The Overdose Response Program (ORP)
is established by statute in Health-General §§13-3101-3111, effective Oct.
1, 2013, with implementing regulations in COMAR 10.47.08.01-.12, effective
Mar. 3, 2014(Chapter revised September 12, 2016).
The Department of Health and
Mental Hygiene (DHMH) oversees the ORP, authorizes private or public
entities to conduct educational training programs, maintains a list of
authorized entities, develops the core training curriculum, collects public
health data on entity program operations and provides technical assistance.
Private or public entities eligible
to apply for authorization approval include local health
departments, community organizations, substance abuse treatment providers,
other health care providers and any “person that addresses medical or social
issues related to drug addiction.” Approved entities receive notification from
DHMH on an official form. Authorization is valid for two years and may be
Authorized entities offer educational training programs to
train and certify individuals on how to recognize and respond to opioid-related
overdoses and safely administer naloxone. The training programs must follow the core
curriculum that covers required topics including recognizing the
signs and symptoms of opioid overdose, the importance of calling 911, and how
to properly perform rescue breathing, administer naloxone (intranasal and/or
intramuscular) and care for the person until emergency help arrives. Training
programs must be conducted by a Maryland-licensed physician or advance practice nurse or by an entity employee or volunteer under a written
agreement between the entity and a supervisory physician or advance practice nurse or pharmacist that
includes components enumerated in the statute and regulations.
Authorized entities issue certificates to successfully trained individuals
and may have a physician/advance practice nurse on site to write prescriptions to certificate
holders and dispense naloxone. Entities may also dispense
naloxone to trainees through the use of an ORP specific standing order. An entity intending to dispense naloxone must
provide information to DHMH on its naloxone dispensing protocols with
its application for authorization. Authorized entities are also
required to maintain and report to DHMH certain records with respect to
training, certificate issuance and naloxone dispensing and reversal reporting.
A certificate applicant shall be at least 18 years old; have, as a result of
his/her occupation or volunteer work or family or social experience, the
ability to assist an individual experiencing an opioid overdose; successfully
complete an educational training program; and submit an official Trainee Application to Entity for Certificate form
to the authorized entity. The authorized entity will issue the individual a
certificate that entitles the certificate holder, upon presentment,
to obtain a prescription for naloxone in his or her own name from a physician
or advance practice nurse with prescribing authrotiy and have the prescription filled at the authorized entity (if it
dispenses naloxone), at a pharmacy that stocks naloxone or by a physician or advance practice nurse who dispenses naloxone.
Certificate holders may possess naloxone and the supplies necessary to
administer the medication (e.g. syringe, atomizer), and administer it to
someone in danger of dying from an opioid overdose when emergency medical
personnel are not immediately available. Certificates are valid for two years
and may be renewed after completion of a refresher training program or
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