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Senate advances Downing/Pignatelli bill authorizing state oversight of opioid addiction treatments
November 20, 2013

BOSTON State Senator Benjamin B. Downing (D- Pittsfield) and State Representative Smitty Pignatelli (D- Lenox) announce their legislation to create state regulatory oversight of the prescription drug Suboxone, which is used to treat opioid addiction, has been unanimously passed by the Senate. The bill is now pending with the House Committee on Steering, Policy & Scheduling and is being considered for debate by the full House of Representatives.
Prior to yesterday’s Senate action S. 1926, An Act regulating the use of buprenorphine in opioid dependence treatment had been reviewed and received favorable recommendations from the Joint Committees on Public Health, Health Care Financing and the Senate Committee on Ethics and Rules. It enjoys the support of the Department of Public Health and its implementation will have no cost to the Commonwealth.
Buprenorphine, also known as “bupe,” is a partial agonist synthetic opioid. Suboxone, a buprenorphine-based drug, is a unique compound used in treating opioid addiction, and has seen a rapid increase in use since its introduction to the market in 2002. Suboxone attaches to brain receptors better than traditional treatments like methadone without the risk of respiratory distress.  Alarmingly, the potential for Suboxone abuse was detailed on the front page of the New York Times this weekend.
“Over the past decade the communities we live in have dealt with the scourge that is opiate addiction and abuse,” said Downing. “One of the many ways to address opioid addiction is to treat it with Suboxone; however, we have seen this drug can be diverted and abused. This particular medication has caught the attention of public health and safety officials, in Berkshire County and beyond. This legislation seeks to increase state oversight of Suboxone by giving regulatory powers to the Department of Public Health.”    
Specifically, S. 1926 empowers the state Department of Public Health (DPH) to promulgate rules relative to the treatment of opioid dependency through the prescription and use of buprenorphine and its variants. Through regulations DPH shall establish licensing and treatment requirements, such as toxicology screens of clients, medication call-backs, maximum take-home dosages and any other diversion control mechanism necessary to limit the diversion of buprenorphine-based medications. 
“This bill is an important step in dealing with the abuse of prescription medication in the Berkshires and across the Commonwealth,” said Pignatelli. “I have recently met with the makers of Suboxone and plan on working with them in the future to take even more steps towards curbing this problem.”
Downing and Pignatelli were inspired to file this legislation during a meeting with DPH officials in March 2012 on the subject of a proposed methadone clinic in the City of Pittsfield. During the conversation DPH officials lamented their lack of authority to implement commonsense regulations in this market.
Suboxone is an innovative tool in the fight against opioid addiction, yet the lack of state oversight has allowed diversion and abuse to become a major issue. Unlike methadone, which faces stringent regulations at both the state and federal levels, Suboxone can be prescribed by any primary care physician who registers with the DEA and completes one 8-hour online course. This ability to prescribe allows patients to access treatment without dealing with the perceived stigma of a methadone clinic setting.
In 2010 Vermont passed legislation to become the first state in the nation to regulate Suboxone.


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