Baker bill looks to address scourge of opioid abuse
https://www.bostonglobe.com/metro/2015/10/15/baker-unveil-opioid-bill-looking-address-crisis/JY30aFl1N5sQlHz4kKSRiL/story.html
Just imagine giving a pt a “72 hr supply” of a opiate/pain management on Thursday or Friday and it is insufficient and they run out over the weekend… so that they end up at a ER… being tagged as a “drug seeker” and even if they aren’t turned away.. there is the ER charge for a couple of days extra of pain management, because “the state” wants to play doctor with no medical training/experience.
Remember there is no educational, other required experience or even COMMON SENSE… to be an elected bureaucrat and it appears to hold true for most of those elected politicians in MASS.
Governor Charlie Baker, facing a deadly scourge of prescription drug and heroin abuse, proposed Thursday to place new limits on how many opioid painkillers doctors and dentists can prescribe to a patient.
Looking to help stanch addiction where it often begins, the bill would limit practitioners to prescribing no more than a 72-hour supply of opioids to patients the first time they prescribe an opioid to them, with exceptions only for certain emergencies.
But the plan, embedded in a wide-ranging legislative package, immediately drew concern from doctors in the state.
“The problem there is it doesn’t necessarily allow for the clinical judgment of physicians — to adjust their prescriptions for different patients with different situations,” said Dr. Dennis Dimitri, president of the Massachusetts Medical Society, which represents more than 25,000 physicians and medical students.
He expressed worry about the “unintended difficulties and consequences” of the prescription-limiting provision.
At a State House news conference, Baker acknowledged that the prescribing limit is controversial but said he has heard far too many stories in recent years of people who come from a doctor’s office, a dental visit, or the hospital with 30 or 60 tablets of opioid drugs, when a handful would do.
A former health insurance company executive, Baker said he has lots of friends and colleagues in the health care world. “I am astonished,” the Republican said, “by the casual nature and the casual attitude that I find when I talk to them about these medications and these issues. And that has got to change. Period.”
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, described a rationale behind the prescribing limit push. She said drug addiction is a disease and, as in dealing with other disease, prevention works.
“We prevent diabetes by limiting exposure to foods and beverages. We prevent lung cancer by limiting exposure to tobacco smoke,” she said at the news conference. So the proposed opioid prescription limit “will help to minimize excessive exposure to opioids.”
The governor’s legislation would also strengthen a prescription monitoring program, requiring every practitioner to check a database before writing a new opioid prescription; increase education about the drugs for athletic coaches, parents, and physicians; and give hospitals new power to force treatment on substance abusers who pose a danger to themselves or others.
Early reviews of the bill from several powerful figures in the state were positive. US Senator Edward J. Markey, a Democrat, commended Baker for the bill. State Senate President Stanley C. Rosenberg and House Speaker Robert A. DeLeo, also Democrats, released warm statements about the legislation.
And in a clear nod to the bipartisan effort to address the crisis, Steven A. Tolman, the president of the Massachusetts AFL-CIO and a sometimes Baker antagonist, stood directly to Baker’s right during the news conference. In remarks, Tolman, a longtime advocate on issues of substance abuse, underscored his support for the governor’s effort to address the scourge.
Lora M. Pellegrini, president and chief executive of the Massachusetts Association of Health Plans, which represents 17 health insurers in the state, praised Baker for leading on the issue of opioid addiction.
“There are a lot of important provisions here that we are quite positive about,” she said of the bill. Among them is the prescribing limits. Pellegrini said the data show a lot of heroin users start with opioid prescription drugs, and the prescription-limiting effort might help reduce the amount of those drugs on the street.
The governor also proposed ending the practice of sending women struggling with addiction — who are found by a court to pose an immediate risk of harm to themselves or others — to a Framingham prison when treatment beds are full.
Jessie Rossman, a staff attorney with the American Civil Liberties Union of Massachusetts, which has brought a lawsuit on behalf of women civilly committed to the prison, said she is reviewing the legislation and hopes any bill that becomes law will actually accomplish the goal of ending the practice.
She also said the ACLU is carefully reviewing Baker’s push to give hospitals new power to force treatment on substance abusers who pose a danger to themselves or others for up to 72 hours — and offered a note of concern about any effort that can deprive people of their liberties.
Baker’s proposal would parallel existing law that permits a 72-hour period of involuntary treatment when a physician determines a person suffers from mental illness and poses a serious risk of harm.
Baker acknowledged that the involuntary commitment for addiction treatment provision is also controversial, but said he thinks it is the right thing to do.
“That 72-hour period is an opportunity to help folks find their way to a better path,” he said.
The Senate has already passed its own bill this fall, focused on steering people away from addiction through education and prevention. Baker’s bill, along with efforts by the House, may be melded into a single legislative package, in the months ahead. Passage of a comprehensive package, in one form or another, is likely.
Baker, who took office in January, has made a wide-ranging state government response to the crisis a centerpiece of his agenda.
Massachusetts has recently seen a stunning rise in unintentional opioid overdose deaths. The state Department of Public Health said this year that an estimated 1,256 Massachusetts residents died from opioid overdoses in 2014, a sharp increase from 2013 and 2012.
Joshua Miller can be reached at joshua.miller@globe.com. Follow him on Twitter @jm_bos and subscribe to his weekday e-mail update on politics at bostonglobe.com/politicalhappyhour
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