Lawmakers dropped the controversial idea to pursue so-called safe injection sites in a compromise addiction and substance use disorder bill they filed Tuesday after months of private negotiations.
Reps. Alice Peisch and Adrian Madaro and Sen. Brendan Crighton filed the bill ( H 5143) at the House clerk’s office at 4:30 p.m. Tuesday. Madaro and Crighton chaired the conference committee.
With opioid-related deaths declining but still at crisis levels, the Senate embraced the sites, also known as overdose prevention centers, where people can use illegal drugs under the supervision of health care workers.
Supporters say they are a life-saving tool to tamp down on the devastating effects of the opioid crisis, which has been exacerbated by the pervasive presence of fentanyl in the drug supply. Opponents say the sites are illegal under federal law and would encourage illegal drug use.
The policy was not included in the House version of the bill, and lawmakers on the negotiating committee pointed to the controversial idea as the main sticking point in their talks for the last few months. The Department of Public Health under Gov. Maura Healey supported the controversial idea for the first time last year, with Public Health Commissioner Robbie Goldstein calling the sites “lifelines, serving not only as places of intervention, but as places of empathy, understanding, and healing.”
Both branches are in session on Thursday, and the House will have the first chance to take up the measure.
The compromise bill is intended to limit the toll of addiction and substance use disorder, including with strategies to boost access to overdose reversal drugs, while the opioid epidemic continues across the state and nation.
Opioid-related overdose deaths dropped 10 percent in 2023 compared to 2022, the largest year-over-year decline in two decades. But the crisis still killed more than 2,000 Bay Staters for the eighth straight year.
“I think this bill is going to save lives, which we don’t say lightly,” Crighton told the News Service after dropping off the final deal in the House clerk’s office. The Lynn Democrat highlighted “the increased access to overdose reversal medication, Naloxone, making sure that’s available to anyone that needs it without any stigma or any penalties.”
The bill would require insurers to cover emergency opioid antagonists used to reverse overdoses, such as naloxone or name-brand Narcan, without cost-sharing or prior authorization, according to a bill summary from Madaro’s office. Substance use treatment facilities would need to provide patients with two doses of an overdose-reversal drug upon discharge, as would hospitals who discharge patients with a history of substance use disorder.
Narcan nasal spray has been shown to reverse 95% of overdose deaths. Goldstein previously attributed the decline in overdose deaths to the state’s distribution of naloxone, syringe service programs, an overdose prevention hotline and a drug checking program that allows officials to monitor the lethality of the drug supply in Massachusetts.
The compromise bill filed Tuesday prohibits life insurance companies from limiting or refusing coverage to a person just because they obtained an opioid antagonist for themself or others.
It would also limit legal liability for drug users and harm reduction workers who, while on the premises of a harm reduction facility, deploy drug-testing equipment to check the potency of someone’s personal drug supply. Supporters say that step will protect individuals from inadvertently taking a contaminated, potentially deadly substance that is far more potent than they intend.
One section of the bill would overhaul the state’s child welfare laws by no longer requiring providers to report parents on medications that treat opioid use disorder.
Reform supporters warn that existing requirements put mothers in recovery in an impossible position: if they continue to take prescribed medication, they could face a Department of Children and Families investigation.
“The compromise bill agreed upon by the lead conferees retains language to end the practice of reporting mothers to the Department of Children and Families (DCF) simply for taking medication prescribed by their doctor to treat substance use disorder and other physical and behavioral health conditions,” a letter from Madaro and Crighton said. “It also requires the state to develop a plan to end the practice of sending civilly committed men to prison for substance use treatment.”
The bill also creates a new licensure and oversight structure for recovery coaches and mandates that all health plans cover the coaching services to help people struggling with addiction.
“It’s the result of a lot of great work between the House and the Senate. Months of collaboration. ... Really this is a nice marriage of the two bills,” Madaro said.
