Dillon’s Law

Proposed bill brings epinephrine training and administration to Illinois residents

Illinois residents may soon have access to free training on how to administer epinephrine to someone experiencing anaphylaxis. This life-threatening allergic reaction causes severe swelling, potentially blocking airways and causing suffocation.

“There are about four people who die every day in our country because epinephrine isn’t available,” says Lenard Markman, DO, a physician in Wisconsin and member of the Advocacy Committee of The Wisconsin Association of Osteopathic Physicians and Surgeons (WAOPS).

Epinephrine is the first-line treatment that combats anaphylaxis. Currently, only people who have life-threatening allergies can be prescribed epinephrine, which comes as a nasal spray, a pre-filled auto-injector, or a vial that can be used to fill a syringe. Typically, expiration dates are 18 months for the injectors and 30 months for the nasal sprays.

If a person doesn’t know they have an allergy, they don’t have access to epinephrine.

Markman is on a mission to change this. In 2017, he learned about Dillon Mueller, 18, of Wisconsin who didn’t know he was allergic to bees. In October 2014, while helping his best friend with yard work, a bee stung Mueller, causing anaphylaxis. His friend performed CPR until an ambulance arrived; however, not even the ambulance had epinephrine. After a week on artificial cardiopulmonary support, Mueller died.

“The tragic reality is if epinephrine were available at the time of his reaction, Dillon most likely would have survived,” Markman says.

Saving lives in Dillon’s honor

Mueller’s story motivated Markman to collaborate with Mueller’s parents and WAOPS. Together, they created state legislation called Dillon’s Law, which the governor signed in Wisconsin in 2017. Dillon’s Law allows any person in Wisconsin to be trained on the use of epinephrine through WAOPS’s free Do it for Dillon Anaphylaxis Training Program. After training, the person can obtain epinephrine at a pharmacy and administer it to any person experiencing anaphylaxis. Wisconsin’s Good Samaritan liability law covers their actions.

“Over 5,000 people have been trained through the program so far, and we know of at least 16 lives that have been saved by people who completed the program,” Markman says.

To create Dillon’s Law, Markman worked with pharmacist Jon Sambs from the University of Wisconsin-Stevens Point.

“We used the same process that allows non-medical people to obtain and administer Narcan to people overdosing on opioids,” Markman says. “Once people are trained, they can take their certificate of completion directly to the pharmacist and purchase epinephrine.”

He notes that the cost for epinephrine has lowered. For people with insurance, the nasal form (Neffy) is marketed at $25 per twin pack.

“Epinephrine needs to be readily available to the public. Wherever there is a defibrillator, there should be epinephrine,” Markman says. “We need to prevent further tragedies by being prepared.”

In 2023, Markman pushed for a national Dillon’s Law, which Congress has yet to vote on. Markman hopes it will make a mark in 2025. Until then, he is working to pass Dillon’s Law at the state level around the country. Indiana, Minnesota, and Colorado have passed it with 100% bipartisan agreement.

Expanding epinephrine access in Illinois

Illinois is Markman’s next target. Illinois State Representative Maurice West is leading the way with House Bill 2462.

“I think this is a great idea for the state of Illinois. I have a daughter with a peanut allergy, so it’s personal for me as well,” West says.

West also supported an Illinois law (House Bill 3639) that caps the price of epinephrine at $60 for a twin pack of autoinjectors.

“This is landmark legislation that we tried to emulate in Wisconsin, but it didn’t move,” Markman says.

In 2022, West backed Elijah’s Law, named in memory of 3-year-old Elijah Silvera who died after having a severe allergic reaction to dairy at his daycare. The law requires every childcare facility to establish anaphylaxis policies and aims for them to have epinephrine auto-injectors on hand in case of emergency.

“I’m glad Representative West is behind Dillon’s Law. If we can get a big state like Illinois to lead, we hope other states will follow,” Markman says.

West says he is hopeful Dillon’s Law will pass this year. Until then, online courses offer training:

Free online course from the Food Allergy Research & Education (FARE)
$35 online course from the American Red Cross

Other Illinois laws that protect people with allergies

The following Illinois laws also protect people living with allergies:

Annie LeGere’s Law
Named after a 13-year-old girl from Elmhurst, who had anaphylaxis at a sleepover. The police officer who responded to the 911 call didn’t have epinephrine, and Annie died. The law enables Illinois police officers to carry and administer epipens after proper training and procedural requirements.

Food Allergy Awareness Training Act
This act requires that all food service establishments in Illinois have a certified food protection manager on site at all times of operation. The law requires that all food service employees complete a food allergy awareness training program within 30 days of employment.