Mirra Supports Gov’s Opioid Plan

Uncategorized / Tuesday, May 15th, 2018

Check out this article from Christian M. Wade of the Lawrence Eagle-Tribune:

Plan to hold addicts gains support on Beacon Hill

Two years ago lawmakers dismissed Gov. Charlie Baker’s proposal to give emergency room clinicians power to force opioid addicts into treatment.

Now the Legislature appears to be warming to the idea as it mulls Baker’s latest plan to combat the scourge of opioid addiction.

Baker’s CARE Act — which stands for an Act Relative to Combating Addiction, Accessing Treatment, Reducing Prescriptions, and Enhancing Prevention — includes a provision authorizing police, medical professionals and others to commit a person suspected of opioid abuse to treatment, even against their will, for up to 72 hours.

The Legislature’s Joint Committee on Mental Health, Substance Abuse and Recovery recently supported the idea, voting to approve a re-write of Baker’s CARE Act, which entails a range of plans to combat opioid addiction, while keeping the 72-hour hold provision. The measure still faces several more hurdles on Beacon Hill including votes in the House and Senate.

“This is an extraordinary step, but these are extraordinary times,” said Rep. Paul Tucker, D-Salem, who supports the measure. “What we’re finding is that addicts are overdosing, leaving the emergency room and ending up back there a few hours later. We need to get more aggressive about treatment.”

Rep. Lenny Mirra, R-West Newbury, said he too believes the state needs to be more forceful about setting addicts on the path to recovery.

“I consider myself a staunch libertarian, but I’ve started to change my thinking on this because we’re seeing the same people overdosing,” said Mirra, a member of the Health Care Financing Committee that is reviewing the bill. “We can’t just sit back and do nothing. The state needs to intervene.”

Baker, a Republican and former healthcare executive, has made similar arguments, saying he wants to end the pinballing of overdosing addicts in and out of emergency rooms, which not only keeps them from getting help but endangers their lives.

Two years ago, Baker proposed involuntary commitments for those who pose a danger to themselves or others due to opioid addiction. That raised concerns about civil liberties and the ability of emergency rooms to hold onto addicts until a bed was available. Lawmakers ultimately rejected it.

Under his new plan, ER personnel could order someone’s involuntary transport to a treatment facility for up to 72 hours. After that, police, family, physicians or others could petition a judge to order the person into long-term treatment under the state’s Section 35 law.

Still, the 72-hour hold faces opposition from the Massachusetts Medical Society, which represents physicians.

“There continues to be uncertainty as to whether appropriate beds exist to care for these patients,” said Dr. Alain A. Chaoui, the society’s president.

A spokeswoman for the Massachusetts Health & Hospital Association, which represents 70 hospitals throughout the state, said the group was still reviewing the proposal.
Some studies have found that involuntary treatment is generally less effective than voluntary admission.

Rep. Andy Vargas, D-Haverhill, said he is still reviewing Baker’s proposal and hasn’t made up his mind.

“Obviously it would be more of a burden on hospital rooms, which is a concern, but I’ve heard from those who are trying to get addicts into treatment who say that some people will never be ready to make that decision on their own, so it’s our duty to do what’s best for them,” he said.

A 2016 law requires ER doctors to offer voluntary substance abuse screening to people treated for opioid overdoses. But a majority of those patients refuse the evaluation, according to health officials, who say the lack of participation is preventing addicts from getting into treatment.

The latest data show the number of opioid-related overdose deaths trending downward for the first time in 15 years. In February, health officials reported 1,977 suspected and confirmed overdose deaths in Massachusetts last year, a 8.3 percent decline from the prior year.

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