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Emergency Department Alternatives to Opioids: Adapting and Implementing Proven Therapies in Practice

Author

Listed:
  • Sarah B. Floyd

    (Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA)

  • Sam NcGarby

    (Department of Emergency Medicine, Prisma Health-Upstate, Greenville, SC 29605, USA)

  • Susan Cordero Romero

    (Department of Emergency Medicine, Prisma Health-Upstate, Greenville, SC 29605, USA)

  • Sam Garrison

    (Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA)

  • Kevin Walker

    (Division of Pain Management, Prisma Health-Upstate, Greenville, SC 29605, USA)

  • William Hendry

    (Integrated Health Partners, Greenville, SC 29609, USA)

  • Phillip C. Moschella

    (Department of Emergency Medicine, Prisma Health-Upstate, Greenville, SC 29605, USA)

Abstract

The use of opioids to treat pain can increase the risk of long-term opioid dependency and is associated with negative patient outcomes. The objective of this study was to present the initial results following the implementation of Emergency-Department Alternatives to Opioids (ED-ALTO), a program that encourages the use of non-narcotic medications and procedures to treat pain in the Emergency Department (ED). We used a pre- and post-implementation study design to compare in-ED opioid utilization, as well as ED-ALTO medication and procedure use in the year before and after the program’s implementation. After ED-ALTO’s implementation, there was a decrease in opioid utilization in the ED and an increase in ED-ALTO medication use. Additionally, there was an increase in ED-ALTO procedure utilization and the complexity of conditions treated with ED-ALTO procedures, including the use of regional nerve blocks for shoulder dislocations and hip and rib fractures. In 8 of the 12 months following ED-ALTO’s implementation, a lower proportion of patients receiving ED-ALTO procedures received an opioid, and the opioid dosage was lower compared to patients with the same diagnoses who received standard care. The continued expansion of ED-ALTO programs across the US may serve as a mechanism to reduce opioid utilization and safely and successfully treat pain in ED settings.

Suggested Citation

  • Sarah B. Floyd & Sam NcGarby & Susan Cordero Romero & Sam Garrison & Kevin Walker & William Hendry & Phillip C. Moschella, 2023. "Emergency Department Alternatives to Opioids: Adapting and Implementing Proven Therapies in Practice," IJERPH, MDPI, vol. 20(2), pages 1-13, January.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:2:p:1206-:d:1030507
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