New Jersey Hospital Opting for Holistic Treatment in the Emergency Room Instead of Using Deadly, Addictive Opiods
Back in January, the emergency department of the St. Joseph’s Regional Medical Center in Paterson, New Jersey – about 20 miles from New York City – launched an innovative program to help stem the tide of narcotic painkiller addiction and abuse. The department has adopted a deliberate policy to avoid prescribing opiate painkillers whenever possible, instead using alternative methods to manage patient pain.
“All chronic pain starts with acute pain,” said Mark Rosenberg, the hospital’s chairman of emergency medicine. “If we can stop using opioids before we give the first dose, then people won’t become addicted.”
More lethal than car accidents
Narcotics, also known as opioids, are highly potent but very addictive painkillers in the family that includes morphine and codeine, as well as street drugs such as opium and heroin. The more limited term “opiate” is used to refer exclusively to medical drugs, primarily used as painkillers.
According to the Centers for Disease Control and Prevention (CDC), more than 29,000 people died from opioid abuse in 2014, the highest death toll to date. Two million people are estimated to either be addicted to or abusing opioid drugs, not even counting an additional half a million people using heroin. Many of these addictions began with a legitimate prescription. Because the drugs are so addictive, many people become dependent simply from using them as directed.
Rising rates of opioid addiction and abuse are driven by rising rates of legitimate prescriptions, experts say. The number of opiate prescriptions written has quadrupled to 260 million since 1999. That’s enough prescriptions to give one bottle of painkillers to every U.S. adult.
St. Joseph’s Alternative to Opiates (ALTO) protocol calls for the use of non-addictive painkillers (such as non-steroidal anti-inflammatory drugs – or Tylenol) and nerve-blocking through local anesthesia, in order to avoid the use of narcotics whenever possible. In the first two months of the program, 75 percent of the 300 patients needing pain relief were able to do without opiates. The conditions being treated ranged from broken bones to kidney stones.
The program – the first of its kind in the country – has been praised by both doctors and lawmakers.
“Too many New Jerseyans have fallen to addiction, too many lives have been lost, too many families shattered,” said Bob Menendez, a U.S. Senator for New Jersey, at a recent round-table discussion about the program.
More people die in New Jersey from opioids than from car accidents.
Opiates prescribed ‘blindly’
The ALTO program is part of a nationwide effort to reduce opiate use. Many surgeons throughout New Jersey have adopted their own individual protocols; St. Joseph’s is unique in that an entire department has adopted a single policy.
The CDC recommends measures similar to those used by St. Joseph’s, namely that before turning to opiates, doctors first try non-opioid painkillers and non-drug pain management methods such as physical therapy.
Sergey Motov of Maimonides Medical Center in Brooklyn said that doctors need to stop using narcotics as a first resort, and instead only use them as a targeted therapy.
“I have no problem with opioids, I have a problem with the way we use them: unintelligently, without understanding them,” Motov said. “We need to talk to patients. The patient needs to be given an option. We never talk to patients routinely—we just blindly give them medication and hope they feel better.”
The recent round-table on the St. Joseph’s program was attended by a wide variety of people with an interest in the problem of opioid abuse, including lawmakers, police, prosecutors and addiction experts. But as U.S. Representative Bill Pascrell Jr., noted, one group was noticeably absent: drug companies.
“We need the pharmaceutical companies here because they’re shoving drugs down our throat,” Pascrell said.
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