Legislature Passes Bill to Combat Substance Use Disorder

Latest step to combat opioid crisis will expand treatment options and help save lives

Special to The Advocate

BOSTON – The Massachusetts Legislature on Wednesday approved legislation to combat the opioid crisis and support residents living with substance use disorder (SUD).

H.5143, An Act relative to treatments and coverage for substance use disorder and recovery coach licensure, will expand non-opioid pain treatments, establish licenses for recovery coaches, and support pregnant people and their children who have been exposed to substances.

It will vastly expand access to opioid-reversal drugs like naloxone. In 2023, 2,125 lives were lost as a result of an overdose, 232 fewer than in 2022, according to the Department of Public Health (DPH). Since 2023, naloxone has reversed more than 10,000 overdoses in Massachusetts.

“As families across Massachusetts know all too well, the impact of opioid addiction can be utterly devastating for the individual and for their loved ones, which is why a continued focus on combating substance use is a critical responsibility that we have as elected officials,” said House Speaker Ronald J. Mariano (D-Quincy). “I want to thank Chairman Madaro for his tireless work on this legislation, as well as all my colleagues in the House and our partners in the Senate, for recognizing the need for reforms that will help those dealing with addiction on their journey to recovery.”

“Drug addiction has devastated families in Revere and beyond. This new law expands access to life-saving opioid reversal drugs, bans discrimination against those using medication-assisted treatments, and introduces licensure for recovery coaches,” said State Representative Jessica Giannino (D – Revere). “By strengthening our support systems, we are lowering the chances of families being faced with the heart-wrenching loss of a loved one due to addiction. I am thankful for the leadership of Speaker Mariano and Chair Madaro on this important issue.”

“Nearly every family in Revere and Winthrop has been ravaged by the tragedy of drug addiction. This important law expands access to life saving opioid reversal medication.  It bans discrimination against those using medications to help resolve their dependency issues.  It licenses recovery coaches.  In whole, this law increases the chances that fewer families will suffer the loss of a loved one due to drug addiction,” said State Representative Jeffrey Rosario Turco (D. Winthrop).

“This comprehensive legislation affirms our commitment to treating substance use as a matter of public health, and I’m proud of our continued progress in promoting recovery and preventing overdose deaths,” said Representative Adrian C. Madaro (D-Boston), House Chair of the Joint Committee on Mental Health, Substance Use and Recovery. “I am grateful to all the advocates, health care professionals, people with lived experience and their loved ones who worked tirelessly to advance these initiatives and to my colleagues for their contributions. I am especially grateful to Speaker Ron Mariano for his leadership and for appointing me to serve on this conference committee.”

“This legislation continues the Commonwealth’s dedication to addressing the opioid crisis by reducing stigma and providing the necessary support for those in recovery,” said Representative Alice Hanlon Peisch (D-Wellesley), Assistant Majority Leader and member of the conference committee. “I want to thank the Speaker for his commitment to those impacted by opioid addiction and Chairman Madaro for his dedication to getting this bill passed.”

“We are pleased that we could get this done before the session closed,” said Representative Michael J. Soter (R-Bellingham), a member of the conference committee. “This bill was compromised so that we can focus on the real issues of the substance abuse problem that plagues our state. I want to thank the Speaker for his work along with the Chair from the North End and Chair Madaro to help our conference committee get this over the finish line.”

The bill mandates that all health plans cover opioid reversal drugs such as naloxone and Narcan—without cost-sharing or prior authorization. It also requires hospitals and substance use treatment facilities to educate patients on opioid reversal drugs and prescribe or dispense at least two doses to at-risk patients upon discharge. It also requires pharmacies in areas with high incidences of overdoses to maintain a sufficient and consistent supply of opioid reversal drugs while requiring them to stock both over the counter and prescription versions.

The bill includes several new insurance provisions, including a prohibition on life insurance companies from limiting or refusing coverage to a person solely because they obtained an opioid-reversal drug, and a prohibition on medical malpractice insurers from discriminating against health care practitioners who provide harm reduction services. It further updates requirements for insurance providers to ensure adequate coverage and access to pain management services including non-opioid treatments and expands access to non-opioid pain treatment by incorporating non-opioid alternatives into provider training.

No person should face discrimination because of substance use disorder or receiving medication for it in the past. This legislation therefore clarifies DPH’s authority to enforce anti-discrimination protections for people with SUD who are covered by public health insurance and prohibits discrimination against those lawfully possessing or taking medication for opioid-related SUD treatment.

Further, the bill protects public health and harm reduction organizations and their agents from professional disciplinary action or civil or criminal liability if they are providing drug checking services in good faith. It also protects individuals from criminal liability when seeking treatment from such organizations. This change should help detect and protect against deadly contaminants that are increasingly found in the drug supply.

In addition, the bill promotes the recovery of pregnant people on medications for substance use disorder by clarifying that encountering a substance-exposed newborn does not trigger an automatic referral to the Department of Children and Families (DCF). It further directs DCF to lead the creation of regulations related to care, treatment, and reporting of substance-exposed newborns.

It also establishes recovery coach licensing in the Commonwealth and places oversight under the DPH, to ensure compliance with best practices. Under this bill, insurance companies would be required to cover services provided by licensed recovery coaches.

A fact sheet with additional highlights of the compromise legislation is available online.

Having passed the Legislature, the bill now heads to the Governor’s desk for her signature.