Legislature Agrees Not to Approve SIFs, but Will Study Them

The long-discussed wide-ranging Opiate treatment bill passed the state legislature late Tuesday night, July 31, just in the nick of time, after a conference committee on that same day agreed to a compromise form of the bill that went through many twists and turns over the past month.

Coming out of all the dust was the issue of Safe Injection Facilities (SIFs), which have been a major sticking point with the overall opiate bill, but in the final bill only became something to study.

That started when a wing of the Senate proposed to include approvals for the siting of the state’s first SIF within the bill. Many in the South End have been following the SIF discussion very closely, as a position paper from the Massachusetts Medical Society identified a location on Albany Street as the ideal location for any pilot program.

The House had rejected the idea of including SIFs and the full Senate did eventually vote it down.

The opiate bill Conference Committee, led by Chair Rep. Denise Garlick and Sen. Cynthia Friedman, came out with a compromise that establishes a commission to study SIFs.

SIFs are illegal in the United States and opposed by the US Attorney for Massachusetts.

The compromise on SIFs created a commission to study the concept with municipal leaders, including Mayor Martin Walsh – who opposes the idea outright.

A second measure in the bill allows a pilot program in county jails and state prisons for treatment medicines, such as Methadone, to be given to inmates. Currently, those in treatment when they enter jail are cut off from that treatment. The pilot, however, does not operate in Suffolk County facilities. Only two state prisons are included – MCI-Cedar Junction and the Plymouth treatment facility for men.

The bill also came to agreement on studying the involuntary commitment (Section 35) of individuals for drug treatment and services – a commitment that could be initiated by a medical professional or law enforcement.

The House had been very much opposed to the idea of Section 35 involuntary treatment, but Gov. Charlie Baker was very supportive of the idea. The program is running in Boston on a pilot with the West Roxbury District Court, and it allows police and medical professionals to involuntarily hold certain individuals for the sake of treatment without the approval of family – which is usually required.

Many of those committed in the pilot program come from the Mass/Cass area in the South End.

The matter was adopted only for study by a commission.

Other highlights of the opiate bill include:

  • Requiring electronic prescribing for all controlled substances, with limited exceptions, effective Jan. 1, 2020.
  • Expanding access to naloxone (Narcan) in the community by (1) establishing a standing order, providing access to naloxone without a prescription, (2) allowing certain Sheriffs to purchase naloxone at a lower cost through the state’s bulk purchasing program, and (3) allowing local governments and agencies to exchange unexpired naloxone.
  • Establishing a commission to make recommendations on the certification of Recovery Coaches.
  • Mandating that providers check the Prescription Monitoring Program (PMP) prior to issuing any prescription for a benzodiazepine.
  • Establishing a Center for Police Training in Crisis Intervention to support cost-effective, evidence-based mental health and substance use crisis response training programs for law enforcement, providing the tools to respond appropriately to behavioral health crises.

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