Massachusetts lawmakers have dropped plans to authorize overdose prevention centers. Despite support from the state’s Senate, health department and voters, a House version of a substance use disorder bill now contains no mention of these lifesaving facilities.
Representatives Alice Peisch and Adrian Madaro, and Senator Brendan Crighton—all Democrats in a Democrat-controlled legislature—presented the amended bill, 5143, on December 17. As local NPR affiliate WBUR reported, this was preceded by months of negotiations over whether to include OPC.
The filed bill instead focuses on expanding naloxone access, protections for people on medications for opioid use disorder, reducing legal liability for people receiving and providing harm reduction services, and licensing for recovery coaches, among other measures.
“I think this bill is going to save lives, which we don’t say lightly,” Sen. Crighton said.
Massachusetts has seen a long battle to advance OPC, which have many supporters in the state—including in the legislature.
Lawmakers are due to meet again on December 19, when they could consider passing the bill. December 31 is the final day of the session.
Massachusetts has seen a long battle to advance OPC, which have many supporters in the state—including in the legislature. In the summer, as Filter reported, the Senate unanimously approved an OPC bill, but failure to reach a last-minute deal with the House prevented it from moving forward that session. Similar legislation has been filed for several years now, with lawmakers such as Senator Julian Cyr (D) outspoken in support.
While Massachusetts’ fatal overdose figures have lately fallen overall, they remain at historically high levels and reflect worsening racial disparities. In June, the state health department revealed that opioid-involved overdose deaths declined 10 percent in 2023, the largest drop in over a decade. Yet 2022 had seen a record 2,357 deaths, and 2,125 people still lost their lives in 2023. And while the decline was largest for white residents, deaths held steady among Black women and increased among Black men.
No overdose death has ever been recorded at OPC around the world, and the facilities are also associated with reduced mortality in surrounding neighborhoods.
In December 2023, Massachusetts Public Health Commissioner Robbie Goldstein called OPC “lifelines, serving not only as places of intervention, but as places of empathy, understanding, and healing.” And though Governor Maura Healey (D) has not gone on record explictly supporting OPC, her administration has had Goldstein’s health department study the idea. The department noted that OPC could face federal lawsuits and other challenges, and recommended the state implement legal protections and rules for participants and staff if it approved OPC.
Some Massachusetts cities have considered opening their own facilities without state authorization, as happened in New York City. But those efforts, too, seem blocked. Somerville announced an OPC plan in 2019, but it still hasn’t happened. In July, Cambridge Day reported that the administration became worried about potential legal liability for participants, staff, property owners and the city, and has shifted some of its focus to state-level advocacy. The city of Cambridge has also explored opening an OPC, but so far has only taken steps to study the legal risks involved.
The impasse in Massachusetts stands in stark contrast to history being made in a neighboring New England state. On December 10, the nation’s first state-authorized OPC opened in Providence, Rhode Island.
As for Massachusetts’ remaining bill, it does contain a number of provisions aimed at helping people who use drugs in other ways. It would require health insurance companies to cover the opioid-overdose antidote naloxone with no cost-sharing or prior authorization required. People who request medicines like naloxone would receive protection from discrimination by life insurance providers. And hospitals and substance use treatment centers would be required to give naloxone to patients with substance use disorder histories upon discharge.
The bill would also protect people who use or offer drug-checking services from legal liability. It would add new licensing and oversight requirements for recovery coaches, and require health insurances to pay for recovery services for people who use drugs.
Under the bill, providers would no longer be required to report on parents who take medications for opioid use disorder.
Another important aspect of the bill would apply to parents with substance use disorders. Currently, a parent who takes a prescribed medicine like methadone or buprenorphine to treat opioid use disorder will be reported to the Department of Children and Families. That could lead to an investigation with the potential for the person’s children to be taken away by the state. Under the bill, providers would no longer be required to report on parents who take these medicines as prescribed.
Such investigations still impact many families, as Imprint News reported—even though federal rehabilitation and disability laws protect parents who use medications for opioid disorders (MOUD), and the federal government has sued in several cases where parents were punished. The National Council of Juvenile and Family Court Judges affirmed in 2019 that such parents are protected, yet many states and localities don’t comply. In 2023, the New York Times and Reveal found that no child welfare agency in any US state formally tracks how parents on MOUD are investigated, but that about 4,800 women said they were reported on for taking MOUD during pregnancy and 40 newborn babies were taken into foster care.
The bill would also reduce Massachusetts’ practice of sending men who are civilly committed to receive substance use disorder treatment at a prison—closing the Massachusetts Alcohol and Substance Abuse Center, which is operated by the corrections department, and replacing it with a state public health and mental health facility.
The practice of civil commitment has been pursued aggressively in Massachusetts, as NPR has described. Under the state’s Section 35, a family member, doctor or cop can ask a court to force someone into drug treatment. In one year, over 6,500 people were sentenced in this way to forced treatment, which experts condemn as unethical, ineffective and often harmful.
Photograph by Photo Claude TRUONG-NGOC via Wikimedia Commons/Creative Commons 3.0
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