House passes opioid abuse prevention bill

Senate set to take up bill; could be on Baker's desk by weekend

STATE HOUSE NEWS SERVICE

THE HOUSE UNANIMOUSLY PASSED a compromise opioid abuse prevention bill on Wednesday afternoon that was negotiated over the past seven weeks with the Senate.

The bill, which included multiple initiatives tied to intervention, treatment, prevention, and education, would limit the size of first-time opioid prescriptions and require schools to screen students for signs of substance abuse.

The bill, which was finalized on Tuesday by a six-member conference committee, passed the House on a 153-0 vote, and moves to the Senate, which is expected to take it up on Thursday. Gov. Charlie Baker, who is on a ski trip in Utah, but who signaled his support for the deal Tuesday night, could find the bill on his desk when he returns to Massachusetts Saturday.

Rep. Elizabeth Malia, a Jamaica Plain Democrat and House chair of the Committee on Mental Health and Substance Abuse, introduced the conference bill on the floor, walking members through some of the main provisions, including a seven-day supply limit on first-time opioid prescriptions for adults and a requirement that patients admitted to the emergency room for an overdose be evaluated for substance abuse disorders within 24 hours before discharge.

While discussing one provision that would require drug manufacturers to participate in a drug stewardship program, Malia admonished the industry for not taking a more active role in working with public policy leaders to address the opioid abuse epidemic.

“The pharmaceutical industry up until this point has been absent, has been unfortunately less than helpful and absolutely, absolutely needs to step up to the plate and give us the resources we need to deal with this crisis,” Malia said.

The conference report adopted House-backed measures to limit first-time prescriptions of powerful painkillers to a seven-day supply, and would require patients presenting in emergency rooms with symptoms of an overdose to be screened within 24 hours for signs of addiction before being discharged.

“We agreed with both of those. We thought they were good constructs. The governor started that process. The House improved it,” Senate President Stanley Rosenberg said during an interview Tuesday night on WGBH’s “Greater Boston.”

Baker had initially proposed a three-day supply limit on pills, and a controversial expansion of the civil commitment law that would have allowed doctors to hold involuntary for up to 72 hours patients presenting with an overdose.

The bill also incorporates a Senate provision that would allow patients to request that only a portion of their opioid prescription be filled in order to discourage overuse of painkillers or the proliferation of unused medicines that can get into the hands of people struggling with substance abuse.

Another Senate idea that found its way into the bill is a proposed requirement that schools conduct voluntary screening of students for signs of addiction or substance abuse.

Sen. Karen Spilka and her House counterpart, Rep. Brian Dempsey, the two lead negotiators on the conference, issued a joint statement Tuesday night saying the compromise language “focuses on intervention, education, and prevention, and incorporates the best ideas from both versions of the bills.”

The conference report sets a requirement for drug companies to participate in a “drug stewardship” program, according to Spilka, who added that if the pharmaceutical companies decide to participate in a Department of Public Health stewardship program the health department would set the cost for participation.

The bill would also require training in substance abuse disorders for medical licenses, Spilka said. Earlier this year medical and dental schools worked with Baker to make addiction education part of their core curriculum.

“We want it codified that this has to be a part of their education and training,” Spilka said.

The legislation has been in the works for months and is aimed at slowing the explosive growth in deaths associated with heroin use and prescription painkiller abuse, which officials say claim four lives a day on average across Massachusetts.

House Speaker Robert DeLeo, who appeared with Rosenberg on “Greater Boston” Tuesday night, said that while he wished it could have been done sooner, the task of finding the right approach was more complicated than it appeared.

“Although it may have seemed like an easy situation because of course everyone said we have to something about substance abuse, it wasn’t so easy in terms of the particular parameters of the bill,” DeLeo said.

The agreement requires doctors to check the prescription monitoring program database each time before writing a prescription for a Schedule 2 or Schedule 3 narcotic and talk to patients about addiction each time an opioid prescription is written, Spilka said. She said under the bill patients who do not want to take opioid medications would be able to list on their electronic health records a directive not to administer or prescribe them opioids.

Meet the Author

Matt Murphy

State House News Service
Meet the Author

Andy Metzger

Guest Contributor

About Andy Metzger

Andy Metzger is currently studying law at Temple University in Philadelphia. Previously, he joined  CommonWealth Magazine as a reporter in January 2019. He has covered news in Massachusetts since 2007. For more than six years starting in May 2012 he wrote about state politics and government for the State House News Service.  At the News Service, he followed three criminal trials from opening statements to verdicts, tracked bills through the flumes and eddies of the Legislature, and sounded out the governor’s point of view on a host of issues – from the proposed Olympics bid to federal politics.

Before that, Metzger worked at the Chelmsford Independent, The Arlington Advocate, the Somerville Journal and the Cambridge Chronicle, weekly community newspapers that cover an array of local topics. Metzger graduated from UMass Boston in 2006. In addition to his written journalism, Metzger produced a work of illustrated journalism about Gov. Charlie Baker’s record regarding the MBTA. He lives in Somerville and commutes mainly by bicycle.

About Andy Metzger

Andy Metzger is currently studying law at Temple University in Philadelphia. Previously, he joined  CommonWealth Magazine as a reporter in January 2019. He has covered news in Massachusetts since 2007. For more than six years starting in May 2012 he wrote about state politics and government for the State House News Service.  At the News Service, he followed three criminal trials from opening statements to verdicts, tracked bills through the flumes and eddies of the Legislature, and sounded out the governor’s point of view on a host of issues – from the proposed Olympics bid to federal politics.

Before that, Metzger worked at the Chelmsford Independent, The Arlington Advocate, the Somerville Journal and the Cambridge Chronicle, weekly community newspapers that cover an array of local topics. Metzger graduated from UMass Boston in 2006. In addition to his written journalism, Metzger produced a work of illustrated journalism about Gov. Charlie Baker’s record regarding the MBTA. He lives in Somerville and commutes mainly by bicycle.

School districts would be required to conduct “some sort of screening,” including one called Screening, Brief Intervention, and Referral to Treatment, known as SBIRT for short, or an alternative program, according to Spilka. The Ashland Democrat said the Department of Elementary and Secondary Education would determine the two grade-levels where that screening would be performed.

She said many schools already perform SBIRT screenings. Driver education courses would also include some addiction training under the legislation.