Cranston resident and Johnston native Lou Massemini walked into the Rhode Island State House with a manila envelope under his arm.
He arrived in Providence to honor the life of his late son, Louis Ryan Massemini, who died after overdosing on prescription medication.
Last Friday morning, Rhode Island Gov. Dan McKee ceremonially signed four bills into law, each aiming to rescue lives from the deadly opioid epidemic.
Lou Massemini was in the audience. He stood behind McKee’s left shoulder as he signed the bills.
“We are working every day to make Rhode Island a healthier and safer place to live for all,” McKee said.
One of the laws, which penalizes doctors engaged in “irresponsible prescription practices,” was inspired by the loss of Ryan Massemini, and may be renamed “Ryan’s Law” next year.
The other three will allow for the exploration of “harm reduction centers,” decriminalize buprenorphine, and require insurers to cover telemedicine visits.
Each piece of legislation was sponsored by state Sen. Joshua Miller (D-District 28, Cranston/Providence), and made its way through the state House and Senate over the summer.
They were finally signed into law during a ceremony at the State House on Friday, Sept. 24.
The bills, sponsored by Miller and state Rep. Deborah Fellela (D-District 43, Johnston), create penalties for irresponsible prescription practices by doctors, to help combat the opioid epidemic.
Lou Massemini at least partially blames his son’s physician for filling an opioid prescription shortly after Ryan’s first suicide attempt.
Ryan recovered and returned home, but then his prescription was refilled. He tried again.
“My son Ryan was diagnosed with Huntington’s disease … at the age of 35,” Massemini wrote in a letter to Rhode Island legislators. “Huntington’s disease (HD) is a fatal genetic disorder that causes the progressive breakdown of the nerve cells in the brain.”
He was prescribed a long list of medications, including oxycodone. The pill regiment eventually triggered suicidal tendencies.
Ryan died on Jan. 8, 2019, nearly two weeks after swallowing 27 oxycodone pills.
Lou Massemini now visits his son, twice each day at St. Ann Cemetery in Cranston.
“In many cases, opioid addiction begins with prescribed painkillers,” Fellela said. “The ramifications of reckless over-prescribing has led to an epidemic that has harmed society and torn families apart. This legislation will provide some serious consequences for the handful of physicians who are neglecting to prevent addiction.”
Fellela, a close family friend of the Massemini’s, knew Ryan since he was a young boy.
She teamed up with Miller to sponsor S-0256Aaa/H-5098A in an effort honor Ryan’s memory by trying to prevent deaths like his in the future.
“Our opioids crisis is, in part, fueled by addictions that started with prescriptions for painkillers,” Miller said. “While most providers take their role in preventing addiction very seriously, there must be real consequences for the few who don’t. The consequences suffered by addicted patients are far worse.”
McKee also signed three other “health-related bills” into law last Friday.
Legislation 2021-S 0016B, 2021-H 5245A, “enables the state to explore establishing a pilot program to create harm reduction centers to help prevent drug overdose deaths,” according to a press release from McKee’s office.
“The opioid epidemic has become a tremendous public health crisis, with overdoses of prescription and non-prescription opioids claiming a record number of lives,” said state Rep. John Edwards (D-Dist. 70, Portsmouth, Tiverton), co-sponsor of S-0016B/H-5245A.
“Not only do harm reduction centers severely mitigate the chance of overdose, they are a gateway to treatment and rehabilitation of people with substance abuse disorder. These locations will be under the supervision of trained medical staff who can direct addicts toward substance use disorder treatment. It’s a way to tackle this epidemic while saving lives in the process.”
“Harm reduction centers” have become a controversial weapon in the war against opioid deaths.
Johnston Town Council recently unanimously passed a resolution prohibiting the designation of “a location for the consumption or use of illicit drugs within the Town of Johnston.”
The pilot program will likely take root in other communities.
“If we are truly going to rein in the drug overdose epidemic, we must recognize drug addiction as the health problem it is, rather than as merely a crime,” said Miller, chairman of the Senate Committee on Health and Human Services. “People who are addicted need help and protection from the most dangerous possibilities of addiction. Having a place where someone can save them from an overdose and where there are people offering them the resources they need for treatment is a much better alternative to people dying alone in their homes or their cars.”
Proponents of the tactic argue the sites will save lives.
“Especially as overdose deaths have climbed during the pandemic and fentanyl-laced drugs continue to pose a lethal threat to unwitting users, we could prevent needless death and turn lives around with a program like this,” Miller said.
“Buprenorphine can be a real survival tool,” Edwards said. “This legislation will prevent overdoses and save lives by encouraging people with substance use disorders to choose buprenorphine over heroin.”
Buprenorphine is an opioid partial agonist, considered weaker than full opioid agonists like methadone and heroin, and has been used successfully to wean addicts off illicit opiates.
“Buprenorphine is an effective medication-assisted treatment,” Miller said. “It offers benefits to those with opioid use disorders when treatment in a methadone clinic is not appropriate or is less convenient.”
During the pandemic, trips to the doctor have evolved, like so many meetings in peoples daily lives.
Bills 2021-S 0004Baa and 2021-H 6032Aaa, co-sponsored by state Rep. Stephen Casey, (D-District 50, Woonsocket), expands telemedicine coverage requirements for insurers and requires that all Rhode Island Medicaid programs cover telemedicine visits.
“Telemedicine has been an extremely valuable tool for maintaining health since the pandemic began,” Miller said. “As its use increased, the public and our health care providers have become more adept at and comfortable using it, too. While its broader use may have been an adaptation for the pandemic, it’s also an improvement to our health care delivery system that will serve us well long after the pandemic. Telemedicine gets health care to people safely, efficiently and effectively, wherever they are. Embracing and expanding it as a permanent option for Rhode Islanders will improve health care access now and in the future.”
Casey, a trained firefighter and EMT, believes the legislation will be a valuable tool.
“Telemedicine is one more way we can make it easier for Rhode Islanders to access the health care they need,” Casey said. “Our experience with its use over the last year or more has shown us that it is an effective way to provide a great many health services. It makes it easier for people who are housebound, those who may not have reliable transportation, and those who simply find it quicker and more convenient than visiting an office. It advances public health by encouraging and helping people to maintain their health.”
McKee scrawled his signature on each bill.
“I am proud to sign bills into law that prioritize wellness and set Rhode Island apart as a leader in opioid use treatment as well as access to telemedicine,” McKee said. “I commend our legislative partners for their steadfast commitment to improving health and wellness across Rhode Island.”
After the signatures were cast in ink, and the pens dispersed to those in the crowd who helped inspire the legislation, Massemini opened his envelope, removed his copies, and asked McKee for one more pen stroke.
The ceremony capped a nearly two-year effort. His grief helped inspire a new law. The governor’s signature didn’t bring his son back, but it might save someone else’s.
“With the passing of ‘Ryan’s Bill,’ I hope to stop unnecessary and dangerous over prescribing of Opiod medications by incompetent physicians,” Massemini wrote. “Physicians need to take the time to treat patients’ diseases without relying on just prescribing addictive medications as a panacea.”