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Baker attempts opioid reform in Massachusetts due to epidemic

A comprehensive legislative package to address the opioid epidemic in Massachusetts is currently being reviewed by The Joint Committee on Mental Health, Substance Abuse and Recovery. Gov. Charlie Baker, who sponsored the bill, testified in support of the legislation Tuesday, along with Secretary of Health and Human Services Marylou Sudders.

The legislation, dubbed the CARE Act, aims to increase access to treatment, bolster substance abuse education and prevention programs, and further regulate the prescription and distribution of opioids, according to a press release from Baker’s office.

In terms of substance abuse prevention, the CARE Act proposes the establishment of the Safe and Supportive Schools Trust, a fund allocated to the expansion and improvement of educational and intervention programs for students.

The funds from this trust will go toward developing a system to identify at-risk youth, which builds upon the efforts of the STEP Act passed in 2016 that mandated schools develop a substance abuse education curriculum and screening process to identify students with substance abuse disorders, according to the release.  

Courtney Chelo, the children’s behavioral health project manager at the Children’s Mental Health Campaign, said preventive efforts like those of the Safe and Supportive Schools Trust are necessary to reach a permanent end to the opioid epidemic.

If we’re going to stem the tide of addiction, what we need to do is really focus on the early prevention and early intervention with young people,” Chelo said. “We really liked that Section 1 of the bill, right there front and center, was investment in prevention in a big way, establishing the Safe and Supportive Schools Trust.”

Despite supporting the CARE Act overall, Chelo said she thinks the education and prevention aspects of the bill should be revised to include increased funding for research examining the effectiveness of substance use prevention programs.

“We also hope that the legislature will take action to make sure that revenues from the sale of recreational marijuana are allocated to the Department of Public Health and the Department of Elementary and Secondary Education to support things like research and development and implementation of informed and evidence-based substance use prevention programs,” Chelo said.

Another major piece of the bill addresses increasing regulation of opioid dispensation to prevent its over-prescription and illicit distribution. For example, prescribers are subject to “referrals for discipline” if they are guilty of overprescribing, violating the seven-day first-time opioid prescribing limit or failing to consult the prescription drug monitoring database that includes a patient’s full prescription history before authorizing an opioid medication.

This rhetoric has scared doctors from prescribing opioids and even treating people with pain, leaving sufferers of chronic pain abandoned by their care providers and without access to a valuable medication option that relieves suffering for many, said Cindy Steinberg, the Policy Council chair of the Massachusetts Pain Initiative.

Moreover, the CARE Act does not increase access to alternative pain management services, like acupuncture and physical therapy, for sufferers of chronic pain, Steinberg said. She suggested requiring insurers to provide more comprehensive coverage for alternative treatments as one possible avenue to actively help people living in serious pain.

Several Boston residents said that while it’s important to combat the opioid epidemic, parts of the bill may be problematic.

Rosa Gomez, 51, of South End, said rehabilitation and preventive education efforts are important to addressing the issue of substance abuse.

“The drug problem is Boston is a big one and it should definitely have the government’s attention,” Martinez said. “Rehabilitation is an important focus and so is educating the kids in our public schools when they’re young since a lot of the drug use starts when they’re young.”

Jim Owens, 55, of Roxbury, said a provision of the bill that allows for people under the influence of drugs to be involuntarily transported and treated if they are at risk of endangering themselves or others, may give rise to many issues.

“Well, I think it’s a controversial piece of legislation,” Owens said. “As much as I want to believe doctors should be able to take whatever actions necessary to revive a patient, I can’t speak for all drug users and neither can they. Maybe someone who’s overdosed doesn’t want to be revived. They probably don’t have the money or the insurance to pay for medical treatment.”

Jenny Morris, 30, of Back Bay, said she supports legislation to prevent opioid addiction due to its pervasive nature.

“Boston is realizing just how widespread of a problem [the opioid epidemic] is,” Morris said. “I think any response to help prevent opioid addiction is a good one at this point.”

 

Hannah Schoenbaum contributed to the reporting of this article.

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