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Governor Baker signs opioid legislation

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Monday at the State House, Governor Charlie Baker signed landmark legislation into law to address the opioid and heroin epidemic afflicting the Commonwealth. The bill, titled An Act relative to substance use, treatment, education and prevention, passed with unanimous votes in both legislative chambers.

“The Commonwealth stands in solidarity to fight the opioid and heroin epidemic that continues to plague our state and burden countless families and individuals,” Baker said. “I am proud to sign this legislation marking a remarkable statewide effort to strengthen prescribing laws and increase education for students and doctors. While there is still much work to be done, our administration is thankful for the legislature’s effort to pass this bill and looks forward to working with the Attorney General and our mayors to bend the trend and support those who have fallen victim to this horrific public health epidemic.”

The legislation includes multiple recommendations from the governor’s Opioid Working Group, including prevention education for students and doctors, and the first law in the nation to establish a seven-day limit on first-time opioid prescriptions. The seven-day limit applies to first time adult prescriptions and every opiate prescription for minors, with certain exceptions.

Other provisions from the recommendations include a requirement that information on opiate-use and misuse be disseminated at annual head injury safety programs for high school athletes, requirements for doctors to check the Prescription Monitoring Program database before writing a prescription for a Schedule Two or Schedule Three narcotic and continuing education requirements for prescribers — ranging from training on effective pain management to the risks of abuse and addiction associated with opioid medications.

Several measures were passed to empower individuals and update current prevention efforts. Patients will receive access to non-opiate directive forms and the option of partially filling opioid prescriptions in consultation with doctors and pharmacists. Schools must annually conduct verbal substance misuse screenings in two grade levels and collaborate with the Departments of Elementary and Second Education and Public Health around effective addiction education policies. To reduce the prevalence of unused medication, manufacturers of controlled substances in Massachusetts must participate in either a drug stewardship program or an alternative plan as determined by Department of Public Health.

This bill strengthens access to insurers and the bed-finder tool website; requires that patients receive information on FDA-approved medication-assisted therapies after being discharged from a substance use treatment program; and ensures civil-liability protection for individuals who administer Narcan.

This week’s signing is the latest collaborative effort across state government to combat the opioid epidemic. It is the fifth piece of legislation signed into law by Baker — including the Fiscal Year 2016 budget and supplemental budget — to help fight opioid addiction and provide funding for prevention, treatment and education.

In late January, Baker signed into law a bill to prohibit the civil commitment of women facing substance use disorders at MCI-Framingham and providing addiction treatment services at Shattuck and Taunton State Hospitals. This reform was a recommendation of the Governor’s Opioid Working Group and will end the practice of sending women committed for treatment for a substance use disorder under section 35 of chapter 123 of the General Laws to MCI-Framingham. For the past 25 years, women committed under section 35 have been sent to this correctional institution instead of a detox center—preventing proper treatment options for women. Under this law, women can only be committed to a facility approved by the Department of Public Health or the Department of Mental Health.

Baker also recently signed a fentanyl trafficking bill, authored by Attorney General Maura Healey, making trafficking in more than ten grams of fentanyl a crime, punishable by up to 20 years in prison.

In addition to legislative action, the Baker-Polito Administration has implemented multiple initiatives from Governor Baker’s action plan announced in June, completing 26 initiatives and implementing another 23. The administration has allocated more than $250 million toward the opioid epidemic for substance use disorders, education, prevention and treatment, increased bulk purchasing of Narcan in municipalities by offering Narcan at a discount to first responders and changed reporting requirements for the Prescription Monitoring Program from seven days to 24 hours. More than two hundred substance use treatment beds have been opened throughout the Commonwealth.

The opioid epidemic continues to impact every community in Massachusetts. According to the most recent data, it is estimated that there were nearly 1,200 unintentional and undetermined opioid deaths in 2014. The estimated rate of 17.4 deaths per 100,000 residents for 2014 is the highest ever for unintentional opioid overdoses and represents a 228% increase from the rate of 5.3 deaths per 100,000 residents in 2000. Preliminary data estimations show, there were over 1,100 opioid deaths between January and September of 2015.

In February 2015, Baker appointed a working group to develop a plan to reduce opioid deaths in the Commonwealth. In June 2015, the Governor’s Opioid Working Group released 65 recommendations and a comprehensive Action Plan aimed at curbing the opioid epidemic. These short and long-term recommendations focus on Prevention, Intervention, Treatment and Recovery Support. Approximately ninety percent of the initiatives in the Governor’s action plan are complete or underway.