| 1 | 1 | | HOUSE . . . . . . . . No. 4656 |
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| 2 | 2 | | The Commonwealth of Massachusetts |
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| 3 | 3 | | ________________________________________ |
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| 4 | 4 | | HOUSE OF REPRESENTATIVES, May 23, 2024. |
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| 5 | 5 | | The committee on Mental Health, Substance Use and Recovery, to |
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| 6 | 6 | | whom were referred the joint petition (accompanied by bill, House, No. |
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| 7 | 7 | | 1962) of James Arciero, Walter F. Timilty and others relative to non- |
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| 8 | 8 | | opioid alternatives in pain treatment and the petition (accompanied by bill, |
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| 9 | 9 | | House, No. 1971) of Tackey Chan for legislation to enhance patient |
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| 10 | 10 | | education and informed consent before issuance of opioids, reports |
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| 11 | 11 | | recommending that the accompanying bill (House, No. 4656) ought to |
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| 12 | 12 | | pass. |
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| 13 | 13 | | For the committee, |
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| 14 | 14 | | ADRIAN C. MADARO. 1 of 2 |
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| 15 | 15 | | FILED ON: 5/15/2024 |
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| 16 | 16 | | HOUSE . . . . . . . . . . . . . . . No. 4656 |
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| 17 | 17 | | The Commonwealth of Massachusetts |
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| 18 | 18 | | _______________ |
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| 19 | 19 | | In the One Hundred and Ninety-Third General Court |
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| 20 | 20 | | (2023-2024) |
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| 21 | 21 | | _______________ |
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| 22 | 22 | | An Act relative to non-opioid alternatives in pain treatment. |
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| 23 | 23 | | Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority |
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| 24 | 24 | | of the same, as follows: |
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| 25 | 25 | | 1 SECTION 1. Chapter 94C of the General Laws is hereby amended by striking out section |
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| 26 | 26 | | 218C and inserting in place thereof the following section:- |
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| 27 | 27 | | 3 Section 18C. (a) Prior to issuing a prescription for an opioid contained in Schedule II of |
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| 28 | 28 | | 4section 3, a practitioner registered under section 7 shall: (i) consult with the patient or, where |
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| 29 | 29 | | 5applicable, a designee, representative or guardian of the patient or, if the patient is a minor, the |
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| 30 | 30 | | 6patient’s parent or guardian regarding the quantity of the opioid and the patient’s option to fill |
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| 31 | 31 | | 7the prescription in a lesser quantity; (ii) inform the patient or the patient’s designee, |
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| 32 | 32 | | 8representative, parent or guardian, where applicable, of the risks associated with the opioid |
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| 33 | 33 | | 9prescribed; (iii) discuss with the patient or the patient’s designee, representative, parent or |
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| 34 | 34 | | 10guardian, where applicable, appropriate, available non-opioid alternatives for the treatment of |
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| 35 | 35 | | 11pain, and the options for referring or prescribing appropriate non-opioid treatment alternatives |
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| 36 | 36 | | 12based on the practitioner’s clinical judgment and following generally accepted clinical |
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| 37 | 37 | | 13guidelines, taking into consideration the preference and consent of the patient or the patient’s |
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| 38 | 38 | | 14designee, representative, parent or guardian, where applicable; (iv) discuss with the patient or the 2 of 2 |
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| 39 | 39 | | 15patient’s designee, representative, parent or guardian, where applicable, the advantages and |
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| 40 | 40 | | 16disadvantages of the use of non-opioid treatment alternatives, considering the patient’s risk of |
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| 41 | 41 | | 17substance misuse; (v) provide the patient or the patient’s designee, representative, parent or |
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| 42 | 42 | | 18guardian, where applicable, with a printed copy of the educational material described in |
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| 43 | 43 | | 19subsection (c); and (vi) document the conversation, including non-opioid alternatives considered, |
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| 44 | 44 | | 20in the patient’s record. For the purposes of this section, non-opioid treatment alternatives include, |
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| 45 | 45 | | 21but are not limited to, medications, restorative therapies, interventional procedures, behavioral |
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| 46 | 46 | | 22health approaches and complementary and integrative treatments. |
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| 47 | 47 | | 23 (b) The requirements of subsection (a) shall not apply if: (i) the patient is receiving care |
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| 48 | 48 | | 24for acute pain in a hospital or surgical care setting, excluding upon discharge; (ii) the patient is |
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| 49 | 49 | | 25receiving outpatient hospice services under section 227 of chapter 111 or is a resident of a long |
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| 50 | 50 | | 26term care facility; or (iii) the opioid is prescribed for use in the treatment of substance use |
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| 51 | 51 | | 27disorder or opioid dependence. |
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| 52 | 52 | | 28 (c) The department, in consultation with relevant stakeholders and experts in the |
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| 53 | 53 | | 29treatment and management of acute and chronic pain and based in part on the Pain Management |
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| 54 | 54 | | 30Best Practices Inter-Agency Task Force Report issued by the United States Department of Health |
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| 55 | 55 | | 31and Human Services, shall develop, publish and maintain on its website educational information |
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| 56 | 56 | | 32regarding the use of non-opioid alternatives for the treatment of acute and chronic pain. The |
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| 57 | 57 | | 33educational information shall include, but not be limited to: (i) information on available non- |
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| 58 | 58 | | 34opioid alternatives for the treatment of pain, including non-opioid medications and non- |
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| 59 | 59 | | 35pharmacological therapies; and (ii) the advantages and disadvantages of the use of such non- |
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| 60 | 60 | | 36opioid alternatives. |
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