An Act To Address Preventable Deaths from Drug Overdose
Maine Legislature, Session 126, LD 1686
Committee: Health and Human Services
Sponsors: GIDEON, CRAVEN, BECK, COOPER, DORNEY, RYKERSON, SANBORN, WILSON, GERZOFSKY
Amends: 5 MRSA §20005, 5 MRSA §20010

Legislative Document 
No. 1686 
H.P. 1209 
House of Representatives, December 30, 2013 
An Act To Address Preventable Deaths from Drug Overdose 
(EMERGENCY) 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203. 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative GIDEON of Freeport. 
Cosponsored by Senator CRAVEN of Androscoggin and 
Representatives: BECK of Waterville, COOPER of Yarmouth, DORNEY of Norridgewock, 
McGOWAN of York, RYKERSON of Kittery, SANBORN of Gorham, WILSON of Augusta, 
Senator: GERZOFSKY of Cumberland. 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, this legislation needs to take effect before the expiration of the 90-day 
period because the number of drug overdoses and ensuing deaths is on the rise, and this 
legislation is needed as soon as possible in order to save lives; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  5 MRSA §20005, sub-§20, as amended by PL 2005, c. 674, §1, is further 
amended to read: 
20.  Review policies.  Review the full range of public policies and strategies existing 
in State Government to identify changes that would strengthen its response, identify 
policies that might discourage excessive consumption of alcohol and other drugs and 
generate new funding for alcohol and other drug services; and 
Sec. 2.  5 MRSA §20005, sub-§21, as enacted by PL 2005, c. 674, §2, is amended 
to read: 
21.  List of banned performance-enhancing substances.  Develop and maintain a 
list of banned performance-enhancing substances in accordance with Title 20-A, section 
6621.; and 
Sec. 3.  5 MRSA §20005, sub-§22 is enacted to read: 
22.  Grants for drug overdose projects.  Make grants from existing resources for: 
A.  Drug overdose prevention, recognition and response education projects; 
B.  Drug overdose prevention, recognition and response training projects for patients 
receiving opioids and their families and caregivers; 
C.  Naloxone hydrochloride prescription or distribution projects; and 
D.  Education and training projects on drug overdose response and treatment for 
emergency services and law enforcement personnel, including, but not limited to, 
volunteer firefighters and volunteer emergency services personnel. 
Sec. 4.  5 MRSA §20010 is enacted to read: 
§20010.  Report on unintentional drug overdose 
The department's office of substance abuse and mental health services shall ascertain 
and document and publish an annual report on the number of and trends, patterns and risk 
factors related to unintentional drug overdose fatalities occurring within the State each 
year.  The report must also provide information on interventions that would be effective 
in reducing the rate of fatal and nonfatal unintentional drug overdose. 
Sec. 5.  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.  Immunity.  The following provisions govern immunity for persons who prescribe, 
possess or administer an opioid antagonist during an opioid-related drug overdose. 
A.  Notwithstanding any other provision of law, a health care professional otherwise 
authorized to prescribe an opioid antagonist may, directly or by standing order, 
prescribe and dispense an opioid antagonist to a person at risk of experiencing an 
opioid-related drug overdose or to a family member or friend of such a person or 
another person in a position to assist a person at risk of experiencing an opioid-
related drug overdose.  Any such prescription must be regarded as being issued for a 
legitimate medical purpose in the usual course of professional practice. 
B.  A health care professional who, acting in good faith and with reasonable care, 
prescribes or dispenses an opioid antagonist pursuant to paragraph A is not subject to 
criminal or civil liability or any professional disciplinary action for: 
(1)  Such prescribing or dispensing; or 
(2) Any outcomes resulting from the administration of the opioid antagonist. 
C.  Notwithstanding any other provision of law, a person acting in good faith may 
possess an opioid antagonist. 
D.  A person who, acting in good faith and with reasonable care, administers an 
opioid antagonist to another person whom the person believes to be experiencing an 
opioid-related drug overdose is immune from criminal prosecution, sanction under 
any professional licensing statute and civil liability for such act. 
3.  Authorizing 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 as clinically indicated. 
4.  Medicaid coverage for naloxone hydrochloride.  The department shall add 
naloxone hydrochloride for outpatient use to the department's formulary of prescription 
and over-the-counter drugs that are subject to reimbursement and coverage under the 
Medicaid program pursuant to section 3174-M.  Reimbursement and coverage must be 
provided through existing resources. 
5.  Exemption from pharmacy license for standing orders for opioid antagonists.  
Notwithstanding any other provision of law, a person 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. 
6.  Collaborative practice.  The following provisions govern collaborative practice 
for naloxone hydrochloride. 
A.  Notwithstanding any other provision of law, a licensed pharmacist may initiate 
naloxone hydrochloride drug 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 naloxone hydrochloride drug therapy initiated pursuant to this 
subsection, the licensed pharmacist shall provide the recipient of the naloxone 
hydrochloride 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. 
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This bill authorizes the prescription, possession and administration of opioid 
antagonists under certain circumstances and provides criminal and civil immunities for 
such prescription, possession and administration; provides for Medicaid coverage of 
naloxone hydrochloride using existing resources; authorizes standing orders and 
collaborative practice agreements for the dispensing of opioid antagonists; provides for 
an annual report on unintentional drug overdose; and directs the Department of Health 
and Human Services to make grants from existing resources for various drug overdose 
prevention projects.