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The amount of painkillers prescribed in the United States have quadrupled between 1999 and 2013, according to the Centers for Disease Control and Prevention in Atlanta.

(Toby Talbot / Associated Press file)

BOSTON -- After months of work by Massachusetts legislators, the House on Wednesday passed a bill addressing opioid addiction by limiting first-time prescriptions of opioids, requiring verbal screenings of all public school students and passing a host of other provisions related to education, treatment and prevention of drug addiction.

"This public health crisis is unlike anything in this state most of us have ever experienced," said State Rep. Elizabeth Malia, D-Jamaica Plain, chairwoman of the Joint Committee on Mental Health and Substance Abuse. "The bill that came out of the conference committee combines the best of the House's offering, the governor's offering and the Senate offering."

The bill, H.4056, emerged from a team of House-Senate negotiators on Tuesday evening after lawmakers reached a compromise on proposals that had been working their way through the legislative process since the fall. Gov. Charlie Baker, a Republican, had recently started pressuring the Democratic-led Legislature to finish work on the bill.

"This conference report focuses on intervention, education and prevention, and incorporates the best ideas from both versions of the bills," said State Rep. Brian Dempsey, D-Haverhill, and State Sen. Karen Spilka, D-Ashland, who chair the House and Senate Committees on Ways and Means, in a joint statement. "We believe that provisions of this report will have a major impact towards reversing the opioid epidemic in the Commonwealth and will provide several new tools to help break the cycle of opioid abuse."

The bill passed the House unanimously, 153-0.

The Senate is expected to take up the bill on Thursday. If it passes, it will go to Baker's desk.

Baker called the bill a step in the right direction. "The Baker-Polito Administration believes more tools are needed to fight the opioid and heroin epidemic currently claiming nearly four lives per day in Massachusetts, and Governor Baker appreciates the Legislature's work on this bill, which takes a strong step in the right direction," said Baker spokeswoman Lizzy Guyton.

Mark Kennard, executive director of Project COPE, an affiliate of Bridgewell which provides substance abuse treatment services, praised the bill. "This is really demonstrating to everyone in the state that our government is working together to deal with this epidemic in a very real way," Kennard said. "They are responding, and it's being done in a thoughtful, coordinated and timely way."

One major change for doctors would be a limit on first-time prescriptions for opioid drugs to a seven-day supply. So for example, a patient who has wisdom tooth surgery or a sports injury could get only seven days worth of opioids without returning to the doctor for another prescription. There would be a seven-day limit for all prescriptions for minors. There would be exceptions for patients with cancer or chronic pain or for palliative care.

The prescription limit, a version of which was originally proposed by Baker, is a way to control the number of excess pills that are lying around people's medicine cabinets.

The Massachusetts Medical Society had lobbied for the seven-day limit, an increase from Baker's proposal for a three-day limit.

Massachusetts Medical Society president Dennis Dimitri said the seven-day limit "should reduce the amount of prescription drugs that can be diverted to abuse or misuse, and at the same time allow a reasonable time for prescriptions for those patients who truly need pain relief."

The bill also includes a proposal made by the Senate to verbally screen students in schools to identify students who are addicted or at risk of addiction to drugs. This would involve a professional, such as a school nurse, having confidential conversations with a students about their involvement with drugs, then referring students to counseling, if necessary. The screenings would be done at two different grade levels, and students and parents would be able to opt out.

The final bill does not include a provision championed by Baker that would have expanded the state's civil commitment law to allow doctors to hospitalize drug addicts involuntarily for 72 hours without a court order if they pose a danger to themselves or others. Civil liberties advocates worried about the proposal, and hospitals said they have no capacity to deal with these patients.

Instead, the bill adopted a proposal made by the House requiring that a mental health professional provide a substance abuse evaluation to anyone who enters the emergency room suffering from an opioid overdose within 24 hours, before he is discharged. The evaluation would include recommendations for future treatment, and it would be up to the patient to consent. The screening would be covered by insurance. Parents would be notified of the results of a minor's screening.

Kennard said today, a patient who goes to the emergency room after a drug overdose is released as soon as he is medically cleared, often without any recommendations for follow-up treatment and without any notice to the patient's primary care doctor. "Being able to require a substance abuse evaluation within 24 hours ... is a wonderful tool to use in terms of assessing people and being able to determine how we can get them into treatment," Kennard said. "It's a tool to engage someone and begin that whole discussion about the problem."

Other provisions of the bill include: