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State Senate offers wide attack on opioids

Multipronged plan tackles health crisis

State Senate leaders, frustrated at what they called a fragmented response to opioid overdoses, unveiled a comprehensive bill Thursday to attack the deadly problem on a wide, multipronged front.

Instead of addressing the issue piecemeal, they have combined more than a dozen proposals from several senators in a single act that would curb the prescription of risky narcotics, expand insurance for treatment and recovery, and require physicians to screen patients to gauge their potential for drug abuse.

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“We have to break the cycle of addiction before it breaks us, and the time to act is now,” Senate President Therese Murray said at a State House news conference. “This is a bold move. We know it.”

The bill is scheduled to be debated Tuesday as the state scrambles to respond to what Governor Deval Patrick declared a public-health crisis in March.

“We’re trying to take a fragmented system and make it whole,” said Senator Jennifer Flanagan, a Democrat from Leominster who is pushing for longer insurance coverage for drug-abuse treatment.

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Patrick praised the proposal as “doing the right thing for the people of Massachusetts by tackling this public health crisis head-on. Opiate addiction deserves attention from all corners of government, and I look forward to working with Senate President Murray to address this emergency.”

Senator Bruce Tarr, the Republican minority leader from Gloucester, called the bill “a great starting point and a wonderful opportunity to begin the process of exchanging ideas to best combat this major issue troubling our society.”

‘We have to break the cycle of addiction before it breaks us, and the time to act is now.’

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The plan takes aim at prescription painkillers with a high risk of abuse by directing a state panel to compile a list of substitutes for opioids “determined to have a heightened level of public-health risk.” Unless prescribing physicians specifically request the riskier drug, pharmacists would be required to distribute the substitute, which would have built-in safeguards such as crush-proof coatings.

In addition, the bill seeks to empower the state health commissioner to bar unspecified drugs from pharmacy shelves for up to a year if they are deemed an “imminent hazard to public safety.”

“It is very difficult to keep up with these new synthetic drugs,” said Senator John F. Keenan, a Democrat from Quincy who is pressing for substitute drugs. “As you clamp down on drugs in one area, there becomes a void. That void will be filled in the Commonwealth of Massachusetts.”

In March, Patrick sought to ban the sale of Zohydro, a powerful painkiller that is considered a risk for addiction by many physicians despite its approval last year by the Food and Drug Administration.

A federal judge in Boston overturned that ban, but the state Board of Registration in Pharmacy approved emergency regulations Tuesday that are designed to keep hydrocodone-only medications such as Zohydro out of the hands of addicts and criminals.

Among other requirements, pharmacists must keep the drugs in a locked container and dispense them only to customers who can show a letter of medical necessity from their prescribing physicians.

The bill also seeks to provide greater insurance coverage for drug-abuse treatment. In a proposal pushed by Flanagan, patients who need up to three weeks of detoxification and follow-up treatment would not need prior authorization from public and commercial insurers. The bill also would require all insurers to pay for substance-abuse services delivered by a licensed alcohol and drug counselor.

Flanagan said this expanded coverage might encourage providers to make more beds available for addicts, many of whom cannot find space in detox and recovery programs and risk relapses while they wait. “We’re here because we need to save lives,” Flanagan said. “This is no longer an issue that can be pushed aside.”

Senator Stephen Brewer, a Democrat from Barre who is chairman of the Ways and Means Committee, said the drug addiction crisis is exacting a heavy price across a wide array of state agencies.

However, he said, “the cost of inaction is much greater than the cost of doing this now,” Brewer said. “The time is now to plant our flag.”

The bill would require the chief medical examiner to file a report with the state Department of Public Health when an overdose death occurs. The DPH has faced criticism for not collecting real-time data on suspected overdoses at a time when nearby states are compiling such numbers to spot clusters and respond quickly.

The Massachusetts State Police reported in February that they had recorded 185 suspected overdose deaths since November. However, that figure did not include deaths in Boston, Springfield, and Worcester, which conduct their own investigations of accidental deaths.

The bill also seeks to strengthen the Prescription Monitoring Program, which is designed to help physicians determine whether patients are receiving drugs from multiple doctors in a short period of time, among other concerns it seeks to address. Critics have said that compliance with the program has been spotty and poorly regulated.

Officials from Blue Cross Blue Shield of Massachusetts said the bill is a positive step. “At first glance, we are pleased that the legislation recognizes the shared responsibility of government, health care providers, and payers to help address this crisis,” said Sharon Torgerson, spokeswoman for the insurer, which has limited the number of painkillers it will cover without prior authorization.

Brian MacQuarrie can be reached at macquarrie@globe.com.

Correction: And earlier version of this story incorrectly named the Food and Drug Administration.

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