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As the state's opioid epidemic shows no signs of slowing down, a Beacon Hill panel listened Monday to hours of testimony on Gov. Charlie Baker's bill seeking to stem the scourge.
Baker acknowledged his proposal disrupts the status quo.
"In 2014, Massachusetts clinicians wrote over 4.4 million Schedule II and III prescriptions, worth over 240 million pills," he testified. "In the same year, over 1,200 people died of opioid overdoses. Simply put, the status quo is unacceptable and it needs to be disrupted."
One of the key provisions of the governor's bill would limit initial prescriptions for opioids to a three-day supply. It's a provision supported by Lori Palazzi Gonsalves, whose son Cory became severely disabled after overdosing on heroin. Before becoming addicted, the one-time captain of the Taunton High School football team was prescribed 120 Percocets for a shoulder injury.
"I wish that the doctor had spoken to me a little bit, or that I knew enough to ask," she testified. "I guess I wasn't educated enough to ask, and I just trusted the doctor to the fact that he would do the right thing."
The Massachusetts Medical Society opposes the three-day limit on first prescriptions, but is suggesting that a seven-day limit might be more appropriate.
One backer of the governor's bill is Boston Mayor Marty Walsh. He lauded a provision that would allow addicts to be held involuntarily for 72 hours. He told legislators more often than once, he's seen a journey of recovery begin with involuntary treatment.
"You might hear people come up to this microphone and say, 'We're not equipped for that.' Well, the addicts and the families who are losing loved ones are not equipped to go to the funeral home to bury their loved ones either," he said. "We can figure it out. This is the greatest commonwealth in the country, greatest state in the country. We can figure out a three-day system inside an emergency room, which would give a family member the opportunity to take further action."
And as the mayor predicted, concerns about involuntary treatment were raised by the medical community.
Detailed Dr. Peter Smulowitz, an emergency room physician with Beth Israel Deaconness Hospital in Plymouth: "What will happen with a 72-hour hold is patients will sit in a locked room in our emergency department or in a hallway bed, in an already-crowded emergency department. Those patients will begin withdrawing. They will want to leave to get their next fix. We will not be able to properly treat them, we will have no definitive treatment for them. The current circumstance of behavioral health boarding in our emergency departments is inhumane and unsustainable. We cannot add more to that burden."
Smulowitz says what's really needed is support for building a real infrastructure for inpatient and outpatient treatment.
As dangerous as opioids can be, some patients are asking lawmakers to also consider the plight of people who suffer chronic pain.
Cindy Steinberg, with the group the Mass Pain Initiative, fears efforts to clamp down on the prescription of opioids will make it tougher for those who need the medication to get it.
"People with pain use them safely, and as prescribed," Steinberg said. "They do not get addicted to them, they do not get high from them. I myself was crushed in a serious accident, and for 10 years my doctor convinced me to take an opioid, a hydrocodone combination medication. I was on the same medication for 10 years."
With the Legislature wrapping up formal sessions for the calendar year this week, an opioid bill won't be ready for a vote until sometime in 2016. After testifying, Baker indicated he's OK with that — for now.
"I'm hopeful that we'll get something passed through the Legislature that we can sign and begin implementing early ... when they come back in January. If the clock's still ticking and nothing's happened in February or March, I'm going to start to get pretty impatient," the governor said.
A separate addiction-related bill may make it through the Legislature before the holiday break. The Senate has indicated it will take up a House-passed bill to outlaw the trafficking of fentanyl, which is often mixed with heroin to increase its potency.
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