^ State Representative Liz Malia : filing a much less forceful alternative to the Governor’s opioid addiction bill

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The legislature has had Governor Baker’s opioid addiction legislation for months now. His bill is a bold one to boldly meet a crisis intensifying. The legislature, however, seems to want something less. I think they’re wrong.

The Governor’s bill includes two provisions that raised hackles in the state’s medical hallways: a 72 hour, forced commitment of addicts and a 72-hour limitation on painkiller prescription dosage. Baker has doggedly amassed support for both, from the state’s Sheriffs, police chiefs, even much of the medical community. The addiction and recovery community, however, seems split on this proposal, and that is most likely why it may be set aside by the legislature. Doctors, too, do not like it.

State Representative Liz Malia of Jamaica Plain and Roslindale has proposed a different opioid addiction bill. This linked Boston Globe story sets forth the differences : http://www.bostonglobe.com/metro/2015/12/28/house-opioid-bill-veers-significantly-from-baker-proposal/dKJrN7vP9pXHeuR7QyqsSJ/story.html

Malia is a veteran legislator, the body’s go to member on mental health issues. Her bill seems likely to gain traction in the House.

I still believe that the forced commitment provision is a good one. Addicts desperately in the power of addiction need, at crisis point, to be taken into detox. At least in the proposed 72 hour period, a recovery beginning can be attempted. Of course, recovery stands a better chance if entered into willfully; but I fail to see the harm in forcing the issue. That’s what an intervention does. Malia’s substitute bill limits intervention to “requir(ing) that patients in an acute care hospital believed to be suffering from an opioid overdose receive a substance abuse evaluation within 24 hours of admission.”

To me, that’s unacceptably weak tea.

Compare Malia’s bill with Baker’s proposal via this link : http://www.mass.gov/governor/press-office/press-releases/fy2016/governor-baker-files-landmark-substance-use-legislation.html

Malia’s bill also vitiates the Baker bill’s prescription limitation. Instead of 72 hours, the Malia limit is seven days. In addition, she widens the Baker bill’s exception for emergencies to include situations of “chronic pain.”

Nobody wants to deny pain remedy medicine to people suffering severe,. chronic pain. But until I read Malia’s definition of “chronic,” I cannot tell if this isn’t a loophole as wide as a Parisian boulevard. Over-prescribing of pain killers is a huge problem in Massachusetts. There’s a vast black market for pain pills. I can tell you, from my own experience with percoset after a surgery ten years ago, that it’s quite easy to endure pain and sell — for a substantial price —  the pills you do not use. In my case, I returned the pills I did not use (because I didn’t really want them after Day One) to the hospital pharmacy; but how many people will do that with pills worth their weight in gold ?

In Maila’s bill, “patients in an acute care hospital believed to be suffering from an opioid overdose receive a substance abuse evaluation within 24 hours of admission.” Gee….

I suppose that any opioid abuse legislation is better than none at all. Still, if Representative Malia’s version supersedes the Governor’s, the arena of combatting opioid abuse will continue to be what it is now : the addiction and recovery community itself : where parents, local clinics, and clinic counselors converse, discuss, and pressure addicts to take that first big step toward a recovery the legislature seems not to want to mandate.

But that is where our state’s addicts are already. Over 1000 of them are dying yearly now, and the number is rising.

— Mike Freedberg / Here and Sphere