Naloxone is an opioid antidote that works almost immediately to reverse an opiate-related overdose. Naloxone has no potential for misuse, few known adverse effects, and can be quickly administered through intramuscular injection or intranasal spray. Both intramuscular and intranasal naloxone are FDA-approved and appropriate for community distribution.

A standing order is a blanket prescription for naloxone for a group of people. This blanket prescription eliminates barriers to having this lifesaving medication on-hand if a person witnesses an overdose, getting naloxone out from behind closed doors and into communities.

New Jersey’s new law requires the Commissioner of Health or Deputy Commissioner for Public Health Services to issue two statewide
standing orders:

• A standing order authorizing any person to distribute free opioid antidotes;
• A standing order authorizing licensed pharmacists to dispense an opioid antidote to any individual or entity.

On August 31, 2021, the New Jersey Department of Health issued a standing order accomplishing both mandates.

New Jersey’s standing order will stay in effect unless and until all forms of opioid antidotes have been approved as over-the-counter medications or until the New Jersey Department of Health withdraws the standing order in writing.

The new law allows individuals and organizations to distribute naloxone for free, without any additional authorizations or separate standing orders. Any pharmacist may dispense an opioid antidote to any person pursuant to the new standing order for pharmacies.

This is a change from previous law, which required individual pharmacists to apply for and obtain a separate standing order.

Yes—New Jersey has robust “Good Samaritan” protections for naloxone distribution and for administering naloxone to someone who you in good faith believe to be experiencing an opioid-related overdose. The new law explicitly states that prescribers and other health care providers are immune from civil and criminal liability and professional discipline for prescribing or dispensing an opioid antidote.

An individual is immune from civil and criminal liability and professional discipline for distributing or administering an opioid antidote in
good faith.

A person distributing opioid antidotes must make reasonable efforts to provide the recipient with overdose prevention information. The law is flexible as to what form the overdose information may take, and does not preclude written information. Information about the following must be included:

• Opioid overdose prevention and recognition;
• How to perform rescue breathing and resuscitation;
• Opioid antidote dosage and instructions on opioid antidote administration;
• The importance of calling the 911 emergency telephone service for assistance with an opioid overdose;
• Appropriate care of a person believed to be experiencing an opioid overdose after administration of the opioid antidote.

The new standing order is a “blanket prescription” allowing any individual and organization, including laypeople, to distribute free naloxone to any other person reasonably believed to be at risk of experiencing an opioid overdose or reasonably believed to be a position to administer the opioid antidote to a person experiencing an overdose. In addition to this statewide standing order, licensed medical prescribers may continue to prescribe naloxone as follows:

• Any health care practitioner authorized to prescribe medications may prescribe or dispense an opioid antidote to any person or
  entity via an individual prescription or standing order. A standing order does not need to specify whether secondary distribution
  is permitted.
  Any health care practitioner may dispense an opioid antidote to any person or entity in accordance with an individual
  prescription or standing order.
  A health care practitioner who prescribes or dispenses an opioid antidote must provide the recipient with specified overdose
  prevention information.

Yes. “Leave-behind” is when emergency medical services and health care professionals distribute one or multiple doses of naloxone to
an individual who experienced an overdose. Per the new law, it is required for first responders and health care professionals providing
services after an overdose to “leave behind” or offer naloxone for the person to take.

For emergency medical responders: If naloxone is administered by a first responder and the person believed to be experiencing an overdose is not subsequently transported to a health care facility, the first responder must offer to give the person additional naloxone and provide the information concerning substance use disorder treatment programs, sterile syringe access programs, and related resources to the person at the time treatment for the drug overdose is complete.

For emergency departments: If a person is admitted to a health care facility or receives treatment in the emergency department of a health care facility, a staff member designated by the health care facility, who may be a social worker, professional counselor, licensed or certified alcohol or drug counselor, or other appropriate professional, must offer to furnish the person, or a family member or friend of the person in attendance during the patient’s admission or emergency department visit, with naloxone upon discharge, along with information regarding the cost of the opioid antidote, and provide the information concerning substance use disorder treatment programs, sterile syringe access programs, and related resources after treatment for the drug overdose is complete, but prior to the person’s discharge from the facility.

To the extent that state funds are made available, recognized places of public access must obtain and maintain a supply of opioid antidotes in one or more secure and easily accessible locations. Recognized places of public access may also enter into agreements with community-based organizations to distribute opioid antidotes on the premises of the place of public access.

Recognized places of public access include a public library, institution of higher education, occupational school, or public transportation hub.