Baker-Polito Administration Further Expands Access to Opioid Reversal Medication

BOSTON – The opioid overdose reversal medication naloxone is now more widely available in Massachusetts, as a result of the second major legislative act signed by Governor Charlie Baker to address the opioid crisis. The Baker-Polito Administration also announced the expansion of current efforts, funded by $36 million in recent federal funding, to address the opioid epidemic during an event at the Massachusetts Substance Use Helpline office.

“We continue to increase the tools and resources to fight the tragic opioid epidemic in the Commonwealth, and the opioid bill signed in August expands access to life-saving medications like naloxone, or Narcan, in addition to several new initiatives to increase access to treatment, education and prevention,” said Governor Charlie Baker. “Our administration will keep working with stakeholders and the Legislature to provide new tools and expand programs to support individuals and families fighting addiction.”

As required by the new law, An Act for Prevention and Access to Appropriate Care and Treatment of Addiction, the Department of Public Health (DPH) has issued a statewide standing order allowing pharmacies to dispense naloxone without a prescription to any person at risk of experiencing an opioid-related overdose, as well as their family members, friends, or others to assist them. The purchase is billable for insurance purposes, regardless of whether the transaction involves the person actually using the medication. Previously, pharmacies were required to have their own pharmacy-specific standing order to dispense naloxone or purchasers had to have a prescription. Also, people could be denied insurance coverage for the purchase of naloxone if they themselves were not the user of the medication.

“Families, individuals with substance use disorders, providers, recovery coaches, and first responders in the field provided our administration with valuable feedback and we are pleased to see expanded availability of this life saving medication become a reality,” said Lt. Governor Polito. “We appreciate their willingness to work with us and our colleagues in the Legislature on this important law and we look forward to continuing to build on the Commonwealth’s existing framework to protect more families from being impacted by this horrible epidemic.”

The Commonwealth will use the recent $36 million in federal funding to expand overdose education and naloxone distribution, office-based opioid treatment, access to medication-assisted treatment, and recovery support services. The funding is part of $930 million in state opioid response grants recently administered by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA).

“The opioid epidemic is a public health crisis requiring a coordinated and targeted response that involves players at every level of government,” said Health and Human Services Secretary Marylou Sudders. “These federal funds further expand our efforts to increase pathways into treatment and recovery.”

The new state law expands who can purchase naloxone at discounted rates through the Municipal Naloxone Bulk Purchasing Program. Houses of Correction and DPH-funded addiction treatment programs and other front line non-profit programs are also able to purchase naloxone through the program which was previously only available to first responders such as fire and police.

In fiscal year 2018, DPH invested more than $7.6 million to improve access to naloxone throughout the Commonwealth. More than 80,000 people have been trained on how to administer naloxone since the Overdose Education and Naloxone Distribution program began in 2007, resulting in more than 17,000 reported overdose rescues. Another 8,000 overdose rescues have been reported by 32 First Responder Naloxone Grant recipients. Since 2016, 177 cities and towns have purchased more than 25,000 doses of naloxone at a significant discount.

Other initiatives currently underway that will be supported by the federal funding include:

• Providing Medication-Assisted Treatment (MAT) to incarcerated individuals with substance use disorders in Houses of Correction and connecting them to community-based treatment providers upon release.

• Increasing provider training and public awareness campaigns designed to decrease the stigma associated with MAT.

• Increasing the capability for community-based providers, detox facilities, and emergency departments to screen for hepatitis C/HIV among people who inject drugs

• Building the network of treatment and recovery services for pregnant, post-partum, and parenting women and their dependent children and families, including the expansion of Moms Do Care and a new home visiting program

Approximately $200,000 of the new funding will also go towards a public awareness campaign to promote the Massachusetts Substance Use Helpline. The Helpline and website, which is funded by the DPH and operated by Health Resources in Action (HRiA), provides information to and confidential referrals for individuals seeking treatment for substance use disorders. The Helpline is staffed by certified specialists with access to a database of over 3,000 resources and addiction services. In FY18 alone, nearly 14,000 Helpline calls resulted in over 10,500 referrals to services.

The public awareness campaign will target Spanish-speaking individuals through the launch of a Spanish version of the Helpline website, bi-lingual videos and posters, and targeted ads on social media. The Helpline has several staff members who speak Spanish and services can be provided in any language using on-demand interpreters. Specialists are available at 800-327-5050 every day (8:00 am to 10:00pm) Monday through Friday, and on weekends and holidays (8:00 am to 6:00 pm).

“The Helpline is launching several new enhancements including an online “chat” where individuals and parents can talk to Helpline employees, and a real-time wait list management system for use by all DPH-funded residential treatment programs. The system will enable providers to communicate with each other on the back end, identifying when a person has been admitted to a program or removed from another waitlist,” said Public Health Commissioner Monica Bharel, MD, MPH. “This helps us reduce duplicated efforts across programs, and provide the most-up-to-date data on waitlist length, wait times, and other key variables.”

Overall in 2017, there was a 4 percent decrease in opioid-related overdose deaths from 2016, according to the latest quarterly opioid-related deaths report released by the Massachusetts Department of Public Health (DPH). However, the presence of fentanyl in overdose deaths rose to nearly 90 percent in 2018, underscoring its impact as the driving force behind the opioid epidemic in Massachusetts.

In a drive to raise awareness about naloxone, earlier this month DPH reissued its public awareness campaign, Make the Right Call, to encourage people to carry naloxone and use it to help save lives. Campaign ads will appear on billboards, transit stations, bus shelters, radio and on Facebook, with a specific focus on populations and neighborhoods most impacted by the opioid epidemic. More information about naloxone can be found at www.mass.gov/naloxone.

Since 2015, the Baker-Polito Administration has added more than 1,200 substance use treatment beds. In August, Governor Baker signed the Administration’s second major legislative action to address the opioid crisis since taking office. Building on the success of the STEP Act, which instituted the nation’s first seven-day limit on first-time opioid prescriptions for adults resulting in a 30 percent decline in prescribing, the new law mandates, in part, that all prescribers convert to electronic prescriptions by 2020; creates a commission to establish credentialing standards for recovery coaches; and expands medication-assisted treatment to emergency departments and five Houses of Correction.