each state.
[17] U.S. Gᴏᴠ’ᴛ Aᴄᴄᴏᴜɴᴛᴀʙɪʟɪᴛʏ Oғғ., supra note 14. Protection does not apply retroactively or for future drug-related criminal offenses.
[18] Id.
[19] Id.
[20] Id.
[21] Id.
[22] Id.
[23] U.S. Gᴏᴠ’ᴛ Aᴄᴄᴏᴜɴᴛᴀʙɪʟɪᴛʏ Oғғ., supra note 13.
[24] Id.
[25] Id.
[26] Id.
[27] Id.
[28] Id.
[29] U.S. Gᴏᴠ’ᴛ Aᴄᴄᴏᴜɴᴛᴀʙɪʟɪᴛʏ Oғғ., supra note 13.
[30] Id.
[31] Leah Hamilton, Corey S. Davis, Nicole Kravitz-Wirtz, William Ponicki & Magdalena Cerda, Good Samaritan laws and overdose mortality in the United States in the fentanyl era, 97 Iɴᴛ. J. Dʀᴜɢ Pᴏʟ’ʏ97 (November 2021). Naloxone is a medication that reverses the effects of opioids and can prevent an overdose. Id. Naloxone Access Laws authorize the access to Naloxone. Id.
[32] Jakubowski, supra note 12.
[33] What is Good Samaritan Law: Everything You Need to Know, CPRSᴇʟᴇᴄᴛ (Oct. 3, 2024), https://www.mycprcertificationonline.com/courses/first-aid/good-samaritan-law#:~:text=Purpose%20and%20Intent%20of%20Good,distress%2C%20ultimately%20creating%20safer%20communities [https://perma.cc/VE5H-3B6W].
[34] Brian West & Matthew Varacallo, Good Samaritan Laws, NIH (Sept. 12, 2022), https://www.ncbi.nlm.nih.gov/books/NBK542176/ [https://perma.cc/8GR5-G8HT]. Studies have shown that awareness of the law varies not just among individuals, but law enforcement as well. See U.S. Gᴏᴠ’ᴛ Aᴄᴄᴏᴜɴᴛᴀʙɪʟɪᴛʏ Oғғ., supra note 13.
[35] Preventing Overdoses Starts with Education, Kᴀɪsᴇʀ Pᴇʀᴍᴀɴᴇɴᴛᴇ (Aug. 29, 2023), https://about.kaiserpermanente.org/health-and-wellness/health-tips/preventing-overdoses-starts-with-education [https://perma.cc/GM6U-A6XT].
[36] Jakubowski, supra note 12.
[37] What is Good Samaritan Law: Everything You Need to Know, supra note 33.
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