An Act To Address Preventable Deaths from Drug Overdose
Maine Legislature, Session 126, LD 1686
Committee Amendment CA_A_H711 (House)

COMMITTEE AMENDMENT" A" to H.P. 1209, L.D. 1686, Bill, "An Act To 
Address Preventable Deaths from Drug Overdose" 
Amend the bill by striking out everything after the title and before the summary and 
inserting the following: 
'Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA c. 556-A is enacted to read: 
CHAPTER 556-A 
OPIOIDS 
§2353. Opioid antagonists 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. "Opioid antagonist" means a drug that binds to opioid receptors and blocks or 
inhibits the effects of opioids acting on those receptors, including, but not limited to, 
naloxone hydrochloride. 
B. "Opioid-related drug overdose" means a condition including, but not limited to, 
extreme physical illness, decreased level of consciousness, respiratory depression, 
coma or death reSUlting from the consumption or use of an opioid, or another 
substance with which an opioid was combined, or a condition that a reasonable 
person would believe to be an opioid-related drug overdose that requires medical 
assistance. 
2. 
Authorized administration of an opioid antagonist by law enforcement 
officers and municipal firefighters. A law enforcement officer as defined in Title 17 -A, 
section 2, subsection 17 and a municipal firefighter as defined in Title 30-A. section 
3151, subsection 2 may administer an intranasal opioid antagonist as clinically indicated. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 1209, L.D. 1686 
3. Authorized administration of an opioid antagonist by emergency medical 
personnel. 
An advanced emergency medical technician, basic emergency medical 
services person, basic emergency medical technician, first responder and emergency 
medical services' person as defined in Title 32, section 83 may administer an opioid 
antagonist in accordance with the provisions of Title 32, chapter 2-B. 
4. Exemption from pharmacy license for standing orders for opioid antagonists. 
Notwithstanding any other provision of law, a person employed by an organization that 
provides a significant level of services to persons who are actively using or have a history 
of actively using drugs, acting under a standing order issued by a health care professional 
who is otherwise authorized to prescribe an opioid antagonist, may store and dispense an 
opioid antagonist without being subject to the provisions of Title 32, chapter 117 as long 
as these activities are undertaken without charge or compensation. 
5. Collaborative practice. The following provisions govern collaborative practice 
for opioid antagonists. 
A. Notwithstanding any other provision of law, a licensed pharmacist may initiate 
opioid antagonist therapy for a person in accordance with standardized procedures or 
protocols developed by the pharmacist and a health care professional authorized to 
prescribe an opioid antagonist. 
B. 
For each opioid antagonist therapy initiated pursuant to this subsection, the 
licensed pharmacist shall provide the recipient of the opioid antagonist with a 
standardized fact sheet developed by the Maine Board of Pharmacy that includes, but 
is not limited to, the indications for use of the drug, the appropriate method for using 
the drug, the potential need for medical follow-up and referral information, 
information on opioid-related drug overdose and other appropriate information. 
C. Nothing in this subsection affects the provisions of law relating to maintaining the 
confidentiality of medical records. 
6. Opioid antagonist prescription, possession and administration. In addition to 
the provisions of subsections 2 to 5, the provisions of this subsection apply to prescribing, 
possessing and administering an opioid antagonist. For the purposes of this subsection, 
"health care professional" means a health care professional licensed under Title 32 with 
authority to prescribe an opioid antagonist. 
A. A health care professional may prescribe and dispense an opioid antagonist to a 
person at risk of experiencing an opioid-related drug overdose. 
B. A health care professional may prescribe and dispense an opioid antagonist to a 
person who, in the judgment of the health care professional, is capable of 
administering the drug in an emergency and may be in a position to assist an 
individual during an opioid-related drug overdose. 
C. 
A health care professional who prescribes or dispenses an opioid antagonist 
pursuant to paragraph A or B shall provide information regarding the opioid 
antagonist to the person for whom the opioid antagonist is prescribed or to whom the 
opioid antagonist is dispensed. 
D. 
A person may receive a prescription for an opioid antagonist pursuant to 
paragraph A or B, possess an opioid antagonist and administer an opioid antagonist to 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT if" to H.P. 1209, L.D. 1686 
an individual who the person believes in good faith may be experiencing an opioid-
related drug overdose.' 
SUMMARY 
This amendment is the majority report of the committee. The amendment strikes the 
emergency preamble and emergency clause. 
Like the bill, the amendment defines 
"opioid antagonist" and "opioid-related drug overdose" and authorizes emergency 
medical personnel to administer opioid antagonists, but the amendment adds a provision 
authorizing law enforcement officers and municipal firefighters to administer intranasal 
opioid antagonists. Like the bill, the amendment allows the prescribing and dispensing of 
an opioid antagonist to a person at risk of an opioid-related drug overdose and to a person 
who may be in a position to assist an individual experiencing an opioid-related drug 
overdose and allows such persons to possess and administer opioid antagonists, but the 
amendment removes the provisions regarding liability. It clarifies the provision in the bill 
that provides an exemption from phannacy license requirements for a person who stores 
or dispenses an opioid antagonist under a standing order from an appropriate health care 
professional to provide that the person must be employed by an organization that 
provides a significant level of services to persons who are actively using drugs or have a 
history of actively using drugs. 
Like the bill, the amendment allows collaborative 
practice between a pharmacist and a health care professional with respect to opioid 
antagonist therapy, but the amendment expands the provision to include all opioid 
antagonists, not just naloxone hydrochloride. It removes the provisions of the bill that 
require the Department of Health and Human Services to make grants from existing 
resources for drug overdose education projects, to publish an annual report on 
unintentional drug overdose fatalities in the State and to add naloxone hydrochloride to 
the department's Medicaid drug fonnulary. 
COMMITTEE AMENDMENT