Massachusetts Medical Society: Testimony in Support of An Act Ensuring Access to Addiction Services

Testimony in Support of An Act Ensuring Access to Addiction Services

The Massachusetts Medical Society wishes to be recorded in support of H.1700/S.1145 An Act Ensuring Access to Addiction Services, which seeks to ensure that all clinical care provided to persons civilly committed for substance use disorder be treated at facilities under the control of the Department of Public Health or the Department of Mental Health.

The Medical Society’s policy making body formally adopted policy in support of this notion as it became clear that treatment via civil commitment is being increasingly used as a primary pathway to treatment, and as concern has been expressed regarding the quality of care at certain facilities that provide treatment to this population. The Medical Society was pleased to raise these important considerations, among many other related topics, through its participation in the recent Section 35 Commission which was established in August 2018 with Governor Baker's signing into law of Chapter 208 of the Acts of 2018.

The Medical Society appreciates that not all clinical care provided under the direction of the Department of Corrections is similar, nor does the source of oversight directly imply a standard of quality. But in a moment in time when the prevailing substance use disorder treatment community is trying to move away from a punitive approach to addiction and toward a disease model, the optimal oversight authority for any non-criminal justice involved person is surely a public health-oriented agency rather than the one based in criminal justice. In addition, the Medical Society takes seriously the importance of ensuring, if this bill were to pass, the need for appropriate, geographically diverse replacement of beds previously under the control of DOC.

Many families, patients, and physicians have spoken of the importance of the Section 35 process as an option of last resort. MMS notes with interest data indicating 10,000 petitions for Section 35. With such significant numbers, we suggest ongoing evaluation of the role of Section 35- whether it is serving as the last resort that it was intended to be, or if it has instead turned into a band-aid for structural problems facing the substance use disorder treatment system across the country. In addition, given the dearth of data supporting involuntary care for substance use disorder treatment, ongoing research and assessment of efficacy is critical.

The Massachusetts Medical Society urges support of this important legislation, and urges the Joint Committee on Mental Health, Substance Use, and Recovery to look broadly at the report of the Special Commission to determine whether this could be paired with other thoughtful, evidence-based reforms to the Section 35 system.

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