Among other laws addressing the opioid addiction crisis in Massachusetts, the state recently enacted a bill requiring that hospitals provide immediate drug-treatment to opioid-addicted people arriving at the ER in crisis. Previously, thousands were being turned away from hospital emergency rooms because the hospitals had no personnel trained to help them.

Midway through 2017, Dr. Alister Martin, an ER doc at Boston’s flagship Mass. General hospital, found himself in this position—turning away a person in crisis—and asked, “We’re in the middle of an opioid crisis, and we’re kicking people out of the emergency room?”

He went to his boss, who went to his, and she proposed that all ER physicians be certified to prescribe medication for addictions—that they recognize the life-or-death urgency of these matters by working with the patients as they enter the ER, rather than referring them to a detox or rehab facility. The administering of treatment drug of choice, buprenorphine (Suboxone trade name), requires, by federal law, that physicians take an 8-hour course to get certified (a “waiver”) for prescribing this med. Few doctors did so.

Beyond the federal reg, the main obstacle to hospital-based service was a lack of training of the ER physicians in dealing with addictions, both in ed school and post-grad. Dr. Martin and his supporters focused on developing some widely available training programs and encouraging doctors to get the waiver. The made December, 2017, “Get Waivered Month,” at Mass. General and the waiver soon became a badge of honor among the hospital’s doctors. Doctors at other hospitals caught on, and convinced their administrators to follow suit.

In a state in which several people die of opioid ODs every day, the legislature and the governor have been striving to enact programs which have in-the-streets results. Massachusetts is the only state which maintains a public-policy campaign which has led to a reduction in the loss of life in this merciless nationwide epidemic. As a result of the work of Dr. Martin and his colleagues, and the backing of their hospitals, the state enacted a law requiring all hospitals to have their ER physicians trained to receive the “waiver” and provide help in the moment of crisis. Lives will be saved thereby.

As a clinical social worker, do you provide treatment or referrals to addicted people? What are you doing about the opioid crisis? Does your state have policies that would give people the urgent care they need? If not, you could make a difference by discussing these matters with fellow professionals toward advocating for new programs like those in Massachusetts. Many lives are at stake!


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