Mass. Medical Society Calls For Changes To Key Provisions In Baker's Opioid Bill

The head of the Massachusetts Medical Society (MMS) is calling for lawmakers to change two key provisions in a bill that Gov. Charlie Baker says is needed to fight the state's growing opioid addiction epidemic.

The Joint Committee on Mental Health and Substance Abuse held a hearing on the legislation Monday, during which MMS President Dr. Dennis Dimitri urged changes to two controversial proposals: limiting first-time opioid prescriptions to a three-day supply, and letting hospitals hold addiction patients against their will for up to three days while trying to place them in treatment.

Testifying before the committee, Baker defended the proposals, saying they are necessary to stem the problem.

"For some patients in the throes of this addiction, the choices may be between a jail cell, a coffin or treatment through this proposed process," Baker said. "I choose the latter over the other two."

According to a press release, MMS President Dimitri testified that the involuntary commitment proposal "cannot work without access to treatment resources and post-hospitalization care.”

Dimitri also said that involuntary commitment "could further exacerbate" the problem of emergency department overcrowding "without actually benefiting patients."

And in response to Baker's proposed three-day cap on first-time opioid prescriptions, Dimitri urged lawmakers to instead consider a seven-day limit that would be phased out "when the crisis has abated." He did not specify a timeline beyond that.

Dimitri said doctors need to be able to decide what is best for individual patients, and noted that opioid prescriptions cannot be phoned in to a pharmacy.

“A patient with acute pain beyond the proposed initial 72-hour treatment period would have to return to their physician’s office, obtain a paper prescription, bring it to the pharmacy and wait for it to be filled," Dimitri testified, according to the press release. "An elderly or disabled or poor patient, especially one without a helping caregiver or transportation, could be left to suffer.”

Boston Mayor Marty Walsh, a Democrat, testified alongside the Republican Baker in support of the legislation. He told lawmakers it's clear what needs to be done to reduce substance abuse.

"We need to invest in prevention, we need to build our treatment capacity, and we need to say to those in active addiction and their families, 'We care enough to meet you where you are, and get you the help you need,' " Walsh testified, according to his prepared remarks.

Baker's bill has received support from many of the state's district attorneys and members of the law enforcement community. But state House and Senate leaders have expressed skepticism.