Committee takes step toward plan of action on opioids
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State Auditor Diana DiZoglio
In its latest effort to stem the deadly opioid epidemic, a House-controlled committee took a step last week towards establishing mandatory three-day substance use therapy for those in peril and requiring hospitals to stock buprenorphine or other medication used as an alternative to street drugs like heroin and fentanyl.
The Committee on Mental Health, Substance Use and Recovery voted to advance a redraft of Gov. Charlie Baker's bill for addressing the opioid crisis. Both the committee bill and Baker's bill require a switch to electronic prescriptions. Senators on the committee suggested they would opt for a different course, electing to reserve their rights rather than voting for or against the bill that cleared committee on a voice vote.
About 4,000 people have died from suspected or confirmed opioid overdoses in Massachusetts the last two years. In recent years lawmakers have sought to increase access to substance use programming, restrict access to prescription narcotics and enhance penalties for trafficking fentanyl.
"While there is much work left to be done to address this public health crisis, last year Massachusetts saw the first decrease in opioid-related deaths in several years and the governor appreciates the Legislature's efforts to advance the CARE Act and bring it one step closer to becoming law," said Brendan Moss, a spokesman for the governor.
The committee's bill would expand access to overdose-reversing Narcan, allowing it to be available by standing order at pharmacies, and it would require hospitals to be equipped to administer opioid agonist treatment like buprenorphine.
When someone is treated for an overdose, they are at a "very high risk for recurrence," and buprenorphine cuts mortality rates in half, according to Dr. Michael Bierer, president of the Massachusetts Society of Addiction Medicine.
The medicine treats the addiction that causes people to seek out dangerous drugs, and buprenorphine attaches to chemical receptors in the body, making opioids like fentanyl less powerful and less deadly, Bierer told the News Service.
"It's very hard to overdose on that drug," said Bierer, who said the society "strongly" supports requiring hospitals to be equipped to administer that type of medically assisted therapy. He said, "We understand how efficacious opioid agonist treatment is."
The bill would create a commission to study the use of methadone and other opioid-addiction medicine in correctional facilities. The addiction medicine society would have preferred language requiring that inmates have access to that kind of treatment, Bierer said.
The society has been skeptical about the policy backed by the governor and included in different form in the committee's bill enabling medical professionals to involuntarily hold those whose substance use or drinking disorder is likely to cause "serious harm."
"We don't want anything that is devoid of a judge being involved in decisions to restrict liberty for substance use disorders other than extreme cases," Bierer said.
Under the bill, when someone is admitted to a treatment facility involuntarily, the facility would be required to inform the person of their right to legal representation through the Committee for Public Counsel Services.
Rep. Denise Garlick, a Needham Democrat, and the House chairwoman of the Committee on Mental Health, Substance Use and Recovery, said the legislation takes a three-pronged approach to the scourge.
"The bill employs three major strategies," Garlick said ahead of Thursday's vote. "First it strengthens public health prevention measures in our schools and communities for children and young adults from birth to age 26. Second, it increases treatment capacity by including access and quality in an expanded behavioral health care system. And third, it provides for the treatment of people who suffer the most from substance-use disorders by offering them options for care and support."
None of the senators on the committee voted for or against the bill, opting instead to reserve their rights, and Sen. Cindy Friedman, an Arlington Democrat and the committee's co-chairwoman, said she has concerns with some provisions – including the involuntary hold language.
"There are things in the bill that I agree with but there are things that I don't know about yet," Friedman told reporters.
One of the top priorities for Friedman is making access to treatment easier, especially for people with both substance-use disorder and mental illness.
The bill would also establish a state program for helping social workers who make up to $45,000 a year with student loan payments.
Rep. Diana DiZoglio, a Methuen Democrat who is running for Senate, also reserved her rights while the other members of the House on the committee supported the legislation in a voice vote.
DiZoglio said that she preferred the governor's approach of sending money "directly to Massachusetts public schools" for prevention and education programs rather than dispersing funding to the Department of Mental Health and the Department of Public Health.
"I hope we can work on that portion of the bill during the process moving forward," DiZoglio told reporters.
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