A major bill aimed at preventing opioid addiction and stemming the current overdose crisis facing the region has passed the state Legislature unanimously. Leaders of the regional addiction fight lauded many aspects of the legislation, which is on the governor’s desk, but some said more focus needs to be put on expanding rehabilitation options going forward.
“There are lots of important things in this bill focused on prevention of prescription opioid abuse and increasing the capacity of health care providers to understand safe prescribing and addiction,” said regional Opioid Task Force Director Marisa Hebble. “It does a lot for prevention.”
A House and Senate conference committee on Tuesday filed a compromise version of a comprehensive bill designed to strengthen substance abuse prevention laws, particularly around the prescription painkillers widely considered to be at the heart of the problem.
The bill, negotiated over nearly two months, was approved by the state House of Representatives Wednesday and the Senate on Thursday.
The bill includes House measures to limit first-time prescriptions to a week’s supply. Northwestern District Attorney David Sullivan said that will give prescribers time to think about a patient’s situation before writing a big prescription. That provision includes exemptions for emergencies, cancer patients and palliative care, he said.
It would also require patients who are brought to the emergency room for an overdose to be screened for addiction with 24 hours before discharge.
It includes Senate provisions that would allow patients to request that their opioid prescriptions be only partially filled to reduce overuse of the drugs and over-prescription. That program would be the first of its kind in the United States.
It’ll also require school nurses to screen students for addiction, and more training for medical providers in substance abuse disorders, a process known as “screening, brief intervention and referral to treatment,” or SBIRT. It would also put new requirements on doctors to check a prescription drug monitoring database before prescribing narcotics to be sure patients aren’t seeking prescriptions from multiple doctors.
The bill also requires drug companies to implement “drug stewardship programs” to safely collect and dispose of unused or unwanted drugs — another first-of-its-kind program.
Sullivan said that provision would ensure manufacturers who “make billions off of seriously addictive medications step up to the plate” and help with proper disposal efforts.
“I’ve been a big advocate for good drug takeback, and the best place for that is at the retail level. It’s easy, it’s accessible, and it’s more effective for the community,” Sullivan said.
Dr. Ruth Potee, a regional opioid task force member and local physician specializing in addiction, said she’s particularly pleased with the provisions requiring additional training about addiction, SBIRT requirements, and partial prescription fills.
In January, however, some local experts told The Recorder that the original bills passed by the House and Senate didn’t go far enough in increasing access to long-term treatment options in the state for those already in the throes of an painkiller or heroin addiction. Many say that’s still the case.
A short-term detox facility is expected to open in Greenfield in May.
“We still have a lot of people struggling, so we have room to grow in long-term sober living and treatment,” Hebble said. “There are lots of 18-to-25-year-olds who need a warm hand-off between treatment stages and sober-living options. Their brains are not quite finished developing. Add an addiction on top of that and it’s a really difficult scenario.”
Potee agreed.
“There’s nothing in the bill that gets more long-term sober living, or more spots at methadone or buprenorphine clinics,” she said. She said there needs to be more funding to truly help those who come to E.R.’s for overdoses. Buprenorphine, also known as Suboxone, is a drug used to treat opioid dependance.
Potee said the focus on reducing prescription opioids is important, but sidesteps other issues with prescription opioid misuse.
“Reducing the number of ‘extra’ pills hanging out in the medicine cabinet is key,” she said, but “stopping treatment of pain in patients for whom opioids make a positive difference is something we should avoid. The issue now is cheap, potent heroin. I have patients whose first drug is heroin, not pills. We need more prevention and treatment for these individuals.”
Hebble said Wednesday that she hopes future legislation will address that need. But she concluded, “This will go a long way toward preventing addiction. It will help us move the needle in the long term.”
Material from the State House News Service and the Associated Press was used in this report.
You can reach Tom Relihan at:
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