Baker would let doctors detain drug abusers for 72 hours

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BOSTON – Clamping down on opioid drug abuse by limiting quantities of prescribed medication, requiring closer prescription monitoring and giving doctors greater power to hold patients for involuntary treatment are just some of the ways Gov. Charlie Baker wants to ease a crisis that has claimed thousands of Massachusetts lives in the past decade.

In a measure he introduced Thursday, Baker also would improve education targeting young people at risk of becoming abusers, move women committed for detoxification treatment into Taunton State Hospital and out of the Framingham state prison, and strengthen training for medical professionals involved in treatments using opioid drugs such as oxycontin and fentanyl.

“Combatting the opioid epidemic in the commonwealth calls for a comprehensive approach, and filing today’s landmark legislation is a critical step toward creating more effective treatment pathways and better controlling opioid prescribing practices for first-time patients,” Baker said in a statement accompanying his legislative proposal. In June, the governor, a former health care executive, called opioid abuse a “public health epidemic.”

Opioids are derived from the same pain-suppressing chemicals found in morphine and heroin, and include medicines such as oxycontin and fentanyl. A surge in abuse of such medications as well as heroin over the past decade led to thousands of deaths in Massachusetts, including 1,256 in 2014, according to the state Department of Public Health, up from roughly 900 the year before and 456 in 2004. Baker has made tackling the problem a priority and convened a task force to come up with recommendations earlier this year. Among steps already taken, the administration has opened 113 new treatment beds across the state and more are on the way, according to the statement.

“Our administration is utilizing every tool in the toolbox to fight the opioid crisis tainting every corner of the Commonwealth,” Lt. Gov. Karyn Polito said in the statement. “Filing today’s bill serves as the latest call to action to execute a dynamic strategy and we look forward to working with the legislature to enact meaningful laws to help our citizens.”

Giving medical practitioners the power to restrain an individual for drug abuse treatment would extend current authority to make involuntary commitments of people deemed to be risks to themselves or others because of mental illness, according to the administration’s statement. It said the provision would create “a new pathway for treatment of individuals with substance use disorder,” and one that could be used when needed. It said currently, a court order is typically required for an involuntary commitment to treat drug abusers.

Under his proposal, Baker, a Republican and former Harvard Pilgrim Health Care chief executive, would give doctors the ability to hold a person for three days “so they can attempt to engage the patient in voluntary treatment or seek court ordered involuntary treatment,” according to the statement.

The first time a doctor prescribes an opioid medication to a patient, it would be limited to no more than a three-day supply, under Baker’s proposal. The same limit would apply to a prescription given by a new doctor to a person already taking an opioid by prescription from another physician. Some exemptions may be granted.

Medical practitioners, including emergency room staff, would be required to check a prescription-monitoring database before handing out opioids, and doctors would be required to take five hours of training on pain management and identifying patients at risk of opioid abuse, under the measure.

Parents, coaches and school medical personnel would also be given instruction on the dangers of opioid use, and the measure would provide a way to develop transportation plans to get students diagnosed with substance use disorder to “recovery high schools” that ensure a “safe, sober and supportive learning environment.”

“Addiction is a disease that is caused by a mix of genetics and exposure,” Dr. Sarah Wakeman, a member of Baker’s Opioid Working Group, said in the statement. “As physicians, legislators and community members, we cannot change people’s genetics but we can begin to work on the exposures that leave individuals vulnerable to this deadly disease.”