The Baker administration’s plan to remedy the opioid abuse epidemic, which led to 1256 deaths in the Commonwealth of Massachusetts in 2014, has been subject to scrutiny as it seeks to provide healthcare practitioners in hospitals with the authority to temporarily detain substance-abuse patients that present an evident and imminent danger to themselves and their contemporaries.
At a news conference earlier in December, Massachusetts Governor Charlie Baker stated that he has heard far too many stories in recent years of patients who returned from a general practitioner’s office, a dental visit, or the hospital with 60 to 80 tablets of an opioid drug, where only a handful would have been necessary to neutralize any physical ailments.
Baker proceeded to chastise the casual nonchalance maintained by his peers in the healthcare industry when faced with remedying the issue. “I am astonished,” the Republican governor stated, “by the casual nature and the casual attitude of my peers when I talk to them about these medications and these issues. And that has got to change. Period.”
The governor’s legislation would strengthen a prescription monitoring program, requiring every practitioner to check a database before writing an opioid prescription, increase education about the drugs for athletic coaches, parents, and physicians, and give hospitals the power to force treatment on substance abusers who pose a danger to themselves or others.
Dr. Sarah Wakeman, a Massachusetts General Hospital physician who served on Baker’s Opioid Working Group, which delivered a lengthy set of recommendations in June that established the legal foundations of the bill, elucidated a rationale for prescribing the push on a more stringent protocol in the administration of opioids.
She stated that drug addiction is a disease and, as in dealing with other diseases, prevention is a useful tactic. “We prevent diabetes by limiting exposure to foods and beverages. We prevent lung cancer by limiting exposure to tobacco smoke,” she stated at the news conference. To that end, the proposed opioid prescription limits would “help to minimize excessive exposure to opioids.”
As of recently, the Department of Public Health (DPH) has implemented a series of concrete strategies to fortify its ongoing efforts to prevent opioid addiction, reduce the number of opioid overdoses, assist those already addicted to recover, and map a long-term solution to ending widespread opioid abuse in the Commonwealth.
Two major departmental endeavors include the provision of funding for an additional 128 acute treatment service beds including detoxification and clinical stabilization beds, and the provision of funding to increase to 18 the number of community health centers located in areas identified as high need able to provide opioid treatment. These health centers will offer buprenorphine and injectable naltrexone, both of which have been proven to be effective drugs in the treatment of opioid addiction.
In seeking to support those in recovery from opioid addiction, Governor Baker has sanctioned funding for Learn to Cope, a support organization which offers education, resources, peer support, and hope for parents and family members of people addicted to opioids and other drugs. Additionally, Baker has awarded funding to the MA Organization for Addiction Recovery to increase its capacity to provide peer services to those in recovery from addiction.
The legal hurdles that the legislators of Massachusetts must circumvent to provide a more supervised injection and treatment site for patients, however, are daunting. Peer organizations that wish to establish supervised injection sites would risk federal prosecution and 20 years in prison under what are known as “crack house statutes,” which make it a felony to “knowingly open, lease, rent, use, or maintain any place . . . for the purpose of manufacturing, distributing, or using any controlled substances.” State lawmakers are faced with the challenge of crafting legislation to shield safe injection site operators from scrutiny from local and state law enforcement — all while hoping to avoid penalization from federal agencies.
The governor has made a wide-ranging legislation response to the crisis a centerpiece of his agenda in 2016. Aides have stated that he is deeply committed to getting a comprehensive bill to address opioid abuse into law and is willing to use his political capital to make it so. “Four people are still dying a day in Massachusetts due to opioid abuse,” Baker stated. “I’ve never seen anything with so much negative momentum and breaking it is going to require doing some controversial things. This has got to stop.”