Maryland Department of Health
The Overdose Response Program

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​Maryland STOP Act​​

Impacts

The STOP Act (Statewide Targeted Overdose Prevention Act), effective July 1, 2022, requires certain organizations to provide naloxone, Narcan, or another opioid overdose reversal drug (OORD) to the people they serve. The Maryland Department of Health (MDH) is required to purchase and provide naloxone or another OORD for identified organizations.


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Background​

The STOP Act began as an administration bill written by the Maryland Department of Health Center for Harm Reduction Services (MDH CHRS) and the Maryland Opioid Operational Command Center (OOCC). As HB408 and SB394, the STOP Act passed unanimously through both Maryland state legislature chambers. The STOP Act created a new law that went into effect on July 1, 2022, requiring certain organizations to provide naloxone or another OORD.
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​Implementation of the STOP Act is being overseen by MDH CHRS in collaboration with the regulatory agencies of affected organizations. Mandates to offer OORDs are in effect while the Department is able to purchase and provide OORDs to affected organizations.

Goals​​

  1. Increase the number of access points for naloxone in Maryland communities​
  2. Ensure access to naloxone in organizations caring for those at greatest risk of overdose
  3. Establish long-term budget allocation for naloxone at the state level
  4. Create opportunities for training, capacity building, and other harm reduction initiatives at identified organizations

Justification​​

  • Providing naloxone to people most likely to experience or witness an overdose ensures the best chance of reducing overdose mortality.
  • MDH CHRS calculates naloxone saturation based on how much naloxone is distributed to high-risk groups.
  • Maryland data suggests that a recent period of abstinence, previous experience of nonfatal overdose, and experiencing homelessness are risk factors for overdose.
  • The distribution of naloxone in Maryland falls short of meeting the needs of those most at risk, despite great advancements in access.

Overdose Resp​​onse Program

MDH authorizes government agencies and community-based organizations to become Overdose Response Programs (ORPs), allowing them to provide overdose prevention education and dispense naloxone to the community. Learn how to become an Overdose Response Program.

Identified Orga​​nizations


Businesses​​​​​​​​​​

Effective July 1, 2022
The STOP Act improved liability protections for businesses and business owners that offer naloxone or other OORDs.
A cause of action may n​ot arise against any business or business owner for any act or omission when the business or busi​ness owner in good faith makes OORDs available to the employees or patrons of the business along with the necessary paraphernalia for administration of the OORD to an individual under 13-3104 or 13-3106.
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EMS Providers​

Effective July 1, 2022
The STOP Act authorizes Emergency Medical Services providers (EMTs, CRTs, and Paramedics) to dispense OORD to patients by changing Article-Education §13-516. Many EMS already dispense take-home OORD through the MIEMSS Naloxone Leave-Behind Pilot protocols.
EMS providers may dispense naloxone or another OORD to:
  • Individuals who receive treatment for a nonfatal drug overdose
  • Individuals who are evaluated by a crisis evaluation team

Homeless Services Programs

By June 30, 2024
The STOP Act requires homeless services programs to offer free naloxone or another OORD to individuals they serve.
​On or before June 30, 2024, a homeless services program that provides services to individuals who have a substance use disorder or an opioid use disorder or are at risk of experiencing a drug overdose shall have a protocol to offer opioid overdose reversal drugs approved by the federal Food and Drug Administration, free of charge, to those individuals who have an opioid use disorder or are at risk of experiencing a drug overdose when the individual receives services from the community services program.
Homeless Services Programs must offer free naloxone (or another OORD) to:
  • Individuals who have an opioid use disorder
  • Individuals at risk of experiencing a drug overdose

State and Local Co​​​rrectional Facilities

By June 30, 2024
State and local correctional facilities shall have a protocol to offer an opioid overdose reversal drug approved by the federal Food and Drug Administration, free of charge, to sentenced individuals who have an opioid use disorder or who are at risk of experiencing a drug overdose before the individual’s release.
State and Local Correctional Facilities must offer free naloxone (or another OORD) to:
  • Sentenced individuals, before release, who either (1) have an opioid use disorder or (2) are at risk of experiencing a drug overdose

Division of Paro​le and Probation​ (DPP)

By June 30, 2024
The Division of Parole and Probation shall have a protocol to offer an opioid overdose reversal drug approved by the federal Food and Drug Administration, free of charge, to individuals under supervision who have an opioid use disorder or are at risk of experiencing a drug overdose.
DPP must offer free naloxone (or another OORD) to:
  • Individuals under supervision who either (1) have an opioid use disorder or (2) are at risk of experiencing a drug overdose

Intensive Outpatient P​​rograms (IO​​Ps)

By June 30, 2023
Intensive Outpatient Treatment Programs (IOPs) must have protocols to offer an OORD, free of charge, to all individuals receiving services. No diagnosis or qualifying criteria apply.
​​On or before June 30, 2023, each opioid treatment program and each intensive outpatient treatment program shall have a protocol to offer an opioid overdose reversal drug approved by the federal Food and Drug Administration, free of charge, when an individual receives services from the opioid treatment ​program or intensive outpatient treatment program.
IOPs must offer free naloxone (or another OORD) to:
  • Individuals receiving services​

Opioid Treatmen​t​​ Programs (OTPs)

By June 30, 2023
Opioid Treatment Programs (OTPs) must have protocols to offer an OORD, free of charge, to all individuals receiving services. No diagnosis or qualifying criteria apply.
On or before June 30, 2023, each opioid treatment program and each intensive outpatient treatment program shall have a protocol to offer an opioid overdose reversal drug approved by the federal Food and Drug Administration, free of charge, when an individual receives services from the opioid treatment program or intensive outpatient treatment program.
OTPs must offer free naloxone (or another OORD) to:
  • Individuals receiving services

Hospitals​​

By June 30, 2023
Since January 1, 2018, Md. Article-Health General §19-310.3 has required Maryland hospitals to have protocols for discharging patients treated for drug overdose or those with Substance Use Disorder (SUD). The prescription of naloxone was previously an optional feature of these protocols. With the passage of the STOP Act, these hospital protocols must now include not simply prescribing OORDs, but offering OORDs directly, free of charge, to patients who were treated for SUD, OUD, or drug overdose. This change ensures that patients who want OORDs receive them directly in-hand prior to discharge; this will reduce missed opportunities that occur because of prohibitive copays or loss to follow-up when providers refer patients to pharmacies for OORDs.
Hospitals must directly offer free naloxone (or another OORD) to:
  • ​Patients who receive treatment for a substance use disorder, opioid use disorder, or nonfatal drug overdose event.​