On January 4th, 2017 St. Joseph’s Regional Medical Center’s Emergency Department started using opioid painkillers only as a last resort in the treatment of pain. The hospital, which is located in Paterson, New Jersey, decided that rather than go the traditional route of prescribing opioids in order to treat patients coming in with pain, they would only use the drugs if they could not treat the symptoms through other means.
Since the inception of opioid painkillers, there has been a general consensus among doctors, and many patients, that using opioids to treat pain is the fastest and most efficient way to deal with the problem, but growing concern over the addictiveness of these drugs has caused St. Joseph’s to rethink this notion. Looking at the opioid epidemic that has swept this nation, they are attempting to help curb the problem, by being conservative with their prescribing practices, and by attempting to use nonnarcotic alternatives, nerve blockers, music therapy, and even energy healing. They feel that by trying these alternatives first, many of which have been proven to help with pain, they can an avoid inadvertently getting patients addicted to opioids, which only causes further problems down the road.
Doctors in the emergency room inform patients of the new methodology they are employing and they tell them right away that opioid painkillers can be highly addictive, so with their consent they would like to try alternative methods for treating the pain.
One patient that was discussed in The New York Times article documenting St. Joseph’s attempt at using alternatives to opioids was Brenda Pitts, who checked herself into the emergency room because of pain she was experiencing from an old shoulder injury. Now under normal emergency room operating procedures, Mrs. Pitts would have been given opioid painkillers when it was shown that her pain was legitimate and needed to be dealt with, but instead, doctors at St. Joseph’s E.R. gave her an injection of Marcaine, a non-opioid analgesic which immediately alleviated her symptoms.
The New York Times article describes the relief and somewhat shock on Mrs. Pitts face when the injection immediately reduced her pain and how she hugged the doctor and moved around effortlessly afterward. If Mrs. Pitts would have been given opioids, neither of these things would have occurred, because the narcotic takes time to work its way into the system, and also leaves many patients drowsy and drugged after they take it.
What happened to Mrs. Pitts also counters the narrative that opioids are the fastest way to deal with pain, as it shows that there are alternatives for dealing with immediate pain that do involve using power narcotics. This is not to say that once the Marcaine wears off Mrs. Pitts’ pain will not return, which is definitely a possibility and is something that her and the doctors will have to work out either through surgery or through some other method of intervention, but at least for the time being, Mrs. Pitts can treat her pain without having using addictive substances to keep it at bay.
What Does This Mean Moving Forward?
The use of non-opioids related methods of dealing with pain is a great step forward towards reducing the general population’s exposure to powerful opioids. This is something that many E.R.s throughout the country have been working towards over the past few year, with St. Joseph’s being at the forefront.
Many hospitals and medical professional have come to realize that the prescribing practices and the use of drugs such as Oxycontin, have contributed to the explosion of opioid usage we have seen in this country over the past 15 years. Part of why this occurred is because of the tremendous “educational” campaign that Purdue Pharma, the manufactures of Oxycontin did back in the late 90s and early 2000s, which essentially informed the way that doctors would go about dealing with pain for the next decade. These educational programs provided those in the medical profession with faulty data relating to the addictiveness of the opioids that Purdue Pharma made, and created an atmosphere where liberal prescribing of opioids became the new norm.
Now faced with the reality of what that sort thinking created, many are beginning to push back on that narrative and look for ways to deal with pain that will minimize long-term risk and maximum short-term benefits.
While not every person who comes into the E.R. for pain will benefit from St. Joseph’s methods, many will, and many will not have to suffer from years of substance abuse because they were unfortunate enough to be introduced to opioid painkillers.
For instance, at St. Joseph’s E.R. will see 170,000 patients this year, 75% of which will be there for pain. If only a fraction of that number can benefit from non-opioid methods of treating pain, then thousands and thousand of people can potentially be spared from having to deal with withdrawal symptoms, or in more sever cases addiction.
Hopefully, more and more hospital will get on board with this way of thinking and begin to incorporate this opioid-second methodology into their treatment of pain. If this occurs, we can begin to effectively deal with the opioid epidemic in this country, and not just continue to propagate it through old outdated medical thinking.
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