A busy New Jersey hospital will be the first emergency room in the United States to drop the use of common opioids such as oxycodone, hydrocodone, and percocet to curb acute pain. Instead, other non-opioids medications, trigger point injections, nitrous oxide, and ultrasound-guided nerve blocks. The Alternatives to Opioids (ALTO) program started in January 2016 at St. Joseph's Regional Medical Center utilizes protocols that primarily target five common conditions: renal colic, sciatica, headaches, musculoskeletal pain, and extremity fractures. Dr. Mark Rosenberg, Chairman of Emergency Medicine has helped develop treatment protocols to curb the use of dangerously addictive opioid medications. Dr. Rosenberg claims that these alternative treatments work better than opioids by working on the same peripheral nervous system receptors that the opioid medications do. He also states that the goal of treatment for pain shouldn't to be to fully alleviate pain but to get them to a more functional level.
Although these serve as great alternatives and a step in the proper direction to aid the fight on opioids, there is more that could be done. The back pain that Dr. Rosenberg describes in previous videos is often mechanical in nature. This mechanical process requires a more active type of treatment rather than passive. Along with these alternative treatments, an educational protocol should be implemented to help patients prevent these recurring episodes of acute low back pain from happening. This is where doctors from the physical medicine realm could be more efficiently utilized. Such is the case when first intervention for mechanical low back pain is to a chiropractor. Studies have shown that utilization of chiropractic care for acute pain episodes can reduce opioid medication.