Almost immediately upon talking office, Governor Baker submitted legislation to address the state’s opioid addiction crisis. Most of what he asked for was enacted but not all. Medical professionals balked at his proposal for 72 hour involuntary commitment of addicts unable to seek help on their own; this part of Baker’s bill was not adopted.

That was a shame, because the opioid addiction community people whose opinion I asked told me that involuntary commitment — a kind of forced “intervention” — was sometimes necessary. Without it, the most incapacitated addicts were left to their own devices.

That said, the medical community had a point : ample beds were not available for the large numbers of addicts who might end up involuntarily committed. Now, two years later, much progress has been made as to treatment availability. Beds are more readily available, and lists of such bed locations find their way onto social media.

Thus the involuntary commitment feature of baker’s first opioid treatment bill is included in his new proposal. You can read his entire memorandum in support of it here:

Click to access TheCAREAct.pdf

For me, an equally significant proposal in Baker’s bill is something badly needed and, at last, supported by Baker: the creation of “recovery coaches” and a commission to establish standards for what ‘recovery coaches” will be asked to do. As Baker’s memorandum puts it,

The bill recognizes the important role that recovery coaches play in successful long-term addiction treatment by creating a commission to recommend standards for establishing a professional credential for recovery coaches as an important step toward formalizing the role of recovery coaches in the regimen of long-term addiction treatment.

Even now, years into the opioid crisis, there is still far too little high quality data guiding decision making about the most effective forms of treatment for addiction. To address this gap, the bill creates a commission to review evidence-based treatment approaches to substance use disorders and mental health conditions. The bill directs the commission to produce fmdings in 180 days to help insurers and patients to identifY the most effective addiction and mental health treatments offered across the full range of licensed behavioral health clinician specialties so that each patient can find the specific treatment that best meets the patient’s needs.

Those who have gone through recovery insist that only members of the “recovery community” have the experience to guide addicts into and through successful recovery. I might add that, very probably, only a recovery person will have the full confidence of those who the recovery process seeks to help.

The idea of having “recovery coaches” is not a new one in his debate. Governor Baker has at least one close friend, Jack Kelly of Charlestown, who since the 2014 campaign, in which he provided significant support to Baker — from recovery people as well as Charlestown activists — has been advocating for the recovery-community’s primacy in the battle against opioid addiction. For a while after baker’s victory, it looked as though Kelly’s views — recovery community being the opioid crisis’s primary responders — would become Baker policy. That did not happen. I do not know why, but the likeliest explanation is that the state’s vast medical establishment opposed it. Now, it looks as though Kelly’s view will be adopted, if the legislature agrees to it.

Baker emphasized the role of “recovery coaches” at a recent address he gave to medical professionals at Beverly Hospital. Youcanread the report here :

Baker has had significant success already in the fight against opioid deaths. It is good to see him now doubling down, requesting $ 174 million of state funds to the effort, and making the availability of naxolone more widespread. It is this reporter’s hope that his new legislation will be enacted in full, as it should be;  and it is my hope, on a personal basis as an admirer of Kelly, that he will ask Jack, whom he knows on a first name basis having sought his advice and knowledge regularly — and who, after Mayor Walsh, is perhaps the most widely followed and trusted recovery person in the Boston area’s political community — to establish the standards for recovery coaching and to oversee their coaching work.

—- Mike Freedberg / Here and Sphere

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