Legality of Dispensing and Administering Expired Naloxone in the District of Columbia
May 21, 2020
Drug overdose is a continuing epidemic that claimed the lives of over 67,000 Americans in 2018. Opioids, both prescription painkillers and illegal drugs such as heroin and illicitly manufactured fentanyl, were responsible for approximately 70% of these deaths. Many of the people killed by opioids would be alive today if they had quickly received the medication naloxone and, where needed, other emergency care. All fifty states and the District of Columbia have modified their laws to increase access to naloxone, the standard first-line treatment for opioid overdose.
While these laws take several approaches to increase access to this life-saving medication, none explicitly address the legality of dispensing naloxone that is past its expiration date. As many governmental and non-governmental organizations will increasingly have stocks of such expired naloxone, which has a listed shelf life of only one to two years, it is important to determine whether distribution or use of that naloxone is permissible under existing law. This fact sheet discusses whether District of Columbia laws forbid the prescription, dispensing, distribution, possession, or administration of expired naloxone and whether such actions impact the risk of civil liability for medical professionals who prescribe or dispense naloxone or laypeople who distribute or administer it.
We conclude that District of Columbia law does not prohibit the possession or use of expired naloxone obtained via a valid individual prescription or standing order. The District of Columbia also does not expressly prohibit the prescribing, dispensing, or distributing of expired naloxone by either pharmacists or recognized community organizations. Though District of Columbia law prohibits pharmacies from dispensing expired “deteriorating drugs”, this prohibition arguably does not extend to naloxone given naloxone’s long-term potency and effectiveness, and does not prevent non-pharmacy community organizations from distributing expired naloxone.