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星期二, 3月 15, 2016

查理貝克簽新法 藥物上癮是病非罪 鴉片類藥物首次開方限七天藥量


麻州州長查理貝克簽署地標性鴉片類藥物法案。(周菊子攝)
             (Boston Orange 周菊子綜合報導)麻州州長查理貝克(Charlie Baker14日在參眾兩會議長,麻州總檢察官,波士頓市長等人聯袂出席,致詞者都很激動的儀式中,宣佈、簽署了標誌性的“鴉片類藥物法”,要加強管制讓人上癮藥物的來源。
            該法案全名為“關於濫用藥物,治療,教育及防範的法案An Act relative to substance use, treatment, education and prevention)”。麻州長辦公室表示,這是全美第一個,鴉片類藥物首次開方限量七天的規定,也是查理貝克上任以來簽署的第五項法案。
            查理貝克表示,該法案強化處方藥管理,加強教育學生,醫師,是全美迄今最全面的打擊鴉片類藥物上癮辦法。他很高興州內兩黨都支持這法案。
            查理貝克致詞時,顯然情緒激動,聲音微顫。他說,希望藉這天簽署的法案,讓鴉片類藥物上癮者及其家屬們知道,州政府在聆聽人們的意見,會繼續幫大家想辦法。

麻州參眾議會議長,羅森伯(左),狄樂歐(右)都支持新法。
(周菊子攝)
麻州總檢察官奚莉(左)致詞時激動含淚。(周菊子攝)
             查理貝克透露,2014年他走遍全州各地競選時,幾乎每到一地都聽到有人因用藥過量致死,根據記錄,幾乎每天都有4人因此而死,總數甚至比因車禍,被槍殺而死的人還多,顯示出這問題嚴重。
            麻州近年面對嚴重的濫用藥物危機,幾乎每個月都有大約100人喪生。根據最近的數據,在2014年內,約有1,200人在無意中過量使用鴉片類藥物而死亡,約等於每10萬名麻州居民中,有17.4人因此死亡,比2000年時的5.3人,增加了百分之228倍。20151月到9月的初步估計數據,因鴉片類藥物死亡的人數已經超過了1,100
            14日起立即生效的新法案,將限制鴉片類藥物首次開方時,最多開給七天藥量。今年七月起,麻州政府將規定醫院,看到任何一個走進急診室,有用藥過量徵狀的人時,必須執行濫用藥物評估。將來這新法案還將規定學校口頭篩檢學生是否濫用藥物。
            10月起,這新法案也要求醫療人員在開具有高度可能被濫用的處方藥之前,做處方藥監管項目登記,藉以制止上癮者不斷更換醫生,以獲取奧斯康丁(OxyContin),波考賽特(Percocet)和維科丁(Vicodin)等鴉片類藥物。
            新法案也准許病患自願的減少他們從藥劑師那兒拿到的鴉片類藥物份量。
            新法案條文包括幾種例外情況,凡是慢性疼痛,癌症疼痛,或是治標性醫療,可以拿超過七天的藥量。學生,家長及學校可以選擇不參加規定的口頭濫用藥物篩檢。
            出席法案簽署儀式的政要,包括參議會議長羅森伯(Stanley C. Rosenberg),眾議會議長狄樂歐(Robert A. DeLeo),麻州總檢察官奚莉(Maura Healey),波士頓市長馬丁華殊(Martin J. Walsh),麻州健康及人民服務秘書長蘇德絲(Marylou Sudders),以及長期協助、輔導上癮者的許多人。
            羅森伯格表示,新法的簽署意味著正確看待上癮這問題的新方向,以前當作是犯罪,現在看成是疾病。他也指出,新法案採納了參議會濫用藥物委員會提出的12點建議。
波士頓市長馬丁華殊強調,濫用藥物上癮是並,不是罪。(周菊子攝)
            狄樂歐指出,新法是因應上癮問題的許多作法之一,打擊濫用藥物的行動要一直持續下去,簽署新法並不意味著打擊行動結束了。
            奚莉致詞時很激動,一度眼眶含淚,語音哽噎。她說,大家都知道,簽署法案帶不回那些各人心愛,已經辭世的藥物濫用者,但將會改變州內其他家庭,個人的未來生活。
            年輕時有過濫用藥物經歷的馬丁華殊,致詞時非常感性的特別感謝麻州長查理貝克推動此法。他透露當州長告訴他打算針對濫用藥物問題,訂定一些措施比較激烈的條文,徵詢他的意見時,他立即回應全部都喜歡,絕對支持。
            馬丁華殊表示,濫用藥物上癮是疾病,不單是個人,家庭,社會都會受影響。人們必須正視。

(麻州州長辦公室視頻)
Governor Baker, Senate President Rosenberg, Speaker DeLeo, Mayor Walsh, Attorney General Healey
Grand StaircaseMassachusetts State House
March 14, 2016

BOSTON – Yesterday, Governor Charlie Baker signed landmark legislation into law to address the deadly opioid and heroin epidemic plaguing the Commonwealth and was joined by a robust group including Senate President Stanley Rosenberg, House Speaker Robert DeLeo, Attorney General Maura Healey, and Mayor Marty Walsh, among others. The bill, titled An Act relative to substance use, treatment, education and prevention, passed with unanimous votes in both legislative chambers and includes numerous recommendations from the Governor’s opioid working group, including prevention education for students and doctors, and the first law in the nation to establish a seven day limit on first-time opioid prescriptions.


Transcription:
GOVERNOR BAKER: “I want to thank you all for sharing your stories. May today’s bill passage signal to you that the Commonwealth is listening, and we will keep fighting for all of you.”

MAYOR WALSH: “One of my first conversations with the governor was about addiction and recovery. We spoke about, ‘How do we battle this issue?’ Because whether it’s Dorchester or Swampscott or Western Mass, wherever it is in Massachusetts, it doesn’t matter. It goes back to being a family disease. And he said ‘I’m gonna be bold here and I’m gonna take some chances,’ he said, ‘will you stand with me?’ And I said ‘absolutely, governor.’ And then he turned to the Attorney General, he said ‘will you stand with me?’ And she said ‘absolutely, governor.’”

SENATE PRESIDENT ROSENBERG: “I’m proud that here in Massachusetts we’ve turned a very big corner. This problem used to be seen as a crime. It’s now understood to be a disease.”

SPEAKER DELEO: “I’m heartened that this legislation builds off of last year’s landmark substance addiction law, which I’ve heard firsthand has saved lives, and that’s an incredibly powerful thing.”

ATTORNEY GENERAL HEALEY: “I recognize, we all recognize that this legislation will not bring your loved ones back. But I want you to know, and I hope that you find some measure and comfort knowing that today there is legislation that is going to change the course for other families.”

GOVERNOR BAKER: “Our administration will continue implementing recommendations from our Working Group, and finding new ways to pursue treatment, recovery and education for all. Thank you very much.”

BOSTON – Today at the State House, Governor Charlie Baker signed landmark legislation into law to address the deadly opioid and heroin epidemic plaguing the Commonwealth and was joined by a robust group including Health and Human Services Secretary Marylou Sudders, Senate President Stanley Rosenberg, House Speaker Robert DeLeo, Attorney General Maura Healey, Auditor Suzanne Bump, members of the legislature, law enforcement, health care providers, community leaders, individuals in recovery and others. The bill, titled An Act relative to substance use, treatment, education and prevention, passed with unanimous votes in both legislative chambers and includes numerous recommendations from the Governor’s opioid working group, including prevention education for students and doctors, and the first law in the nation to establish a seven day limit on first-time opioid prescriptions.

“Today, the Commonwealth stands in solidarity to fight the opioid and heroin epidemic that continues to plague our state and burden countless families and individuals,” said Governor Baker.  “I am proud to sign this legislation marking a remarkable statewide effort to strengthen prescribing laws and increase education for students and doctors.  While there is still much work to be done, our administration is thankful for the legislature’s effort to pass this bill and looks forward to working with the Attorney General and our mayors to bend the trend and support those who have fallen victim to this horrific public health epidemic.”

“Today, we take another step forward by passing landmark legislation that will help the individuals and communities affected by the deadly opioid and heroin epidemic,”said Lt. Governor Polito.  “We are grateful for the legislature’s progress and for the partnership of Attorney General Healey, our mayors and several others as we continue pursuing aggressive reforms to combat this crisis from the Berkshires to the Cape.”

“Today our state takes a strong step to intervene earlier to save lives. This law will contain the amount of pills prescribed that can too easily lead to addiction. It will provide for screening to identify those at risk. It will allow people to voluntarily agree to treatment after an opioid overdose,” said Health and Human Services Secretary Sudders. “Thanks to the hard work of legislators, families and providers who have spent countless hours raising awareness and calling for change, this bill increases the tools available to fight this powerful epidemic and stop the cycle of addiction.”

“We are in the midst of a public health crisis that is draining vitality from our hometowns, extinguishing lives and stealing souls,” said House Speaker Robert A. DeLeo (D-Winthrop). “We’ve focused on workable solutions, consensus-building and legislation that complements our landmark 2014 law. I wholeheartedly thank my colleagues and the Baker Administration for their creative and compassionate work. I am personally indebted to the courageous individuals who shared their stories, paving a path for the recovery of thousands of our loved ones, and in fact, a path for our wounded Commonwealth.” 

“The opioid crisis has ripped apart our communities and families.  Over the past few years, the Legislature has focused on access to treatment, funding for substance abuse programs, and continuity of care.  This bill focuses on preventing addiction, enhancing public education, and removing pills from circulation,” said Senate President Stan Rosenberg (D-Amherst). “Twelve recommendations of the Special Senate Committee on Substance Abuse are included in this legislation and they will make a real difference in fighting the opioid scourge in our communities.  I thank my colleagues in the Legislature, Speaker DeLeo, and Governor Baker for their hard work on this bill and dedication to bringing an end to the opioid epidemic in our state.”

“This landmark legislation is the result of broad support and partnership from the many stakeholders we have worked with over the last year to tackle the very real struggle people in Massachusetts and across the country are dealing with right now when it comes to prescription painkillers and heroin. This bill will not only change how we as a society treat opioid painkillers, it will provide the treatment, education and prevention we so desperately need,” said Attorney General Healey. “I am grateful for the hard work of the Conference Committee and thank the Governor and Legislature for putting a significant solution in place that will save lives and prevent our future generations from seeing the devastating consequences of this epidemic.”

"Substance abuse has devastated families across the Commonwealth. In Boston, we have taken a multi-pronged approach, working from every angle to promote prevention, offer treatment and provide recovery and support services,” said Mayor Martin J. Walsh. “I applaud Governor Baker, Senate President Rosenberg, and Speaker DeLeo for passing this important legislation. Addiction is a powerful force, but this bill equips us with additional tools to reduce its impact in our communities."
This bill includes multiple provisions from Governor Baker’s legislation, most notably the first law in the nation to limit an opioid prescription to a 7-day supply for a first time adult prescriptions and a 7-day limit on every opiate prescription for minors, with certain exceptions.  Other provisions from the Governor’s recommendations include a requirement that information on opiate-use and misuse be disseminated at annual head injury safety programs for high school athletes, requirements for doctors to check the Prescription Monitoring Program (PMP) database before writing a prescription for a Schedule 2 or Schedule 3 narcotic and continuing education requirements for prescribers—ranging from training on effective pain management to the risks of abuse and addiction associated with opioid medications.
 
Several measures were passed to empower individuals and update current prevention efforts. Patients will receive access to non-opiate directive forms and the option of partially filling opioid prescriptions in consultation with doctors and pharmacists. Schools must annually conduct verbal substance misuse screenings in two grade levels and collaborate with the Departments of Elementary and Second Education (DESE) and Public Health (DPH) around effective addiction education policies. To reduce the prevalence of unused medication, manufacturers of controlled substances in Massachusetts must participate in either a drug stewardship program or an alternative plan as determined by DPH. 

This bill strengthens access to insurers and the bed-finder tool website; requiring patients receive information on FDA-approved medication-assisted therapies after being discharged from a substance use treatment program; and ensuring civil-liability protection for individuals who administer Narcan.

Today’s bill signing symbolizes the latest collaborative effort across state government to combat the opioid epidemic claiming nearly 4 lives per day in the Commonwealth and marks the fifth piece of legislation signed into law by Governor Baker, including the Fiscal Year 2016 budget and supplemental budget, to help fight this public health epidemic and provide critical funding for prevention, treatment and education.

In late January, Governor Baker signed into law a bill to prohibit the civil commitment of women facing substance use disorders at MCI-Framingham and providing addiction treatment services at Shattuck and Taunton State Hospitals. This reform was a recommendation of the Governor’s Opioid Working Group and will end the practice of sending women committed for treatment for a substance use disorder under section 35 of chapter 123 of the General Laws to MCI-Framingham.  For the past 25 years, women committed under section 35 have been sent to this correctional institution instead of a detox center—preventing proper treatment options for women.  Under this law, women can only be committed to a facility approved by the Department of Public Health (DPH) or the Department of Mental Health (DMH).

Governor Baker also recently signed a fentanyl trafficking bill, authored by Attorney General Maura Healey, making trafficking in more than 10 grams of fentanyl a crime, punishable by up to 20 years in prison.

In addition to legislative action, the Baker-Polito Administration has implemented numerous initiatives from Governor Baker’s action plan announced in June, completing 26 initiatives and currently implementing another 23.  The administration has allocated more than $250 million toward the opioid epidemic for substance use disorders, education, prevention and treatment, increased bulk purchasing of Narcan in municipalities by offering Narcan at a discount to our first responders and changed reporting requirements for the Prescription Monitoring Program from 7 days to 24 hours.  More than two hundred substance use treatment beds have been opened throughout the Commonwealth.

Since taking office, the Baker-Polito Administration has added 28 dedicated section 35 beds at Lemuel Shattuck Hospital and 15 beds at Taunton State Hospital, with an additional 30 beds at Taunton expected in the summer of 2016.  Last July, Governor Baker allotted $5.8 million in a supplemental budget to move women civilly committed for substance use problems to Taunton State Hospital.  The Baker-Polito Administration has also launched two multi-media awareness campaigns and partnered with medical and dental schools to develop core competencies and require increased education on opioids for medical and dental students.

The opioid epidemic continues to impact every community in Massachusetts. According to the most recent data, it is estimated that there were nearly 1,200 unintentional and undetermined opioid deaths in 2014. The estimated rate of 17.4 deaths per 100,000 residents for 2014 is the highest ever for unintentional opioid overdoses and represents a 228% increase from the rate of 5.3 deaths per 100,000 residents in 2000. And the trend isn’t slowing. Preliminary data estimations show, there were over 1,100 opioid deaths between January and September of 2015.

Fighting this ongoing epidemic has been a priority of the Baker-Polito Administration since day one. In February 2015, Governor Baker appointed a working group to develop a plan to reduce opioid deaths in the Commonwealth. In June 2015, the Governor’s Opioid Working Group released 65 recommendations and a comprehensive Action Plan aimed at curbing the opioid epidemic. These short and long-term recommendations focus on Prevention, Intervention, Treatment and Recovery Support. Approximately ninety percent of the initiatives in the Governor’s action plan are complete or underway.