Lawmakers revisit 72-hour hold for opioid addicts

JAIME CAMPOS/Staff photo State Sen. Bruce Tarr, R-Gloucester

 

BOSTON -- Backers of a plan to force suspected opioid addicts into treatment continue to push for the controversial measure, despite its rejection by lawmakers.

Legislation filed by Senate Minority Leader Bruce Tarr would allow doctors to place addicts who've overdosed more than once within a 30-day period into a 72-hour hold "for treatment, evaluation and counseling." The bill was one of several heard by the Legislature's Judiciary Committee on Tuesday dealing with the issue of involuntary commitment.

"We're trying to stop people from dying from overdoses," Tarr said in an interview Tuesday. "The goal is to create the most effective path for treatment, so that we don't lose people who are clearly at risk. That 72 hours can be critical to saving someone's life."

His bill is similar to a proposal by Gov. Charlie Baker, who has pushed for involuntary commitments for those who pose a danger to themselves or others. Baker’s proposed 72-hour hold was a key provision of a broader opioid bill, signed last year, that was supported by many substance abuse counselors and first responders.

But the provision raised concerns about civil liberties and the ability of emergency rooms to hold an addict until a treatment bed is available. Lawmakers ultimately rejected it.

Lawmakers have revived the proposal, arguing that involuntary commitment can prevent fatal overdoses.

More than 2,000 people in Massachusetts died from opioid overdoses last year, according to the state Department of Public Health.

Still, the 72-hour hold faces opposition from the Massachusetts Medical Society, which represents physicians.

A 2016 law requires ER doctors to offer voluntary substance-abuse screening to people treated for opioid overdoses. But a majority of those patients refuse, according to health officials, who say the lack of participation is preventing addicts from getting into treatment.

Doctors can also hold an individual for up to 24 hours for evaluation.

A state commission that studied involuntary commitments suggested its use only when "it is clear that the subject individual is in danger of causing severe immediate harm to self or others or loss of life above and beyond the harms that are routinely attendant upon the abuse of substances, such as death by overdose."

Opioid addicts can be sentenced to state-run treatment facility for up to 90 days under the Section 35 law, which also requires follow-up treatment once someone is released.

Massachusetts judges have seen a sizable increase in Section 35 requests filed by family members, physicians, court officers and police — from 5,903 in 2010 to 10,770 in 2018, according to the state. A majority were for adult drug abuse, and many of those committed were white, homeless men.

More than 4 of 5 requests for Section 35 orders heard by judges last year — 6,048 — resulted in a person being committed for substance abuse treatment.

Lawmakers who support the get-tough approach say it would save lives and help end the "pinballing" of overdosing addicts in and out of hospital ERs.

"We have not shaken this epidemic," said Rep. Paul Tucker, D-Salem, a former city police chief who supports the measure. "We hear from first responders who are reviving the same people over and over again. They're treated and released and then overdose again, sometimes on the same day. We need to do everything we can to get them into treatment."

Rep. Lenny Mirra, R-West Newbury, said he, too, believes the state needs to be more forceful about setting addicts on the path to recovery.

"Personally I don't want government to detain a person against their will unless it's absolutely necessary," he said. "But opioid addiction is a scourge that requires extreme responses."

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group’s newspapers and websites. Email him at cwade@cnhi.com.

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