Proposed Legislation to Boycott Opioid Manufacturers Would Undermine the Public Health Response to Opioid Overdose

Over the past year, several bills that would impose novel restrictions on the purchasing of naloxone and other opioid antagonists (medications that reverse opioid overdose) have been introduced in state legislatures.

These bills have been introduced in numerous states, including California, Colorado, New Jersey, Maryland, Montana, and Washington. While their text differs slightly, each is designed to restrict the use of state funds to purchase opioid antagonists from entities that have entered into an opioid-related litigation settlement regarding misconduct in the sale or distribution of prescription opioids.

Many major pharmaceutical manufacturers and distributors that have entered into these agreements now sell or distribute overdose reversal products. Manufacturers such as Hikma, Teva, Pfizer, Amneal, and Purdue, and major distributors such as Amerisource Bergen (Cencora), Cardinal, and McKesson, have all entered into a state opioid litigation settlement. These bills would forbid or restrict the purchasing of opioid antagonists from these companies, among others.

At first glance, these bills appear to be designed to prevent companies who profited from prescription opioid misconduct from profiting from state efforts to remediate the opioid overdose crisis. However, the main result of these bills may be to drive sales to a small number of manufacturers and distributors, increasing costs and undermining the public health response to the crisis.

For example, Emergent Biosolutions, the manufacturer of Narcan, a brand-name naloxone product, is one of only a few companies that manufacture opioid antagonists that would not be disqualified by these proposed laws. If these bills become law, therefore, they would likely drive business to Emergent even when lower-cost opioid antagonists are available.

For the major pharmaceutical companies targeted by these bills, opioid antagonists represent only a small fraction of sales. But for the people and communities most affected by opioid-related harm, naloxone is a crucial life-saving intervention. Indeed, efforts to increase access to naloxone have played a major role in the recent reduction in opioid overdose deaths. However, Black and Indigenous communities have not experienced this downturn, and part of this disparity is due to lack of naloxone saturation in their communities. Rather than imposing a negligible economic punishment on these companies, policymakers should focus on getting the most naloxone possible into the hands of people most likely to need it.

As of this writing, none of the bills listed above have become law, and it is too late for most to be enacted this legislative session. It is common, however, for bills to be reintroduced in subsequent legislative sessions. As they consider whether these laws are in the best interests of both taxpayers and people at risk of overdose, policymakers and advocates should consider the negative effect such laws would likely have on access to lifesaving overdose reversal medications.

This post was written by Michael Abrams, J.D., Senior Attorney, Network for Public Health Law—Harm Reduction Legal Project.

The Network promotes public health and health equity through non-partisan educational resources and technical assistance. These materials provided are provided solely for educational purposes and do not constitute legal advice. The Network’s provision of these materials does not create an attorney-client relationship with you or any other person and is subject to the Network’s Disclaimer.

Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.