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Over that same period, policymakers have taken steps to increase the availability of naloxone\u2014an opioid antagonist used to rescue overdose victims\u2014to people in the community. Previous studies, most of which have examined the effects of state laws designed to facilitate access to naloxone, have reached mixed conclusions about the effects of naloxone access on fatal and non\u2010fatal overdoses. This paper exploits a unique policy experiment provided by two naloxone giveaways intended to increase naloxone possession among the general public in Pennsylvania to estimate the causal impact of naloxone distribution on fatal overdoses and opioid\u2010related emergency department (ED) visits. Using a difference\u2010in\u2010differences design, I find evidence that opioid overdose deaths fell immediately following the first giveaway but increased following the second giveaway and discuss these apparently contradictory findings in the context of the changing composition of the opioid supply. I also find some evidence of a decline in opioid overdose\u2010related ED visits following the giveaways. This study is the first to examine the effects of untargeted naloxone distribution and has implications for other novel, naloxone distribution efforts currently underway.<\/jats:p>","DOI":"10.1002\/hec.4755","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T03:59:35Z","timestamp":1693972775000},"page":"2801-2818","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The effect of untargeted naloxone distribution on opioid overdose outcomes"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6331-060X","authenticated-orcid":false,"given":"William N.","family":"Dowd","sequence":"first","affiliation":[{"name":"Public Health Division RTI International  Research Triangle Park North Carolina USA"},{"name":"Division of Health Research Lancaster University  Lancaster UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.0272"},{"key":"e_1_2_11_3_1","unstructured":"Ahmad F. 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(2018).Gov. Wolf receives naloxone kit for stop overdoses in PA: Get Help Now week.https:\/\/www.governor.pa.gov\/newsroom\/gov\u2010wolf\u2010receives\u2010naloxone\u2010kit\u2010part\u2010stop\u2010overdoses\u2010pa\u2010get\u2010help\u2010now\u2010week\/"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000492"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2018.05.020"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6831e1"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010resource\u2010121517\u2010033306"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.09.015"},{"key":"e_1_2_11_24_1","doi-asserted-by":"crossref","unstructured":"Hedegaard H. Mini\u00f1o A. Spencer M. R. &Warner M.(2021).Drug overdose deaths in the United States 1999\u20132020. 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