Alternatives to Opioids (ALTO)

If you experience an injury that requires a trip to the local emergency room, there is a good chance that you will be prescribed an opioid narcotic for the pain and will be told to follow up with your primary care physician. If you are still experiencing pain when you see your family doctor, there is an even greater chance that you will be prescribed more painkillers. In fact, nearly half of all opioid prescriptions written in the United States come from primary care physicians. One does not have to take opioids for too long before dependence develops, a slippery slope towards addiction which began back at the emergency room. So, what would happen if emergency room doctors only prescribe opioids as a last resort?

At one emergency room in New Jersey, the chairman of emergency medicine has decided to answer that question. At St. Joseph's Regional Medical Center in Paterson, NJ, doctors have begun using opioid alternatives to treat pain, keeping opioids off to the side for last ditch treatment efforts only, the Associated Press reports. The program, Alternatives to Opiates (ALTO), has been used since January, and in the first two months 75 percent of the emergency rooms 300 patients did not receive prescription opioids.

This month, the Centers for Disease Control and Prevention (CDC) released new prescribing guidelines, calling on primary care physicians to only use prescription opioids when every other alternative proves ineffective. While the guidelines are not something the CDC is normally responsible for creating, due to the dire nature of this epidemic every health agency needs to work together to put a stop to prescribing opioids when they are unnecessary.

Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing points out that emergency rooms are the front lines of the opioid crisis we face, according to the article. He supports the doctors at St. Joseph's, utilizing alternative forms of pain management.

"In many cases, we're exposing people to opioids when we don't need to be," said Kolodny.