On March 14, 2016, Massachusetts Governor Charlie Baker signed comprehensive legislation designed to curb opioid addiction.  The legislation reflects growing concern for the “dangers in the medicine cabinet” (i.e., risks presented by unused supplies of opioids) as well as a desire to curb addiction through prevention and education measures.

The Massachusetts law limits first-time prescriptions for opioid drugs—such as those prescribed as painkillers after surgery or an injury—to a seven-day supply. There is also a seven-day limit for all opioid prescriptions for minors. The legislation allows for longer-term supplies for patients with cancer, chronic pain, or receiving palliative care.

Patients who enter an acute care hospital or a satellite emergency facility suffering from an opioid overdose shall receive a substance abuse evaluation within 24 hours. The evaluation must be presented to the patient in person and include recommendations for future treatment.

Other provisions of the legislation include:

• Requirement that prescribers check the Massachusetts Prescription Monitoring Program (PMP) before prescribing a Schedule II or Schedule III drug. Massachusetts, like every state except for Missouri, employs a PMP which is designed to give visibility to the patient’s prescription history, so as to avoid situations where a patient receives multiple prescriptions from different doctors.

• Requirement that physicians and pharmacists provide patients information about the dangers of opioid addition when a drug is prescribed and dispensed.

• Liability protection from civil lawsuits for anyone who administers the anti-overdose drug naloxone to someone suspected of overdosing.

• Additional training for medical students and practitioners about substance abuse and safe prescribing practices.

• Establishment of a five-year drug stewardship program, in which drug manufacturers must participate, to collect and dispose of unneeded prescription medication.

• Allowance for patients to fill a lesser amount of an opioid prescription. The remainder of the prescription will be void, and the pharmacist must notify the doctor of the amount that was dispensed.

• Creation of a procedure for patients to voluntarily “opt out” of being prescribed opioid drugs.

• Creation of screening mechanisms for schools to use in identifying students who may be at risk for addiction and incorporates education about opioid addiction into annual high school sports training and driver education.

The Massachusetts legislation reflects intensifying state efforts to curb addiction to dangerous drugs. Complementing controlled substance enforcement efforts, states are increasingly focusing on drug diversion and abuse as a public health issue.