“The
Massachusetts Medical Society supports the intent of the revised CARE Act and
is thankful for the opportunity to have worked with Chairwoman Garlick and others
as they take carefully measured yet urgent action to strive toward means to
curtail the loss of life and loss of hope resulting from our state’s indiscriminate
opioid epidemic.
“We
are pleased at the commitment to streamline the process for securing naloxone
statewide, particularly for those who may be at increased risk of overdose or who
are likely to encounter an overdose.
“The
Medical Society has long held that increasing capacity for all forms of
evidence-based treatment will save lives, and therefore commends the House for
proposing a novel program to support prescribers of medication assisted treatment.
“The
partial-fill provision is wise policy and is firmly endorsed by the Massachusetts
Medical Society. In addition to giving the patient a stronger voice in managing
their medically appropriate pain medication, partial-fill lessens the
likelihood that unused opioid-based pain medication will be ingested by anyone
other than the patient for whom it was prescribed.
“While
the Massachusetts Medical Society is in support of the intent of the CARE Act,
we take issue with some of the provisions contained within the revised bill.
The incorporation of language on electronic prescribing is no doubt included
with the noble intent of increasing patient safety, but we have concerns that the
proposed rigid and broad implementation of e-prescribing guidelines could
hinder work flow and patients’ timely access to prescription medications.
“We
take issue with the 72-hour involuntary commitment of patients with substance
use disorder, primarily because there continues to be uncertainty as to whether
appropriate beds exist to care for these patients. In addition, the lack of
appropriate facilities to take care of committed patients will exacerbate
problems of overcrowding in hospital emergency departments that already
exists. Infrastructure must be created
that will include the clinical bandwidth to support medically appropriate
treatment when and if the patient is able to find an available bed. Finally,
there is no good evidence that involuntary commitment of those not yet ready to
commit to treatment results in better outcomes.
“Evidence
from the Massachusetts Department of Public Health compiled last August tells
us that the opioid-related overdose death rate is 120 times higher for inmates
released from Massachusetts prisons and jails, and, in 2015, nearly 50 percent
of all deaths of among those who were released from incarceration were
opioid-related. We hoped that those
unfortunate statistics would have compelled the Legislature to include a
provision or provisions that would make available in Massachusetts prisons and
jails medication-assisted treatment (MAT) for inmates in an effort to save
lives and increase the opportunity for recovery from substance use disorder
among one of our most vulnerable populations.
“Solving
the opioid crisis is by no means simple nor can it be accomplished without
collaboration from a multitude of concerned parties, including physicians and
those in the health care realm who can most directly affect outcomes for those with
substance use disorder. We stand by readily to continue our work with the
Legislature to work toward policy based in the latest evidence and to discuss
innovative measures to improve public health and to foster harm reduction.”
