State Lawmakers Support ‘Landmark’ Opioid Bill

On Monday Governor Charlie Baker signed “landmark legislation” into law to address the deadly opioid and heroin epidemic. According to an announcement from the Governor’s office, the new law includes numerous recommendations from the Governor’s opioid working group, including prevention education for students and doctors, and the first law in the nation to establish a seven day limit on first-time opioid prescriptions.

“Today, the Commonwealth stands in solidarity to fight the opioid and heroin epidemic that continues to plague our state and burden countless families and individuals,” said Governor Baker. “I am proud to sign this legislation marking a remarkable statewide effort to strengthen prescribing laws and increase education for students and doctors. While there is still much work to be done, our administration is thankful for the legislature’s effort to pass this bill and looks forward to working with the Attorney General and our mayors to bend the trend and support those who have fallen victim to this horrific public health epidemic.”

Medford’s entire state delegation voted in favor of the bill, which passed the state legislature with unanimous support.

“Massachusetts is one of several states across the nation currently facing an opioid crisis that has caused extreme damage to the lives of so many people,” said Senator Jehlen. “I am proud to see the legislature tackle this issue and pass this landmark legislation. We have solidified our commitment to slowing and reversing the impacts of substance abuse and addiction, and will hopefully bring much needed aid to those who so desperately need it.”

Emergency Room Treatment

According to information released by Sen. Jehlen, the law calls for the creation of a framework to evaluate and treat patients who present in emergency rooms with an apparent overdose.

This new practice, which will be covered by insurance, is designed to ensure the proper assessment and discharge of patients who seek voluntary treatment. If a patient refuses treatment, information on health and community resources will be provided. This framework reflects the 2012 University of Miami Medical School findings that voluntary treatment is more effective and affordable than involuntary commitment.

Prescription Changes

The bill limits first-time opiate prescriptions to seven days for adults and all opiate prescriptions for minors to seven days, with exceptions for chronic pain management, cancer, and palliative care. Practitioners must now check the prescription monitoring program (PMP) each time they prescribe any opiate and correspondingly note that in the patient’s medical records.

From its discussions with numerous stakeholders and recovery groups, the Legislature recognizes the importance of empowering individuals as they grapple with addiction. As a result, this bill establishes a non-opiate directive form, allowing patients to include a notation in their records that they shall not be offered opiates. It also provides the option of a “partial fill” which allows patients, in consultation with their doctor, to request a lesser amount than indicated on the script.

School Screenings

In an effort to build upon current prevention efforts, the legislation updates current law on substance abuse education at public schools. In addition, schools will annually be required to conduct a verbal substance abuse screening in two grade levels. These screenings are subject to appropriate ages and include an opt-out provision for students and parents.

Drug Disposal

To ensure that unused medications are safely collected and disposed of, this legislation requires manufacturers of controlled substances in Massachusetts to participate in either a drug stewardship program or an alternative plan as determined by DPH.

Other Provisions

This bill also:

– Requires that contact information for all insurers be posted on the bed-finder tool website and updates the law to ensure the site is available 24 hours a day;

– Requires that patients being discharged from substance addiction receive information on all FDA-approved medication-assisted therapies;

– Ensures civil-liability protection for individuals who administer Narcan;

– Updates the training guidelines for all practitioners who prescribe controlled substances;

This legislation follows a 65.2% increase in substance addiction funding since FY12 and the landmark substance addiction law passed in 2014, which, for the first time, mandated detox and stabilization coverage. The two bills are intended to complement each other and reflect a consensus-driven approach.

Opioid Abuse & State Efforts to Address the Issue

The opioid epidemic continues to impact every community in Massachusetts. According to the most recent data, it is estimated that there were nearly 1,200 unintentional and undetermined opioid deaths in 2014. The estimated rate of 17.4 deaths per 100,000 residents for 2014 is the highest ever for unintentional opioid overdoses and represents a 228% increase from the rate of 5.3 deaths per 100,000 residents in 2000. And the trend isn’t slowing. Preliminary data estimations show, there were over 1,100 opioid deaths between January and September of 2015.

Fighting this ongoing epidemic has been a priority of the Baker-Polito Administration since day one. In February 2015, Governor Baker appointed a working group to develop a plan to reduce opioid deaths in the Commonwealth. In June 2015, the Governor’s Opioid Working Group released 65 recommendations and a comprehensive Action Plan aimed at curbing the opioid epidemic. These short and long-term recommendations focus on Prevention, Intervention, Treatment and Recovery Support. Approximately ninety percent of the initiatives in the Governor’s action plan are complete or underway.

– Information from Governor Baker’s office and Sen. Jehlen’s office