The alternative to opioids (ALTO) program, developed at St Joseph’s University Medical Center in New Jersey, has proven highly successful at treating acute pain.
Over the course of five months with this innovative program, the hospitals reduced opioid use in the ED by 38 percent while treating 500 acute pain patients, with about three-quarters of the efforts being successful. The ALTO toolbox expands treatment options available to providers.
ALTO uses targeted non-opioid medications, trigger-point injections, nitrous oxide and ultrasound-guided nerve blocks to tailor itself to its patients’ pain management needs and avoid opioids when possible. ALTO treatments have successfully treated patients with five different acute pain diagnoses, including headache, long-bone fractures, kidney stones, back pain and other musculoskeletal pain. In these diagnoses, non-opioid pain medication is frequently better than opioids because the non-opioid medications target receptors in the body that block the sensation of pain.
Drs. Krebs, Gravely and Nugent released their findings from the SPACE randomized Clinical Trial in JAMA March 6.
A total of 240 patients with moderate-to-severe back or knee pain were studied with respect to pain control and function.
The use of opioids did not result in better pain-related function over the course of 12 months, and therefore the doctors recommended not initiating opioid therapy for moderate-to-severe chronic back pain, or hip or knee osteoarthritis.
If you would like more information on best prescribing guidelines, including the ALTO program for your providers and facility, please contact Trish Anderson at WSHA. (Trish Anderson)