Sen. Sal DiDomenico and his colleagues in the Massachusetts Legislature recently passed bipartisan legislation providing an additional set of tools to address the opioid crisis and establishing the Commonwealth as a national leader in the fight against this epidemic. Among the provisions included in the bill are increasing access to medication-assisted treatment (MAT), exploring tools to reduce harm and save lives, expanding prevention efforts, and addressing the high rates of co-occurring conditions of substance use disorder (SUD) and mental illness.
The bill, An Act for prevention and access to appropriate care and treatment of addiction, is the result of extensive work researching evidence-based best practices and collaborating with healthcare researchers and clinicians, hospitals, behavioral health providers, law enforcement officials, patient advocates and individuals with lived experience, to develop policies to address the opioid epidemic.
“This comprehensive bill is a critical next step in our Commonwealth’s commitment to fighting the opioid epidemic,” said Sen. DiDomenico. “By focusing on prevention and ensuring that people have greater access to the medicine and treatment they need, we can continue to be a leader in this growing national crisis and help people get the support they need.”
Under this bill, someone who receives treatment in an emergency department (ED) for an opioid overdose will now have the opportunity to begin treatment for their SUD before they leave the ED. The bill requires that all EDs and all satellite emergency facilities have the capacity to initiate voluntary SUD treatment, including opioid agonist treatment, after treatment for overdose.
Under the legislation, the Department of Public Health (DPH) is directed to issue a statewide standing order authorizing every pharmacy in the state to dispense naloxone, eliminating the current requirement that each pharmacy obtain an individual authorization. The bill also brings Massachusetts in line with other states by providing liability protections, including protection from criminal or civil liability, for practitioners who prescribe and pharmacists who dispense naloxone in good faith.
In Massachusetts, nearly 1 out of every 11 individuals dying from opioid-related overdoses has a history of incarceration in state jails and prisons, and in 2015 alone, nearly 50-percent of all deaths among those released from incarceration were opioid-related. In response, this bill makes significant strides towards extending access to medication-assisted treatment in correctional facilities, making medication-assisted treatment available in the state correctional system and establishing a medication-assisted treatment pilot program at 5 county correctional facilities.
The bill also includes several provisions to address dual diagnosis and the high rates of co-occurring SUD and mental illness in the Commonwealth. According to the National Association on Mental Illness-Massachusetts, over 50-percent of individuals seeking treatment for SUD also suffer from a mental health condition. To ensure that the right kind of treatment facilities will be available to serve every patient who needs treatment, the bill enhances the oversight authority of the Department of Mental Health (DMH) and the DPH’s Bureau of Substance Addiction Services (DPH/BSAS) – the two agencies that license facilities that provide treatment for mental illness and addiction.
Under the bill, a center for police training in crisis intervention is established to serve as a clearinghouse for best practices in police response to people with mental illness and substance use disorders. The center would also implement crisis intervention training for all municipal police officers and provide technical assistance to cities and towns to form collaborative partnerships between law enforcement and human service providers to maximize referrals to treatment services.
In addition, the legislation recognizes the important role that recovery coaches play in successful long-term addiction and mental illness treatment by creating a commission to recommend standards for establishing a professional credential for recovery coaches as an important step toward formalizing the role that they play in the pathway to treatment and recovery.
The bill also creates a Community-Based Behavioral Health Promotion and Prevention Trust Fund to promote positive mental, emotional and behavioral health among children and young adults and to prevent substance use disorders among children and young adults.
The bill also updates the state’s partial fill law by clarifying that any patient who decides to partially fill a prescription for a Schedule II controlled substance will not have to pay a duplicate co-pay at the pharmacy if they decide to fill the remainder of the prescription later.
In an attempt to ensure that those experiencing chronic pain have access to the treatments they need, the bill also establishes a MCPAP for Pain program to provide remote consultations to primary care practices, nurse practitioners and other health care providers who are caring for chronic pain patients.
This bill was signed by the Governor on Aug. 9, 2019.