SynthesisAddiction (Abingdon, England)2021
Systematic review of the emerging literature on the effectiveness of naloxone access laws in the United States.
Synthesis in Addiction (Abingdon, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
60 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of the novel coronavirus disease (COVID-19) pandemic on drug overdose-related deaths in the United States and Canada: a systematic review of observational studies and analysis of public health surveillance data.Substance abuse treatment, prevention, and policy · 2021Pooled it
- Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study.Preventive medicine · 2024Trial
- Knowledge, attitudes and practices among Australian community pharmacists towards naloxone and overdose prevention: a national cross-sectional study.International journal of clinical pharmacy · 2026Article
- Implementation and sustainability of hospital-based harm reduction delivery: a qualitative analysis.Harm reduction journal · 2026Article
- Syringe service program utilization, behavioral, and experiential factors associated with greater naloxone protection in a longitudinal cohort of people who use illicit opioids in New York city.Harm reduction journal · 2026Article
- Illicit drug supply, naloxone availability, and overdose mortality in the fentanyl era: a systematic review.Health affairs scholar · 2026Review
- Factors Associated With Opioid Agonist Treatment Engagement and Harm Reduction Service Use: Findings From the New South Wales Opioid Dependence Survey.Drug and alcohol review · 2026Article
- A comprehensive review of state laws that govern the distribution and possession of drug use equipment in the United States.The International journal on drug policy · 2026Review
- A descriptive study of drug overdose epidemics, overdose prevention efforts, and opioid settlement fund distribution across six states.The International journal on drug policy · 2026Article
- Syringe Service Program Utilization, Behavioral, and Experiential Factors Associated with Greater Naloxone Protection in a Longitudinal Cohort of People Who Use Illicit Opioids in New York City.Research square · 2025Article
- Creating a Classification System of Opioid Use Disorder Treatment Policies: A Research Protocol.Substance use & addiction journal · 2025Article
- Trends and correlates of naloxone possession and use among people who inject drugs in Seattle, Washington.The International journal on drug policy · 2025Article
- Having naloxone when you need it: Factors associated with owning and carrying naloxone among people who use opioids.The International journal on drug policy · 2025Article
- Improving Policy Evaluations Of The Opioid Crisis.Health affairs (Project Hope) · 2025Article
- People entering opioid substance use treatment have low rates of naloxone knowledge and possession.Drug and alcohol dependence · 2025Article
- Naloxone Knowledge, Carrying, Purchase, and Use.JAMA network open · 2025Article
- How do restrictions on opioid prescribing, harm reduction, and treatment coverage policies relate to opioid overdose deaths in the United States in 2013-2020? An application of a new state opioid policy scale.The International journal on drug policy · 2025Article
- Article
- Article
- Price Sensitivity and Information Barriers to the Take-Up of Naloxone.American economic journal. Economic policy · 2024Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
BACKGROUND AND
aimsNaloxone access laws (NALs) have been suggested to be an important strategy to reduce opioid-related harm. We describe the evolution of NALs across states and over time and review existing evidence of their overall association with naloxone distribution and opioid overdose as well as the potential effects of specific NAL components.
methodsDescriptive analysis of temporal variation in US regional adoption of NAL components, accompanied by a systematic search of 13 databases for studies (published between 2005 and 20 December 2019) assessing the effects of NALs on naloxone distribution or opioid-related health outcomes. Eleven studies, all published since 2018, met inclusion criteria. Study time-frames spanned 1999-2017. Opioid-related overdose mortality, emergency department episodes and naloxone distribution were correlated with the presence of a NAL and, where data were available, NAL components.
resultsExisting evidence suggests mixed, but generally beneficial, effects for NALs. Nearly all studies show that NALs, particularly those that permit naloxone distribution without patient-specific prescriptions, are associated with increased naloxone access [incidence rate ratios (IRR) range from 1.40, 95% confidence interval (CI) = 1.15-1.66 to 7.75, 95% CI = 1.22-49.35] and increased opioid-related emergency department visits (IRR range from 1.14, 95% CI = 1.07-1.20 to 1.15, 95% CI = 1.02-1.29). Most studies show NALs are associated with reduced overdose mortality, although findings vary depending on the specific NAL components and time-period analyzed (IRR range from 0.66, 95% CI = 0.42-0.90 to 1.27, 95% CI = 1.27-1.27). Few studies account for the variation in opioid environments (i.e. illicit versus prescription) or other policy dimensions that may be correlated with outcomes.
conclusionsThe existing literature on naloxone access laws in the United States supports beneficial effects for increased naloxone distribution, but provides inconclusive evidence for reduced fatal opioid overdose. Mixed findings may reflect variation in the laws' design and implementation, confounding effects of concurrent policy adoption, or differential effectiveness in light of changing opioid environments.
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