The impact of naloxone access laws on opioid overdose deaths in the U.S.

Opioid overdoses are the leading cause of unintentional death in the U.S. This research investigates the effects of state-level Naloxone access laws on opioid overdose death rates. Spatial difference-in-differences models reveal that no matter how the access law is measured (either as a binary variable, number of days after the law, or differentiated between access law provisions), the only consistent result is positive indirect effects on overdose death rates. These results indicate that Naloxone access provisions have regional impacts via spillover effects in neighboring states. Looking across multiple provisions, our findings show that, except for third party authorization, there are significant positive effects on overdose death rates. When access laws are evaluated in isolation of any other state level policy response to opioids, increasing access to Naloxone does not reduce overdose death rates, but leads to an overall increase. Thus, the moral hazard problem stemming from this public health policy may be an accurate assessment of the outcome.