Sunday, July 29, 2012

Update on prescription drug bill: Please help

UPDATE: July 29, 2012
My latest info is that a rally will take place at 10am at the Statehouse tomorrow (Monday). As soon as I have a location, I'll let you know.

I understand that most of you cannot attend the rally, but you can help us out by sending an appeal to release this bill from committee via email to the House Way & Means chairman, Brian Dempsey. Original letters are best and most effective if they are short and concise.

Below, I've reproduced an example letter and bullet points about the bill that Kate McHugh put together.

[Sample Email]

Addressee list:;;

Honorable Chair Brian Dempsey
Honorable Vice Chair Stephen Kulik
Honorable Asst. Vice Chair Martha Walz

House Committee on Ways and Means
State House, Room 237
Boston, MA 02133

I am respectfully asking you to release S.2125 (An Act Relative to Prescription Drug Diversion, Abuse and Addiction) from the House Way & Means Committee for a floor vote before the end of legislative session on July 31.

Ten Massachusetts residents a week die from prescription drug abuse. Hundreds more overdose and require emergency care.
More Massachusetts residents now die from opiate-related overdoses than car accidents.

Alarmingly, the prescription pill epidemic is out of control, devastating wonderful families and our children.

We need a strong law that better educates parents and children about the dangers of prescription drug abuse, reduces doctor-shopping and pill theft, and provides more help to our loved ones, friends, and neighbors in need.

The time is now for strong, practical and common-sense legislation that will combat this growing epidemic.

S2125 will save lives. Please pass it now.

Thank you for your consideration in this matter.



[Additional information for composing your own email]:

* More Massachusetts residents now die from opiate-related overdoses than car accidents.

* Opiates kill more people than heroin and cocaine combined.

* As many teenagers are now experimenting with prescription painkillers as experiment with marijuana.

* Ten Massachusetts residents a week die from prescription drug abuse. Hundreds more overdose and require emergency care.

About S2125: This bill takes a number of important steps to address the prescription drug abuse epidemic gripping our communities. Specifically, S2125:

* Requires prescription painkillers come with an easily-understood pamphlet explaining the dangers of prescription drug abuse, where to turn for help, and how to safely store and dispose of the medications.

* Ensures that prescriptions for painkillers are written on secure, tamper-resistant prescription pads to discourage tampering.

* Requires doctors, dentists and other practitioners to simply check a new patient's drug history through an existing database once before prescribing painkillers, while providing exemptions for emergency situations.

* Forms a working group of doctors, nurses, and other health care providers to establish best practices for the prescribing of painkillers.

* Increases opportunities for pharmacists to check patient drug histories to prevent fraud.

* Ensures parents or guardians are notified when their child is treated in the emergency room for an overdose.
* Bans the sale, manufacture and use of "bath salts."

* Strengthens the State's Medicaid prescription drug fraud program.

* Establishes new professional substance abuse training for court personnel and attorneys.

* Provides for a pilot substance abuse education curriculum for five school districts with high prescription painkiller abuse rates.

* Provides for a Good Samaritan Policy, allowing for certain immunity to persons calling 911 during an overdose. It would also increase access to Naloxone or Narcan, a medication that can reverse a potentially fatal opioid overdose. This bill allows for expanded legal protection to prescribe, possess and administer Naloxone or Narcan to someone appearing to have an opioid overdose.

ORIGINAL ARTICLE: February 7, 2012
A key piece of legislation designed to combat multiple issues related to prescription drugs and "bath salts" is working its way through the process on Beacon Hill. A consolidation of a number of free standing bills, massaged and enhanced by the Joint Committee on Mental Health and Substance Abuse, the omnibus bill takes up where previous legislation left off after the report of the OxyContin and Heroin Commission several years ago.

The Committee has scheduled a public forum on the various aspects of this bill along with a discussion by doctors on new methods for detection and treatment of drug abusers, including a pilot program at the Barnstable County Correctional Facility using Vivitrol (extended release naltrexone).

Joint Committee on Mental Health and Substance Abuse Public Forum

An Evening of Solutions for the Problem of Prescription Drug Abuse

Monday, March 5, 2012 at 7pm
Sandwich High School Auditorium
Exit 3 off Route 6
365 Quaker Meeting House Road, East Sandwich, MA 02537

An Act Relative to Prescription Drug Diversion, Abuse and Addiction
S.2125 Section Summary
Prescription Monitoring Program
(Section 1,6,16,18A,21)
·        Requires a practitioner (not including a veterinarian), who prescribes controlled substances register as a participant in the Prescription Monitoring Program (PMP) when obtaining or renewing their Massachusetts Controlled Substances Registration.
·        Requires the Department of Public Health (DPH) to promulgate rules and regulations relative to the use of the PMP by registered participants that includes requiring participants to utilize the PMP prior to the issuance of a prescription for a narcotic drug contained in Schedule II or III to a new patient.
·        DPH shall specify the circumstances under which narcotics may be prescribed without first utilizing the PMP. 
·        DPH may also specify the circumstances under which licensed support staff may use the PMP on behalf of a registered participant.
·        Directs DPH to require pharmacists be trained in the use of the PMP as part of the continuing education requirements mandated for licensure by the board of registration in pharmacy.
·        Requires DPH to study the feasibility and value of expanding the PMP to include Schedule VI prescription drugs.
·        Requires DPH to notify pharmacists of the opportunity to use the PMP when conducting a prospective drug review.
·        Directs the DPH Commissioner to work with a nationally recognized entity specializing in prescription monitoring programs to establish interstate compacts between the commonwealth and other states that have programs and with those states that do not to securely share prescription data to improve public health and safety.
·        Requires a practitioner who is not registered with the PMP and who is identified by the PMP as within the top 30% of prescribers of controlled substances in the preceding 12 months to register as a participant in the prescription monitoring program not later than January 1, 2013. 

Report theft or loss of controlled substances
(Section 2)
·        Requires a person registered to manufacture, distribute, dispense, or possess controlled substances that discovers a theft or loss of controlled substances that requires the filing of a DEA Form 106 with the federal Drug Enforcement Administration must simultaneously file a copy of that form with local law enforcement and the state police.

Issuance of Schedule II prescription for a narcotic by an out of state physician
(Section 2B)
·        In addition to a Massachusetts practitioner, a prescription for a Schedule II narcotic may only be issued by a licensed physician in a contiguous state.

Naloxone (Narcan) prescriptions
(Section 2C)
·        Allows Naloxone (Narcan) or other opioid antagonist to be prescribed and dispensed for a legitimate medical purpose in the usual course of professional practice to a person at risk of experiencing an opiate related overdose or to a family member, friend or other person in a position to assist a person at risk of experiencing an opiate related overdose. 

Consumer education
(Section 3)
·        Requires the Department of Public Health to produce a pamphlet for distribution by  pharmacists with every Schedule II or III prescription that includes educational information on misuse and abuse for adults and youth, risk of dependency and addiction, proper storage and disposal, and addiction support and treatment resources.

Lock boxes for securing prescription drugs 
(Section 4,13)
·        A pharmacy registered in the Commonwealth to dispense Schedule II, III, IV or V prescription drugs shall make available prescription lock boxes for sale at each store location.
·        Pharmacies shall make customers aware of the availability of the lock boxes by displaying a sign on or near the pharmacy counter that: (i) is at least 4 inches by 5 inches; and (ii) includes the following statement in legibly printed font: “Lock boxes for securing your prescription medications are available at this pharmacy.”
·        Section 11 of chapter 283 of the acts of 2010 is repealed.

Tamper resistant prescription form
(Section 5,14)
·        Requires a written prescription for a controlled substance be written on a secure form.
·        Requires the Department of Public Health Commissioner to promulgate regulations concerning the security standards for written prescription forms.

Bath Salts
(Section 7)
·        Adds 16 chemical compounds commonly known as “Bath Salts” to the list of Class C controlled substances.

Good Samaritan
(Section 8)
·        Provides limited immunity from drug possession charges and prosecution when a drug related overdose victim or a witness to an overdose seeks medical attention.
·        Allows a person to receive and possess a Naloxone (Narcan) prescription and to administer it to a person appearing to experience an opiate related overdose.

Overdose notification and prevention for minors
(Section 9)
·        Requires the Department of Public Health (DPH) to produce a pamphlet with contact information for its Bureau of Substance Abuse Services, information on the benefits and availability of addiction treatment and on the prevention of future overdoses.
·        Requires any physician, nurse practitioner or hospital that treats a person under 18 years of age for a drug or alcohol overdose as defined by DPH to: (i) notify the minor’s parent, legal guardian or other person having custody or control of a minor child of the overdose as part of the discharge planning process; (ii) provide the pamphlet to the parent, legal guardian or other person having custody or control of a minor child and to the minor child; and (iii) provide access to a social worker, if available.

MassHealth Controlled Substance Management Program
(Section 10,17)
·        Requires MassHealth to establish a controlled substance management program for MassHealth enrollees who use excessive quantities of prescribed drugs.
·        Enrollees shall be restricted to obtaining prescription drugs only from the provider that the MassHealth designates as the enrollee’s primary pharmacy.
·        MassHealth must promulgate rules and regulations relative to the program, including criteria for participation, service restriction, responsibilities of primary pharmacy, change in primary pharmacy and participation status, utilization review, and enforcement.

Substance abuse training for Courts and CPCS
(Section 11,12)
·        Requires the Judicial Institute, in consultation with the Bureau of Substance Abuse Services, to provide substance abuse training for judicial and non-judicial personnel of the trial court, the appeals court and the supreme judicial court.
·        Requires the Committee for Public Counsel Services, in consultation with the Bureau of Substance Abuse Services, to provide substance abuse training for both private counsel who accept assignments and salaried public counsel.

Substance abuse education in schools
(Section 13A)
·        The study authorized by section 14 of chapter 283 of the acts of 2010 shall also include a cost estimate for a pilot substance abuse education program in 5 school districts that have surrounding communities with high rates of opioid drug abuse. 
·        The pilot program shall include evidence based curricula to decrease experimentation and provide skills for using prescription drugs appropriately.

Opioid prescribing practices
(Section 18)
·        Requires the Department of Public Health Commissioner to convene a joint policy working group consisting of 14 members to investigate and study best practices to promote safe and responsible opioid and other abused prescription drugs prescribing practices with the goal of reducing diversion, abuse and addiction.
·        Based on the working group’s report and recommendations the Commissioner shall promulgate rules and regulations relative to safe and responsible opioid prescribing practices with the goal of reducing diversion, abuse and addiction.

Medication assisted treatment on pre-release opioid dependent offenders
(Section 19)
·        Requires the Department of Public Health (DPH), in collaboration with the Department of Correction and the Massachusetts Sheriffs' Association, to study the use of FDA approved medication assisted treatments, including nonnarcotic, opioid antagonist therapies, for opioid dependent offenders leaving correctional facilities and transitioning to community based treatment programs. 
·        Allows DPH to enter into pilot programs to provide voluntary treatment for opioid dependent offenders with sheriff's offices that choose to participate with the goal of improving treatment outcomes and reducing recidivism.

Reschedule of a controlled substance from Schedule III to Schedule II
(Section 19A)
·        Directs the Department of Public Health Commissioner to reschedule the controlled substance hydrocodone combination product <15 mg/du (DEA Number 9806) from Schedule III to Schedule II.

Substance abuse treatment in the Massachusetts correctional system 
(Section 19B)
·        Requires the Department of Public Health, in collaboration with the Department of Correction and the Massachusetts Sheriffs' Association, to study the treatment programs and services available within the Massachusetts correctional system for offenders dealing with substance abuse and opioid dependency issues. 
·        The study shall focus on the accessibility and adequacy of those programs and services that currently exist within the department of corrections, and shall attempt to identify any gaps within the existing system and ways to improve upon the delivery and effectiveness of these treatment programs and services, including, but not limited to, the use of FDA approved medication assisted treatments. 

Prescription drug abuse among seniors
(Section 20)
·        Requires the Executive Office of Elder Affairs, in conjunction with the Bureau of Substance Abuse Services, to conduct a study of prescription drug abuse among seniors.

Tuesday, July 24, 2012

Pledges can be problematic

Candidates are bombarded with questionnaires during a campaign. Every interest group sends its package of questions in order to determine if the candidate will receive its endorsement.

Okay. Fair enough.

Do I support the Second Amendment? Yes.

Do I support clean air? Yes.

Do I support taxing people on the miles they drive? No.

Do I support open and transparent government? Yes.

These are a few questions I've fielded this year. I dutifully answer the questionnaires and assume that my responses will be on the Internet at some point.

It's when these groups go beyond sending a survey, and ask instead that you to sign a pledge, that I get a little like the bandito in Blazing Saddles who said, and I'm paraphrasing here, "We don't need no stinkin' pledges."

The problem with pledges is that you're taking an option off the table before you ever get to the table. It was illustrated quite well during the Republican primaries when everyone on the stage raised their hands to the question: "Can you raise your hand if you feel so strongly about not raising taxes, you'd walk away on the ten [dollars of spending cuts] to one [dollar of tax increases] deal?"

To balance the federal budget, shouldn't we consider such a deal? The reality, of course, is that there is no proposal to do this and Congress is not likely to ever produce a budget that does this. To turn this improbability into an impossibility, the candidates all affirmed that there would be no such option on the table by pledging not to increase taxes, no matter what.

How did that work out for George H. W. Bush? He hamstrung himself by taking a self-imposed pledge: "Read my lips. No new taxes." When he got to the table, he went back on that pledge. He was summarily dismissed from his job in 1992, having lost 20 points of his support base to Ross Perot (some would argue about the exact number), and was replaced by Bill Clinton. who raised taxes even more.

On a state level, we have Citizens for Limited Taxation, a great group of people led by Barbara Anderson that requires a signed "no new taxes" pledge in return for a possible campaign contribution. We have another group, the Massachusetts Fiscal Alliance, requesting signed pledges to make government transparent. I'm certainly in both of those camps, philosophically, but I would rather that they look at my voting record and professional background in making their assessments of who to endorse.

So let this be my formal announcement, a pledge if you will, that I won't be signing any pledges this year.

Saturday, July 21, 2012

Cape & Islands no-discharge area completes years-long quest to protect state waters

Several years ago, as a selectman for the Town of Sandwich, I played a small role in securing a no-discharge area (NDA) for a portion of Cape Cod Bay that includes the Sandwich Marina/East Boat Basin. Yesterday, I took part in a press conference where it was announced that the final pieces to the NDA designation in the state's ocean waters have been put in place.

We were joined by federal, state, county and local officials in Hyannis for the announcement. Read the press release by clicking here.

About $16 million in infrastructure improvements have been made in this latest round of establishing NDAs, funding of which comes from permits issued by U.S. Fish and Wildlife Service.

Although our senior senator interjected a number of remarks about partisanship in Washington, D.C., throwing several barbs at the Republican Party, the rest of us steered clear of his rhetoric and applauded the efforts of the staffs from the U.S. EPA Region 1 the MA Executive Office of Energy and Environmental Affairs. Sarah Colvin, producer of Barnstable Today, did a nice job editing out the unnecessary comments in the video at the bottom of this post.

From left to right: Eric Shufelt, Town of Barnstable Marina Manager; Tom Lynch,
Barnstable Town Manger; State Representative Randy Hunt; Stefanie Coxe,
District Representative for Congressman Bill Keating; Curt Spalding, New England
Region Administrator for the U.S. EPA; State Senator Dan Wolf; Secretary Rick
Sullivan (speaking), Massachusetts Executive Office of Energy and Environmental
Affairs; and U.S. Senator John Kerry.

Click on image for a higher resolution version.

What's in a name?

My mom called me Alan so many times I got used to it. Alan is my older brother.

I practically renamed my youngest son as well, introducing him as Dan. Without hesitation, he reaches out to shake a hand and matter-of-factly announces: "Hi, nice to meet you. I'm Jeff."

I've even called both of my girls Maggie. Maggie was our black lab.

Just last week, I was with Gayle looking at photos of an event and asked her how she managed not to be in any of the pics. I knew she was there because her three kids were in several shots. Gayle reminded me that she arrived in Boston for her vacation the day following the event, that she has no kids, and isn't married yet.

The good news is that I'm not at a loss for names; I just get them wrong. So far, I've avoided the ultimate miscue: "Hello, I'm Randy Hunt and this is my wife... Uh... Hmm... Help me out here, Hon."

Monday, July 16, 2012

Bridge in Sagamore Beach named for fallen Green Beret Pucino

UPDATE: July 16, 2012
The Pucino family joined legislators to witness the signing of Senate Bill 2218 by Governor Deval Patrick. The governor's press release follows:
L to R: Rep. Randy Hunt, Lisa Haglof, Phil Haglof,
Governor Deval Patrick, Melissa Pucino,
Senate President Therese Murray, Rep. Vinny deMacedo

BOSTON – Monday, July 16, 2012 – Governor Deval Patrick today joined family members and legislators to sign S. 2218, “An Act Designating Certain Bridges In The Town of Bourne As The Staff Sergeant Matthew A. Pucino Bridges,” honoring Staff Sergeant Matthew Pucino, who was killed in action in Afghanistan in 2009 when his mounted patrol unit was attacked with an IED.

“Naming these bridges in Sergeant Pucino’s honor is a small gesture of thanks for a very big service to our country,” said Governor Patrick.

"Matthew was a Green Beret, which takes hard work, commitment and courage," said Senate President Therese Murray. "He had all those traits and more. Matthew was a hero, and with this dedication we acknowledge his service and sacrifice and honor his family and his legacy."

“I am proud we have chosen to remember Matthew by naming this bridge in his honor,” said State Representative Vinny deMacedo. “He elected to put himself in harm’s way to protect the country he loved. This is one small measure in which his community can thank him for that ultimate sacrifice.”

"There is no way that the commonwealth can pay back Staff Sergeant Matthew A. Pucino for his service to our country and his ultimate sacrifice while leading a convoy on that fateful day in November 2009,” said State Representative Randy Hunt. “But we can commemorate this great American hero by naming a bridge in his honor on the approach to the Cape Cod Canal in Matt's hometown village of Sagamore Beach."

The division of highways in the Massachusetts Department of Transportation will be charged with creating and maintaining suitable markers bearing the new designation of the Sagamore overpass spanning U.S. Route 6 that crosses over Meetinghouse Lane and the Scenic Highway.

*  *  *  *  *

June 29, 2012
The Massachusetts House of Representatives and Senate enacted Senate Bill 2218 yesterday naming a twin-span bridge in Bourne for Staff Sergeant Matthew A. Pucino, who was killed in Afghanistan in November 2009. The bridge is on Route 3 and passes over the Bourne Scenic Highway on the approach to the Sagamore Bridge. It was built as part of the "flyover" project that eliminated the Sagamore Beach rotary.

Matthew Pucino's parents, sisters, brother-in-law and niece attended the House session and witnessed the bill being passed. Members of the House then greeted them and passed on their condolences for their loss.
Prior to the session, the family visited with Speaker of the House, Robert DeLeo in his office where they received a House of Representatives citation honoring the family's creation of the SSG Matthew A. Pucino Memorial Foundation, a non-profit organization that raises funds for disabled veterans and for Gold Star families.

Pucino family receiving House of Representatives citation. Left to right: State Representative Randy Hunt, Katelyn Haglof, Melissa Pucino, Albert Pucino, Kathryn Pucino, House Speaker Robert DeLeo, Phil Haglof, Lisa Haglof, State Representative Susan Gifford, State Representative Vinny deMacedo.

The family was introduced to the House members by Speaker DeLeo:
Today, we're taking up Senate 2218, a bill to name a Route 3 bridge in the Town of Bourne for Staff Sergeant Matthew Albert Pucino.

Pucino, who grew up in Plymouth and Bourne, was assigned to the 2nd Battalion, 20th Special Forces Group of the Maryland Army National Guard.

As a Special Forces Green Beret, Staff Sergeant Pucino was instrumental in freeing the local population in an area of Afghanistan from Taliban forces who had set up a terrorist training camp.

On November 23, 2009, Pucino was killed in Pashay Kala, Afghanistan, when his mounted patrol unit was attacked with an improvised explosive device.

His awards and decorations include:

the Purple Heart Medal

two Bronze Star Medals

Army Commendation Medal

Iraq Campaign Medal

Combat Infantryman Badge

Parachutist Badge

Special Forces Tab

NATO Medal

Global War on Terrorism Expeditionary Medal, and

Global War on Terrorism Service Medal.

We are joined this afternoon to the right of the rostrum by Staff Sergeant Matthew Pucino's family:
Mother and father, Albert & Kathryn Pucino;
Sisters Melissa Pucino and Lisa Haglof;
Brother-in-law, Phil Haglof; and

Niece Katelyn Haglof.
State Representative Randy Hunt then offered the bill for a vote:
Thank you, Mr. Speaker, and through you to the members.

I want to thank Matt's family for attending our session today. I also want to thank you, Mr. Speaker, and my esteemed colleagues from West Boylston, Plymouth and Wareham for coordinating the timing of this vote to coincide with Mr. and Mrs. Pucino's trip to Boston from Florida.

There is no way that this House can pay back Staff Sergeant Matthew A. Pucino for his service to our country and his ultimate sacrifice while leading a convoy on that fateful day in November 2009. But we can commemorate this great American hero by naming a bridge in his honor on the approach to the Cape Cod Canal in Matt's hometown village of Sagamore Beach.

This will provide a permanent reminder for his family, friends, neighbors and all of the thousands of people who travel Route 3 to Cape Cod every day.

I urge everyone in this body to join with me in passing this bill.
After the House session, the Pucinos were honored by the State Senate. Senate President, Therese Murray, said that she keeps a photograph of Matthew Puccino on her desk, which she held up to show the family and senators. She said, "We can never replace your son, but I want you to know how much we appreciate your sacrifice and his sacrifice. We are pleased to have you in the chamber today to witness the passing of this bill."