Healthcare News & Insights

Stopping opioid abuse: Hospital uses alternatives to manage pain in ED

Opioid abuse is a serious problem in the United States, and the Centers for Disease Control & Prevention (CDC) is calling on hospitals and other healthcare providers to play a bigger role in reducing opioid addiction. 

Pain Management written on a clipboardAccording to data from the CDC, healthcare providers wrote 259 million prescriptions for opioid pain medication in 2012 (the most recent year for which data was available).

That’s enough medication for every adult in the country to have a bottle of pills.

Many patients need these pills to manage severe chronic or acute pain. But others are addicted – and the toll of their addiction is climbing. Deaths due to misuse of opioids are on the rise. According to the CDC, in 2014, more than 29,000 people died directly because of opioid misuse.

In response to this problem, the CDC recently released new guidelines to govern the use of prescription opioids. But the guidelines are mostly geared toward primary care providers – and many addicts visit the emergency department (ED) in hopes of getting their fix.

By inventing symptoms and exaggerating their pain levels, these “doctor shoppers” hope they can get a prescription for powerful opioid medications to feed their habits. Sometimes, it can be tough for providers to know when a patient really needs pain medicine, or if the person plans to use the prescription for illegal means.

Different approach to pain

One hospital’s gone the extra mile in its ED to curb excess opioid use, and its tactics may be helpful for facilities across the country.

St. Joseph’s Regional Medical Center in Paterson, NJ, has become the first facility in the nation to stop prescribing opioid pain medication in the ED. Its approach was detailed in an article from the Associated Press, published on Yahoo News.

The hospital has the busiest ED in New Jersey, and it saw its share of patients come to the hospital in search of pills. That, combined with its desire to help the CDC with curbing the nationwide epidemic, inspired the facility to create the Alternative to Opiates (ALTO) program.

Per the article, the goal of the ALTO program is to treat patients without resorting to opioids right away.

Patients with cancer and other chronic conditions where opioids are required to manage their pain aren’t placed in the program. But it’s been effective for patients who have other issues with pain, such as broken bones, kidney stones, migraines and acute lower back pain.

The hospital started the program at the beginning of the year, and so far, 75% of the patients who have participated ended up not needing opioids at all.

According to a news release about the program, instead of defaulting to opioids, St. Joseph’s takes a different approach to alleviating patients’ pain, using options such as:

  • non-opioid medications
  • trigger-point injections
  • nitrous oxide, and
  • ultrasound-guided nerve blocks.

Given the success of the hospital’s program so far, similar approaches may be the next step for managing pain in the ED setting.

Using tactics like these in your hospital could help lower rates of opioid addiction while still keeping patients comfortable and pain-free. So it’s worth investigating if this strategy could be feasible for your facility.

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