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House passes opiod abuse prevention bill

Rep. Josh Cutler joined his colleagues in the Mass. House of Representatives to pass a bi-partisan substance addiction legislation that creates a new standard to evaluate and treat patients who present in emergency rooms with an apparent overdose.

The bill also 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.

Additionally, to cut down on so-called “doctor-shopping”, practitioners must check the prescription monitoring program (PMP) each time they prescribe any opiate and note that in the patient’s medical records.

“The bipartisan legislation the House passed today creates a safety net and a new standard in acute care settings designed to ensure the proper assessment and discharge of patients who seek voluntary treatment,” said Liz Malia, Chair of the Joint Committee on Mental Health and Substance Abuse. “It builds off of our efforts from last session that effective October 1, 2015 required insurers to cover up to 14 days of medical detox and step-down services by also guaranteeing insurance coverage of the substance abuse evaluation. This new best practice will arm providers with the resources necessary to ensure our most vulnerable population has the access to treatment they need.”

Rep. Cutler added, “By limiting first-time opiate prescriptions, having hospitals conduct substance abuse evaluations within 24 hours, and strengthening our prescription monitoring program — we can help transform prescription drug practices across the Commonwealth and help pave a pathway to recovery.”

From its discussions with numerous stakeholders and recovery groups, the House 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 requires that patients being discharged from substance addiction programs receive information on all FDA-approved medication-assisted therapies.

In an effort to build upon current prevention efforts, the legislation updates current law requiring all public schools to have a policy regarding substance abuse education by requiring schools to report their plans to the Department of Elementary and Secondary Education (DESE). DESE will then consult with the Department of Public Health (DPH) to provide recommendations that will assist schools and ensure they are providing effective and up-to-date education. Additional education materials will be provided to all student-athletes.

Over the past few years, the House’s efforts related to substance addiction have focused on behavioral health and the prevalence of co-occurring disorders. This legislation requires the Health Policy Commission to conduct a study on access to dual-diagnosis treatment in the Commonwealth for children, adolescents and adults. To help ensure parity between behavioral and physical health care, the legislation also requires insurance companies to report annually on their denied claims.

This bill also:

  1. 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;

  2. Ends the practice of sending women who are civilly committed for alcohol or substance-use disorders to MCI-Framingham;

  3. Ensures civil-liability protection for individuals who administer Narcan;

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

  5. Establishes the Massachusetts Council on Substance Use Disorder Prevention and Treatment, which will help the Commonwealth understand and confront addiction in a unified way.

  6. 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.

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