Reps. Lyons, Miceli Back Bill To Address State’s Opioid Crisis Through Treatment, Education And Prevention
Jan 22, 2016 03:29PM
By Bill Gilman
State Rep. Jim Miceli, D-Wilmington and State Rep. Jim Lyons, R-Andover.
BOSTON – State Representative Jim Lyons, R-Andover, yesterday backed a comprehensive substance abuse bill designed to address the state’s growing opioid crisis through expanded treatment, education and prevention methods.
House Bill 3944, which passed the House of Representatives on a unanimous vote of 149-0 on January 13, sets limits on the amount of opioids that can be prescribed for acute care patients, expands the use of the Prescription Monitoring Program (PMP), and mandates that hospitals conduct a clinical assessment of individuals who are brought to the emergency room after an overdose within the first 24 hours. The bill also contains provisions to ensure that students in public and charter schools have access to information on substance abuse prevention.
“Drug overdoses have claimed the lives of far too many, and opioid abuse has now reached epidemic proportions in Massachusetts,” said Rep. Lyons. “We are taking important steps through this bill to address the scourge of substance abuse that is tearing apart families and communities, but this is really only the start of this process because there is still much work to be done on this critical public health issue.”
An average of four people die from an opioid overdose every single day in Massachusetts. According to the Department of Public Health (DPH), 263 of the state’s 351 cities and towns – 3 out of every 4 communities – experienced at least one opioid-related overdose death between 2012 and 2014.
In 2014 alone, 1,089 people died from opioid use in Massachusetts, representing a 20% increase over the previous calendar year and a 63% increase over 2012. Based on data available as of October 15, 2015, DPH estimates that the total number of confirmed opioid overdose deaths in 2014 could rise as high as 1,256 once all cases are finalized.
Several amendments offered by the House Republican Caucus were adopted during the recent House debate, including a proposal by House Minority Leader Bradley H. Jones, Jr. (R-North Reading) that requires the PMP to be utilized prior to the issuance of any prescription for a narcotic drug contained in schedule II or III. In 2014 alone, prescribers in Massachusetts wrote 4.4 million prescriptions and 240 million schedule II and III pills were disbursed in the Commonwealth, according to the Baker-Polito Administration. The House also adopted a Republican amendment requiring the state’s boards of registration to mandate a minimum of 5 hours of training every 2 years in areas such as effective pain management, opioid antagonists and overdose prevention treatments, as a condition for licensure for practitioners who are authorized to prescribe medications.
One amendment, sponsored by Rep. Lyons, sought to allow doctors and care givers the power to involuntarily hold overdose victims at a hospital or drug treatment facility for an initial three day period to receive emergency treatment.Despite unanimous support from the House Republican Caucus, the amendment was defeated on a partisan roll call vote of 34-113.
The amendment would have empowered licensed physicians and other qualified medical personnel to restrain a patient and arrange for their referral to a treatment facility if they believe that failure to treat the patient would create a likelihood of serious harm. It also would have allowed the superintendent of the treatment facility to file for a commitment order through the courts after the initial holding period.
Massachusetts law currently permits the emergency restraint and hospitalization of individuals who pose a risk of serious harm by reason of mental illness, but not for those suffering from substance abuse. The proposed amendment would have extended the same emergency treatment measures to substance abusers, mirroring language that was included in an opioid abuse bill filed by Governor Charlie Baker last fall.
Representative Lyons said authorizing a three-day commitment procedure for overdose victims is critical to ensuring that they receive proper treatment to help them overcome their addiction. Having such an option available, he noted, would help to break the vicious cycle that results in many overdose victims returning to the same emergency room multiple times.
“When Governor Baker first filed his comprehensive plan, one of the key tenants of the proposal was the need to disrupt the cycle of addiction that was driving the overdoses across our state. The 72 hour hold would have done much to disrupt that cycle,” commented Lyons. “While I’m disappointed that the House wasn’t able to reach a consensus on this idea, I will continue to work with both sides of the aisle on possible solutions to ending this terrible epidemic in the Commonwealth.”
The House bill also:
- - limits first-time opiate prescriptions for adult outpatient use to a 7-day supply, while limiting all such prescriptions for minors to a 7-day supply;
- - requires insurers to provide coverage for mandatory “substance abuse evaluations” to be performed within 24 hours of a patient arriving at a hospital or satellite emergency facility after suffering from an apparent overdose, and for patients who have recently received Naloxone;
- - establishes a voluntary non-opiate directive form, which will allow patients to have a note inserted in their medical records and in the PMP stating they should not be offered opiate medications;
- - requires the Department of Elementary and Secondary Education, in consultation with DPH, to post recommendations on its website providing guidance to public and charter schools for developing and implementing effective substance use prevention and abuse education policies, which will be reviewed and updated on a regular basis to reflect best practices; and
- - requires that education materials relative to opiate misuse and abuse be provided to student athletes through the head injury safety training program, which is mandatory for all public schools subject to MIAA rules.
The bill now heads to the Senate for further action.