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State naloxone co-prescribing laws show mixed effects on overdose mortality rates

Syringe next to a yellow bottle


MaryKate Duska, Jared M. Rhoads, Elizabeth C. Saunders, Tracy Onega


July 25, 2022


To examine the relative changes in opioid overdose mortality rates between states that have and have not adopted naloxone co-prescribing laws.


We performed a synthetic control analysis. National Vital Statistics data for the years 2012–2018 were analysed, and five states with naloxone co-prescribing laws were examined: Arizona, Florida, Rhode Island, Vermont, and Virginia. Opioid overdose-related deaths were identified through cause-of-death ICD-10 codes.


Our pooled analysis for all opioid-related deaths showed no significant changes in opioid-related mortality rates in treated states, post naloxone co-prescribing law adoption (−0.05; 95% CI: −0.43, 0.33). Rates of other and unspecified narcotic-related mortality rates in Rhode Island were found to have decreased post-law adoption (−0.13; 95% CI: −0.25, −0.00).


These findings suggest that naloxone co-prescribing laws were not associated with changes to overall opioid overdose mortality rates, post-law adoption, during the study period. However, Rhode Island did see a decrease in other and unspecified narcotic-related mortality rates post-law adoption. This is perhaps due to the comprehensive nature of the state’s law. As overall rates of naloxone co-prescribing remain low, interventions to enhance naloxone prescribing and distribution may be necessary for co-prescribing laws to impact opioid-related mortality rates.

This research was published in the Drug Science, Policy and Law Journal the definitive source of evidence-based information and comment for academics, scientists, policymakers, frontline workers and the general public on drugs and related issues.

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