Expanding Safe Hospital Access AM for Overdose Care in Lebanon.

In Lebanon, the criminalization of drug use and the misapplication of ministerial directives have led hospitals to report overdose cases to law enforcement, deterring people who use drugs from seeking urgent medical care and increasing the risk of preventable death. This paper examines overdose response as a right to health issue, using civil society advocacy in Lebanon to illustrate how law enforcement involvement in health care settings undermines access to emergency care. Drawing on repeated nationwide mappings of hospital practices when receiving overdose cases conducted between 2016 and 2024, the paper documents patterns of compliance and noncompliance with Ministry of Public Health directives prohibiting the reporting of overdoses to the police. While sustained advocacy has contributed to multiple policy milestones, including ministerial and syndicate circulars reaffirming hospitals' duty of care without police involvement, implementation has remained uneven. Although more hospitals have stopped reporting overdose cases to the police, continued reporting remains tied to limited staff awareness, fear of liability, and stigmatizing attitudes toward people who use drugs. The Lebanese case highlights both the critical role and the structural limits of civil society monitoring in safeguarding access to emergency medical care under conditions of criminalization, crisis, and weak accountability. We argue that incremental protective policies are insufficient where emergency care remains entangled with punitive drug policy.