7.1 Naloxone & Opioid-Safety Laws in Utah
Key Takeaways
A Utah pharmacist may dispense an opiate antagonist without any other prescription under a physician's standing order issued under Utah Code § 26B-4-510.
Utah permits naloxone to be given to a person at increased risk of an opiate overdose, a family member, friend, or other person in a position to assist, or an overdose outreach provider (Utah Code §§ 26B-4-509, -510).
A pharmacy that dispenses naloxone under a standing order must report total doses and products annually to DOPL and the issuing physician by 15 days after December 31 (R156-17b-625).
Utah law since 2026 allows dispensing and good-faith administration of an expired opiate antagonist up to 24 months past its expiration date (Utah Code §§ 26B-4-509, -510).
A Utah prescriber must offer an opiate antagonist with an initial opiate prescription of 50 MME per day or more, or with a concurrent benzodiazepine, unless the supply is three days or less or is administered directly (Utah Code § 58-37-306(4)).
7.1 Naloxone & Opioid-Safety Laws in Utah
Blueprint item 2.5 covers "requirements for promoting quality and safety of public health." Utah's opiate-antagonist laws are in Title 26B, Chapter 4, §§ 26B-4-508 to -514 (formerly Title 26, Chapter 55), R156-17b-625, DHHS's Utah Statewide Naloxone Standing Order, and DOPL's Utah Guidance for Naloxone under § 58-17b-627.
Two paths to dispense naloxone without an individual prescription
| Pathway | Authority | Key features |
|---|---|---|
| Physician standing order | § 26B-4-510; R156-17b-625; statewide standing order | Issued by a physician (including a DHHS physician or local health department medical director). Recipients are limited to the categories below. Dispensers are identified by license number. The physician reviews dispensing practices at least annually. Dispensers keep records. DOPL approves the protocol by rule. |
| Pharmacist prescribing | § 58-17b-627; R156-17b-627; Utah Guidance for Naloxone | The pharmacist assesses eligibility, prescribes, and must personally train the patient before dispensing. Written materials cannot replace the consultation. PCP notification and 5-year retention apply (Section 6.3). |
Participation is voluntary and creates no standard of care to prescribe or dispense (§ 26B-4-508).
Who may receive an opiate antagonist
Under §§ 26B-4-509(3) and 26B-4-510(3), naloxone may be prescribed or dispensed, without a prescriber-patient relationship, to:
- an individual at increased risk of an opiate-related overdose;
- a family member, friend, or other person in a position to assist that individual. The standing order lists examples, including people acting on behalf of law enforcement, DHHS, local health departments, treatment and recovery organizations, homeless service providers, naloxone-training organizations, harm-reduction programs, and schools; or
- an overdose outreach provider, for furnishing to those individuals or for administering during an overdose.
The recipient need not be the at-risk person and need not bring any records. A worried parent may obtain naloxone for an adult child.
Products and quantities (standing order and DOPL guidance)
- Nasal spray 4 mg/0.1 mL: one box of two devices. One spray in one nostril, and repeat with the second device in the other nostril after 2–3 minutes if there is no or minimal response. Call 911 if used.
- Naloxone 1 mg/mL in 2-mL prefilled syringes with atomizers: two syringes with two atomizers, 1 mL in each nostril.
- Auto-injector 2 mg/0.4 mL: one box of two, injected into the outer thigh.
- 0.4 mg/mL vials or prefilled syringes: two 1-mL doses with syringes for IM injection in the deltoid or thigh.
- Dispense at least two doses to an individual, or an amount appropriate for an organization that will redistribute. Refills are allowed.
Required education
A provider who dispenses under these statutes must give written instruction on how to recognize an opiate overdose, how to respond (administer the antagonist and make sure the person gets additional medical care and evaluation as soon as possible), and the safety, efficacy, and risks of an expired antagonist (§ 26B-4-509(4)). DOPL's guidance also requires the pharmacist to cover:
- the signs and symptoms of overdose;
- calling 911 as soon as possible, and the possible need for rescue breathing;
- how to use the specific product;
- adverse reactions, including opioid withdrawal after administration;
- storage conditions and temperature excursions;
- expiration and disposal; and
- information about substance use and behavioral health treatment, if applicable.
Expired opiate antagonists (2026)
An "expired opiate antagonist" is one no more than 24 months past its labeled expiration month and year. The statutes now authorize prescribing, dispensing, furnishing, and good-faith administration of such products, with education on their safety, efficacy, and risks (§§ 26B-4-509 to -511, amended 2026).
Records and reporting
- Annual report (R156-17b-625): the PIC or a responsible corporate officer of each pharmacy that dispenses under a standing order must affirm compliance and report the total single doses dispensed and each product with its dose count to DOPL and to the issuing physician, no later than 15 days after December 31. Chains may submit one combined report broken out by location. No report is needed if nothing was dispensed. The DHHS standing order directs reports through naloxone.utah.gov. Failing to report on time is unprofessional conduct (R156-17b-502(25)).
- Records kept for audit (R156-17b-625(5)): recipient's name; product name, quantity, strength, and dosage quantity; the dispensing outlet; date; and the physician who issued the standing order.
Related opioid-safety provisions
- Initial opiate prescriptions (§ 58-37-306). Before an initial opiate prescription, the prescriber must discuss addiction and overdose risks, the dangers of combining with alcohol and benzodiazepines, why the prescription is needed, alternatives, and other risks. This does not apply to active cancer treatment, hospice, or substance use disorder treatment. Since January 1, 2024, the prescriber must offer an opiate antagonist when the initial opiate prescription is 50 MME/day or more, or when a benzodiazepine is also prescribed. The offer is not required if the drug is administered directly or the supply is three days or less. The patient does not have to accept it.
- Pharmacy offer and warning duties (§ 58-37-112). When dispensing a Schedule II or III opiate, the pharmacy must put the warning "Caution: Opioid. Risk of overdose and addiction" on the container or lid. Since January 1, 2024, it must also offer to counsel on and offer to dispense an opiate antagonist when a single opioid prescription is 50 MME/day or more, or when an opioid and a benzodiazepine are dispensed to the patient within 30 days of each other. It must display DHHS's opioid pamphlet at the point of sale if one is available (Section 10.1).
- Hospital and ED dispensing. A hospital pharmacy may dispense an opioid antagonist at discharge without the usual "Class A pharmacy unavailable" condition, and must accept wholesale acquisition cost as payment (§ 58-17b-610.6(2)(b)). ED prescribers may provide a naloxone kit (R156-17b-610.5(2)(b)).
- Pharmacist IM administration of naloxone requires training and physician direction (§ 58-17b-625; Section 6.1).
Immunity and Good Samaritan protections
- Administration: an overdose outreach provider, or a person other than a health care facility or provider, who administers an antagonist in good faith (including an expired one) to someone believed to be overdosing is immune from civil and criminal liability. A health care provider acting within the scope of their duties is not covered by this immunity (§ 26B-4-509(2)).
- Prescribing and dispensing: a prescriber or dispenser acting in good faith under § 26B-4-509(3) is not liable for civil damages.
- Reporting an overdose: a person who reports an overdose in good faith, gives the location, stays at the scene until responders arrive, cooperates, and whose offense arose from the same events has an affirmative defense to possession or use charges (§ 76-18-207(10), enacted 2026). The same conduct is a mitigating factor at sentencing for Utah controlled-substance offenses (§ 76-3-203.11). "Good faith" excludes calls made during execution of a search or arrest warrant.
A mother asks a Utah pharmacist for naloxone because her adult son, who is not present, has an opioid use disorder. How should the pharmacist proceed?
Require a prescription written in the son's name by his physician
Dispense naloxone to the mother under the standing order or pharmacist-prescribing guidance, with the required overdose-response education
Refer her to the local health department, because pharmacies may not dispense to family members
Refuse, because only the at-risk individual may receive naloxone
A Utah pharmacy dispensed naloxone under the physician standing order during the calendar year. Under R156-17b-625, what reporting is required?
A monthly report of each recipient's name to the Controlled Substance Database
A report to DEA within one business day of each dispensing
An annual report of total single doses and doses per product, sent to DOPL and the issuing physician no later than 15 days after December 31
No reporting, because naloxone is not a controlled substance
Under Utah Code § 58-37-306(4), when must a prescriber offer to prescribe or dispense an opiate antagonist?
Only for patients who have had a documented prior overdose
Only when the pharmacist requests it after reviewing the CSD
With every opioid prescription, including refills of chronic therapy
With an initial opiate prescription of 50 MME per day or more, or when a benzodiazepine is also prescribed, unless the supply is three days or less or the drug is administered directly
A bystander calls 911, gives the location, stays with an overdosing friend, and cooperates with responders. Police find a small amount of a controlled substance on the bystander. What does Utah law provide?
The bystander is immune from any felony distribution charge
The bystander has an affirmative defense to possession or use arising from the same events under Utah Code § 76-18-207(10)
The bystander has no protection, because Good Samaritan laws cover only licensed health professionals
The bystander is protected only if the call was made during execution of a search warrant
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