Code of the District of Columbia

§ 7–404. Prescribing authority of opioid antagonist for overdose victim and 3rd parties.

(a) For the purposes of this section, the term:

(1) "Community-based organization" means an organization that provides services, including medical care, counseling, homeless services, or drug treatment, to individuals and communities impacted by drug use. The term "community-based organization" includes all organizations currently participating in the Needle Exchange Program with the Department of Human Services under § 48-1103.01.

(2) "Health care professional" means a physician or pharmacist licensed under Chapter 12 of Title 3 practicing within the scope of practice for his or her profession.

(3) "Opioid antagonist" shall have the same meaning as provided in § 7-403(i)(2).

(4) "Overdose" shall have the same meaning as provided in § 7-403(i)(3).

(5) "Standing order" means a prescriptive order written by a health care professional that is not specific to and does not identify a particular patient.

(b) Except as provided in subsection (d) of this section, a health care professional acting in good faith may directly or by standing order prescribe, dispense, and distribute an opioid antagonist to the following persons:

(1) A person at risk of experiencing an opioid-related overdose;

(2) A family member, friend, or other person in a position to assist a person at risk of experiencing an opioid-related overdose; or

(3) An employee or volunteer of a community-based organization.

(b-1) An opioid antagonist issued in accordance with subsection (b) of this section shall be regarded as being issued for a legitimate medical purpose in the usual course of professional practice.

(c) Except as provided in subsection (d) of this section, an employee or volunteer of a community-based organization acting in good faith and in accordance with a standing order or under a health care professional's prescriptive authority may dispense and distribute an opioid antagonist to the following persons:

(1) A person at risk of experiencing an opioid-related overdose; or

(2) A family member, friend, or other person in a position to assist a person at risk of experiencing an opioid-related overdose.

(d)(1)(A) A pharmacist may dispense or distribute, but not prescribe, an opioid antagonist pursuant to a written protocol and standing order.

(B) An employee or volunteer of a community-based organization shall not dispense or distribute an opioid antagonist under this section unless he or she completes training conducted by the Department of Health.

(2) The frequency of the training required by this subsection shall be determined by the Department of Health through rulemaking.

(3) The training required by this subsection shall include:

(A) How to screen a patient for being at risk of an opioid-related overdose;

(B) How opioid antagonists operate to stop an opioid-related overdose;

(C) When the administration of an opioid antagonist is medically indicated;

(D) How to properly administer an opioid antagonist and circumstances under which administration of an opioid antagonist is contraindicated; and

(E) Precautions, warnings, and potential adverse reactions related to the administration of an opioid antagonist.

(e) Upon prescribing, dispensing, or distributing an opioid antagonist, the health care professional or employee or volunteer of a community-based organization shall provide education and training to the recipient of an opioid antagonist. The education and training shall include:

(1) How to identify an opioid-related overdose;

(2) How to properly administer the prescribed opioid antagonist and circumstances under which administration is contraindicated;

(3) Precautions, warnings, and potential adverse reactions related to administration of the prescribed opioid antagonist;

(4) How opioid antagonists operate to stop an opioid-related overdose;

(5) The importance of seeking medical care for the person experiencing the opioid-related overdose immediately after the opioid antagonist is administered; and

(6) Information on how to access substance abuse treatment services.

(f)(1) A health care professional or an employee or volunteer of a community-based organization who prescribes, dispenses, or distributes an opioid antagonist in accordance with this section shall be immune from civil or criminal liability for the subsequent use of the opioid antagonist, unless the health care professional's actions or the actions of the employee or volunteer of a community-based organization with regard to prescribing, dispensing, or distributing the opioid antagonist constitute recklessness, gross negligence, or intentional misconduct.

(2) The immunity granted pursuant to paragraph (1) of this subsection shall apply whether or not the opioid antagonist is administered by or to the person for whom it was prescribed, dispensed, or distributed.

(f-1)(A) Nothing in this section shall be construed to require a health care professional to prescribe, dispense, or distribute an opioid antagonist to a person at risk of experiencing an opioid related overdose or a family member, or friend, or other person in a position to assist a person at risk of experiencing an opioid related overdose, or an employee or volunteer of a community based organization.

(B) A health care professional that does not prescribe, dispense, or distribute an opioid antagonist based upon his or her professional judgment shall be immune from civil or criminal liability, unless the health care professional's decision not to prescribe, dispense, or distribute an opioid antagonist constitutes recklessness, gross negligence, or intentional misconduct.

(f-2) Nothing in this section shall be construed to expand the scope of practice of a health care professional.

(g) Within 180 days after April 11, 2019, the Mayor, pursuant to subchapter I of Chapter 5 of Title 2, shall issue rules to implement the provisions of this section.


(Nov. 8, 1965, 79 Stat. 1302, Pub. L. 89-341, § 4; as added Feb. 18, 2017, D.C. Law 21-186, § 2, 63 DCR 14361; Apr. 11, 2019, D.C. Law 22-288, § 301, 66 DCR 1656.)