Texas Good Samaritan Overdose Law and Naloxone Explained

The Texas Good Samaritan Overdose Law and Naloxone: What Families Should Knowtexasrehabs.net

Since September 1, 2021, Texas law has given people a defense to prosecution for possessing small amounts of drugs when they are the first to call for emergency help during an overdose, stay until help arrives and cooperate. The person who overdosed is also covered. The defense has real limits, so it is not blanket immunity. Naloxone, the medicine that reverses opioid overdoses, is sold over the counter.

Fear of arrest keeps some people from calling for help when a friend or family member overdoses. Texas lawmakers passed House Bill 1694 in 2021 to change that. Here is what the law does, what it does not do, and how to be ready with naloxone.

What HB 1694 does

HB 1694 created a defense to prosecution for certain drug possession offenses when a person:

Is the first person to request emergency medical assistance for someone experiencing a possible overdose.
Remains on the scene until medical help arrives.
Cooperates with medical responders and law enforcement.

The law also covers the person who overdosed when someone calls for them. It took effect September 1, 2021. The defense applies to possession offenses listed in the bill, including small amounts of the most serious drug category (under one gram), other controlled substance groups, marijuana and drug paraphernalia.

The limits you need to know

A defense to prosecution is raised in the criminal case. It is not a promise that no one will be arrested, and it does not cover other crimes. Under the law, the defense is not available if:

Police were already making an arrest or serving a warrant when the call was made.
The person has a prior conviction or deferred adjudication for a drug offense.
The person has used this defense before.
The person requested emergency help for an overdose within the previous 18 months.

Even with those limits, the safest choice during an overdose is always to call for help. A person can survive an overdose. They cannot recover from one that goes untreated.

Naloxone: the medicine that reverses opioid overdoses

Naloxone rapidly reverses the effects of an opioid overdose and is the standard treatment for it. In March 2023 the FDA approved a naloxone nasal spray for over-the-counter sale, the first naloxone product approved for use without a prescription. That opened sales in drug stores, grocery stores, convenience stores and online. It is also often available free through community programs and health departments.

Texas law supports access in several ways:

Prescribers may prescribe naloxone or another opioid antagonist to a person at risk of an opioid overdose, or to a family member or friend, directly or through a standing order.
Pharmacists may dispense it on a valid prescription to an at-risk person or a family member or friend, and they are protected from liability when acting in good faith.
A person or organization acting under a standing order may store and give out naloxone, as long as it does not charge for it.

Who should keep naloxone on hand

SAMHSA suggests overdose reversal medication for people who take high doses of opioids for chronic pain, take long-acting or extended-release opioids, have been treated in an emergency room for an opioid overdose, or have recently gone without opioids for a while, including people just released from incarceration. Families of anyone using opioids, prescribed or not, should consider keeping it at home and in the car, and should replace it when it expires.

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What to do during a suspected opioid overdose

SAMHSA lists these signs of an opioid overdose: the person does not wake up or respond to touch or voice, breathing is very slow, abnormal or has stopped, pupils are pinpoint-sized, and lips and nose look bluish. If you see them:

Call 911. Say the person is not breathing or not responding, and give the exact address.
Give naloxone following the directions on the package.
Support breathing if you have learned rescue breathing. A doctor, pharmacist or overdose prevention program can teach you how to give naloxone and rescue breaths before you ever need to.
Stay with them until help arrives. SAMHSA notes that naloxone is a temporary treatment whose effects do not last long, so medical care is still critical after it is given.

Naloxone can bring on sudden opioid withdrawal in someone dependent on opioids. The FDA lists symptoms such as body aches, diarrhea, fast heart rate, sweating, nausea, vomiting and irritability. Withdrawal is unpleasant, but it is far less dangerous than an untreated overdose. Naloxone works even when opioids were mixed with other drugs, but SAMHSA notes it does not treat benzodiazepine overdoses or stimulant overdoses from cocaine or amphetamines, so emergency care is essential whatever was taken.

The danger right after detox or treatment

MedlinePlus, from the National Library of Medicine, warns that most opioid overdose deaths occur in people who have just detoxed. Withdrawal lowers tolerance, so a much smaller dose than before can be fatal. That is why families should keep naloxone at home when a loved one leaves detox, jail, a hospital or a residential program, and why continuing care matters so much.

Turning a close call into treatment

An overdose is often the moment a person or family decides something has to change. Medications such as methadone and buprenorphine treat opioid withdrawal and can be continued long term, and licensed Texas programs cannot deny admission simply because someone takes prescribed medication. If your loved one is ready, start with medical detox or an assessment for inpatient care. If they are not ready, our guide on helping a loved one into treatment covers conversations, boundaries and legal options.

For mental health or suicide concerns at any point, call or text 988 or visit our crisis help page. To find programs close to home, browse cities like El Paso or Lubbock, or see all Texas locations. Planning for life after treatment? Read sober living and aftercare in Texas.

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The Texas Good Samaritan Overdose Law and Naloxone: What Families Should Know