Massachusetts can now boast, as Gov. Charlie Baker put it Monday, “the most comprehensive measure in the country to combat opioid addiction.”
While self-congratulation is typical at bill-signing ceremonies, Baker was right to remind everyone this is a problem that fights back.
The moment was understandably emotional, witnessed by families who have lost members to overdoses. As many as 100 Massachusetts residents are falling victim each month to the disease of opioid addiction.
The governor broke down at one point, his voice shaking as he told families: “May today’s bill passage signal to you that the Commonwealth is listening and we will keep fighting for all of you.”
Baker was right to pledge that government will do still more.
To be sure, the new law is historic, with provisions that go hard after the supply of prescription opioid drugs blamed for saddling many thousands of state residents with addiction. But the fight isn’t over.
Amid evidence the problem is growing, the measures that became law Monday, or will be rolled out in coming months, cannot be expected on their own to turn the tide against this crisis.
In the short term, limiting patient access to opioid prescription drugs like OxyContin, Percocet and Vicodin may drive more people battling addiction to use heroin instead, exposing them to other risks, including uncertainty about that drug’s potency and adulterating ingredients. It is possible that some will die as a result of this law.
And while the state has been slowly improving access to treatment, it is far from assured that those who manage to sever their dependence on opioid drugs will find the care they need. Access to treatment is limited and insurance rules governing coverage are byzantine. Awaiting people who have just broken addiction’s hold lie recovery programs that work for some, but not for all, including the 12-step programs to which many former addicts are referred.
Two years ago, when former Gov. Deval Patrick declared an opioid crisis in Massachusetts and got task forces rolling, the state stood ill-prepared to respond. Since then, Gov. Baker, who took office just over a year ago, has signed five separate pieces of legislation that attend to aspects of the crisis.
The latest measures limit to seven days the initial supply of opioid drugs, with some exceptions for palliative and cancer care. They also require verbal screenings at two school grade levels for evidence of substance abuse. Starting in July, hospitals will be required to administer substance-abuse evaluations of people who turn up in emergency rooms with apparent opioid overdoses.
And come fall, doctors will be required to check a prescription-monitoring program before giving their patients access to drugs considered habit-forming – to be sure they haven’t sought them from other practitioners. On their own, patients will be able to decline to fill a full prescription for opioid drugs, opting for small numbers of pills.
With this new prevention-oriented law in place, it’s time to improve the odds for those who are trying to break free from addiction by fashioning better forms of treatment.
About the time the Patrick administration identified a crisis, an article in the New England Journal of Medicine put the problem simply: “The epidemic of prescription-opioid overdose is complex.” That remains the case, regardless of how many laws are created. The May 2014 journal article called both for expanding access to alternative drugs like suboxone that wean addicts from dependence and for curbing inappropriate access to opioid drugs, which it called “the key upstream driver of the epidemic.” But it noted that these measures must avoid “jeopardizing critical or even lifesaving opioid treatment when it is needed.”
There is no question opioid drugs fall into the wrong hands. But for countless people, they effectively treat disabling pain. The new law took this balance into consideration in amending the governor’s original call for a three-day limit on initial prescriptions. As restrictions tighten down on the supply of opioid drugs, patients who legitimately need them must not be penalized or scorned. Nonetheless, while these drugs make life possible for some with chronic pain, they murder others. This new law isn’t a solution, but it will make it harder for addiction to take hold of a person. That’s why, amid tears, it was celebrated Monday.