Overdose Response Program

The Overdose Response Program (ORP) is established by statute in Health-Ge​neral §§13-3101-3111, effective Oct. 1, 2013, with implementing regulations in COMAR​​, 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 renewed.

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 demonstrated proficiency.​