Legislature Passes Bill to Combat Substance Use Disorder

The Massachusetts Legislature 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.  

"The legislature stands united in confronting this epidemic head-on that has historically plagued communities of color but is now touching all homes across the Commonwealth regardless of race, age or gender,” said State Senator Adam Gomez (D-Springfield). “By reforming aspects of health plans and delivering proven recovery tools, our body has created a pathway for families to effectively combat this dire public health crisis. I am proud to join my colleagues in the Senate and the House, and grateful for the countless advocates who helped shape this powerful piece of legislation.”  

“Too many families have known the pain of substance use disorder and, tragically, the loss of a loved one because of it,” said Senate President Karen E. Spilka (D-Ashland). “Opioids have stolen life from parents, children, siblings, and friends. The legislation approved by the Legislature today makes powerful strides towards mitigating this crisis by helping those coping with substance use disorder reduce harm, find treatment, and achieve recovery that lasts a lifetime. I am grateful for the work of Senators Crighton and Velis, my colleagues in the Senate, and our partners in the House to see this bill through to final passage.” 

“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.” 

“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.” 

“The tragic truth is that most people in our Commonwealth know someone who is struggling or has struggled with addiction, and it is truly heartbreaking how many loved ones we continue to lose to substance use disorders every year. Not only does this legislation bolster access to life saving overdose reversal tools but it also expands access to recovery coaches, vital providers who truly understand what it is like to navigate recovery because of their lived experiences,” stated Senator John C. Velis (D-Westfield). “As Senate Chair of the Joint Committee on Mental Health, Substance Use, and Recovery, one of my top priorities this session has been to send comprehensive legislation to the Governor that will help keep people alive and make quality recovery resources more accessible throughout Massachusetts. That is why I am so grateful to Senate President Spilka, Senator Crighton, Representative Madaro, and all of my colleagues who have worked tirelessly on this final legislation that will undoubtedly save and change countless lives.”  

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.