Special to the Journal
The Massachusetts House of Representatives today passed a wide-ranging opioid bill which covers the licensure of recovery coaches, makes opioid overdose reversal drugs more accessible, protects harm reduction providers, and removes barriers that new mothers in recovery face at the time they give birth.
“As families across Massachusetts know all too well, the impact of opioid addiction can be utterly devastating for the individual and for their loved ones, which is why a continued focus on combating substance use is a critical responsibility that we have as elected officials,” said House Speaker Ronald J. Mariano (D-Quincy). “I want to thank Chairman Michlewitz and Chairman Madaro for their tireless work on this legislation, as well as all my colleagues in the House for recognizing the need for reforms that will help those dealing with addiction on their journey to recovery.”
“This legislation will help the Commonwealth to address the opioid epidemic by expanding treatment options and by making it easier for those in need to seek assistance,” said Representative Aaron Michlewitz (D-Boston), Chair of the House Committee on Ways & Means. “By making treatment options more accessible and by removing barriers for thousands of people seeking help, we can help people rebuild their lives and stay on the road to recovery. I want to thank Speaker Mariano for his commitment and dedication to this issue, as well as Chairman Madaro, and all my House colleagues for their work and dedication to addressing substance use disorder.”
“The bill passed today builds on the commitment of the House to support individuals and communities across the Commonwealth who are dealing with the effects of the opioid crisis,” said Representative Adrian C. Madaro (D-East Boston), House Chair of the Joint Committee on Mental Health, Substance Use and Recovery. “By ensuring greater access to overdose reversal drugs, protecting harm reduction workers, removing barriers to mothers in recovery, and licensing recovery coaches, we are empowering health care providers, community members, and individuals to save lives. Thank you to Speaker Mariano for your leadership and guidance on this issue, and to Chair Michlewitz for your partnership in passing this critical legislation.”
In 2023, there were 2,125 confirmed and estimated opioid-related overdose deaths, according to the latest data published by the Department of Public Health (DPH). In 2023, there were 232 fewer confirmed and estimated deaths than 2022.
Recovery coaches
Recovery coaches help people with substance use needs become and stay engaged in their recovery process. The bill passed today establishes recovery coach licensing and oversight within DPH, and mandates that all health plans cover recovery coach services without cost-sharing or prior authorization. The bill also directs the Bureau of Substance Addiction Services (BSAS) to study and report on barriers to certification, credentialing, and other employment and practice requirements for recovery coaches, and requires them to create a peer support program for recovery coaches consisting of mentorship, technical assistance on billing and employment practices, and resources.
“Today marks a pivotal moment for our community and for those battling substance use disorders,” said Representative Jim O’Day (D-West Boylston), Fourth Division Chair and lead sponsor of the bill. “With the passage of H. 4743, we are taking significant steps to enhance treatment options, expand coverage, and, crucially, to recognize the indispensable role of recovery coaches. This legislation builds on our historical commitment to reducing stigma and providing comprehensive support for individuals in recovery. By embracing harm reduction strategies, patient education, and compassionate care, we are advancing public health and offering renewed hope to those affected by substance use disorders. Together, we are forging a path towards a healthier, more supportive future for all. Let us stand proud of this achievement and continue to champion the cause of recovery.”
Opioid overdose reversal drugs
The bill passed today mandates that all health plans cover opioid overdose reversal drugs, such as naloxone, without cost-sharing or prior authorization. It also requires substance use disorder treatment facilities to educate on and dispense at least two doses of opioid overdose reversal drugs to an individual upon discharge, as well as requires hospitals to educate on and prescribe or dispense at least two doses of opioid overdose reversal drugs to an individual with a history of opioid use or opioid use disorder upon discharge.
It also requires pharmacies in areas with high incidence of overdose to maintain a continuous supply of opioid overdose reversal drugs and to report to DPH if they are unable to maintain compliance with this provision due to insufficient stock or supply.
Patient education
In an effort to prevent opioid misuse, the bill requires prescribers to be educated on pain treatment, including appropriate non-opioid alternatives to pain treatment. It also requires pharmacists to provide printed educational materials issued by DPH on non-opioid alternatives for the treatment of pain to patients prior to dispensing an opioid.
Harm reduction
The bill protects public health or harm reduction organizations and their agents who provide drug-checking services, such as needle exchange programs, to reduce the risk of accidental overdose from civil liability or professional disciplinary action from a board of registration, as well as from being criminally charged or prosecuted for possession of drug paraphernalia, unlawful possession of controlled substances, and conspiracy to violate the Controlled Substances Act (the CSA).
It also protects individuals who seek drug-checking services on substances intended only for personal use from being criminally charged or prosecuted for possession of drug paraphernalia, unlawful possession of controlled substances, and conspiracy to violate the CSA while on the premises of a public health or harm reduction organization providing said services.
Ensuring non-discriminatory treatment
The bill clarifies DPH’s authority to enforce anti-discrimination protections for people with substance use disorder who are on public health insurance. It also prohibits life insurance companies from limiting or refusing coverage to individuals solely because they obtained an opioid overdose reversal drug for themselves or others. It also prohibits discrimination on the basis of lawful possession and use of a medication for the treatment of an opioid-related substance use disorder, such as methadone or buprenorphine.
Pregnant people on medications for addiction treatment
The bill passed today removes “physical dependence upon an addictive drug at birth” from the conditions necessitating a child abuse and neglect report, thereby exempting pregnant people taking medications prescribed by their doctor from automatic investigation by the Department of Children and Families (DCF). It requires DCF, in consultation with DPH, the Office of the Child Advocate (OCA), and stakeholders, to promulgate regulations on the care, treatment, and reporting of substance-exposed newborns (SENs).
Having passed the House of Representatives 153-0, the bill now goes to the Senate for its consideration.
