House unveils its own opioid bill
Measure drops Baker push for three-day commitment, extends Rx limit
THE HOUSE UNVEILED its version of a bill to address the opioid epidemic in the state but the measure drops two key provisions of legislation filed by Gov. Charlie Baker, including a three-day involuntary commitment for addicts who pose a danger to themselves or the community.
Baker filed his bill last fall and included a provision allowing doctors to hold addicts seeking emergency room treatment against their will for up to 72 hours if they determine the person is a danger to themselves or others. The House bill only requires doctors to perform an evaluation of the patient and offer recommendations for treatment.
“We know voluntary treatment is the most effective course of treatment,” Speaker Robert DeLeo said Monday at a press conference surrounded by lawmakers and leaders from health care and addiction treatment service groups. “I have some concerns that if we hold a person there [at a hospital for] three days, there is some concern over whether that is constitutional.”
The House bill also extends the initial time period for a first-time prescription of opiates. Under Baker’s bill, doctors would only be allowed to issue a prescription for 72 hours for first-time users with limited exceptions, a period that ran into opposition from the medical community. Under the House bill, doctors could prescribe up to seven days of opioids for first-time use. The House bill also limits all opiate prescriptions for minors to just seven days.
“In an ideal world we really think that physicians should be allowed to apply their clinical judgment, their expertise, their learning,” Dr. Dennis Dimitri, president of the Massachusetts Medical Society, told State House News after the House bill was unveiled. “But we realize there’s also a very specific crisis situation that we’re in right now so we are willing to be open-minded and somewhat compromising on this and put a number out there to make physicians stop and think.”
Baker, meeting with reporters after the weekly leadership meeting with DeLeo and Senate President Stan Rosenberg, said he hasn’t had a chance to read the entire bill but downplayed the differences.
“When we filed the legislation we said we knew it would be controversial and it was going to contain a number of controversial elements and we fully expected that everybody wouldn’t agree with everything we put on on our bill,” Baker said. “But the good news here is there seems to be a fair amount of agreement on a number of elements and I’m looking forward to being able to sign a comprehensive reform bill sometime soon after the Senate comes back into session.”
The bill also eliminates the mandate that female addicts committed by courts be sent to MCI-Framingham, the state’s lone prison for women inmates. There is a facility in Bridgewater for treating male addicts but no state facility dedicated to treatment of women. The measure calls for women committed by courts for treatment to be sent to “a secure facility for women approved by the department of public health or the department of mental health.”
One concern is the mandate for evaluation and referral by hospitals would be a hollow tool because of the lack of treatment beds in the state and the uneven distribution of those facilities. State Rep. Elizabeth Malia of Jamaica Plain, chairwoman of the Joint Committee on Mental Health and Substance Abuse, said the bill would utilize digital resources to give real-time updates for available placements and shore up those areas in the state that are lacking treatment resources.“We start with what we can work with and build for the future,” said Malia. “Our goal with this is to develop a safety net. Some of us are in recovery, some of us have lost loved ones. We understand how crucial the battle is.”
“The prior bill taught me how difficult it is to find consensus,” said DeLeo. “What is important to note is the governor, the Senate, and the House all agree that something has to be done.”