Dissertations & Theses (Open Access)

Date of Award

12-2022

Degree Name

Doctor of Philosophy (PhD)

Advisor(s)

Stephen H. Linder

Second Advisor

Gretchen H. Walton

Third Advisor

Wenyaw Chan

Abstract

To fight soaring overdose mortality rates in the United States, lawmakers adopted a variety of harm reduction tools. Among these, 911 Good Samaritan Laws (GSLs) derive their name from the biblical parable of the Good Samaritan, a bystander who broke cultural convention to come to the aid of a man beset by thieves. These laws provide limited criminal immunity for bystanders in possession of controlled substances to encourage them to report drug overdoses. While previous studies associate GSLs with a modest reduction in opioid mortality, analyses often model them as equivocal or divide them coarsely across individual provisions. Evaluating these laws inductively reveals substantial heterogeneity. Laws passed in some states protect Good Samaritans engaged in a breadth of offenses and provide robust protection beyond immunity from arrest or prosecution. Conversely, other laws place burdensome obligations on the Good Samaritan or exempt many from immunity altogether. Differences among these laws can be charted visually to reveal patterns in their provisions. These patterns may be clustered into five groups: Minimal laws provide scant immunity for a limited range of offenses; Moderate laws are designed simply to apply to most emergency scenarios while offering constrained protection; Narrow laws are acutely described to immunize possession of controlled substances and provide strong immunity, while excepting other offenses or violations; Rigorous laws require substantial compliance on the part of the Good Samaritan, but award potent protection to those who obey; and Strong laws, which exhibit the theme of the parable by immunizing virtually all persons in most imaginable substance-related circumstances so long as they act in good faith. These groups provide an alternative method of modeling the relationship between overdose mortality and GSLs. Indeed, Strong laws save lives. Following adoption of a Strong law, states experience a reliable decrease in overdose mortality. However, the effect is not conserved over time. Ratifying Rigorous laws, conversely, predicts an increase in general overdose mortality. Together, this evidence substantiates the ability of good faith harm reduction policy to save vulnerable lives. However, prioritizing compliance over compassion, in contravention of the parable, does more harm than good.

Download

Share

COinS