CORPUS CHRISTI, Texas — The next time you go to the emergency room with knee, hip, or back pain, you might be surprised when they don’t offer you narcotics.
The Corpus Christi Medical Center (CCMC) is taking crucial first steps to address the opioid epidemic in South Texas by launching a relatively new method called ALTO, or Alternatives to Opioids.
“The ALTO program is focusing on things like lower back pain, herniated discs, migraine headaches, kidney stones, and looking at the use of local injections, trigger point injections, nerve blocks, maybe Ketamine IV, you may have heard of that term or drug before, Lidocaine, things of that nature which will get better pain control, but not expose a patient to an opiate,” said Corpus Christi Medical Center Chief Medical Officer Dr. Eric Deppert.
This is a community-wide addiction prevention program designed to reduce initial exposure to opioids through hospitals.
“We will set up dashboards and metrics, working with our providers, working with the community," Deppert said. "When we see there is a decrease in drugs, we are going to celebrate that, if not, we are going to try and find out why and what more we can do. It is a work in progress."
The ALTO program has been proven to work in other states, decreasing ER prescription rates by more than 60 percent within a year.
“We, at Corpus Christi Medical Center can’t just have this program and expect it is going to work. We need to have every provider, every physician, every emergency room, and every hospital system. This is not a Corpus Christi Medical Center program, this a Nueces County, Corpus Christi City program that we want to roll out across all providers,” Deppert said.
The ALTO program gives doctors guidelines to look into different pain treatment options, including physical therapy, acupuncture and in some cases, over the counter pain medications.
“We will also have a comprehensive group involving behavioral health and addiction services, recovery networks so we can handle not only those patients with acute pain, but those who have chronic pain and are addicted. 1-4 patients on a opiate are probably addicted to it,” said Deppert.
The Corpus Christi Medical Center will host a city event on Aug. 20 to introduce their newest ALTO program.
The ALTO program is a unique approach that tailors patients’ pain management needs with targeted non-opioid medications, trigger point injections, nitrous oxide, ultrasound-guided nerve blocks, and other approaches; avoiding opioids whenever possible.
On July 7, 2019, CCMC implemented ALTO in its four emergency rooms (ER) located in Corpus Christi and Portland. Northwest Regional, Northshore Emergency Center, Bay Area, and Doctors Regional are utilizing evidence-based protocols and more effective pain management treatments tailored to each patient’s needs.
The medical professionals are dedicated to understanding and responding appropriately to ER patients’ physical and emotional symptoms of pain in addition to taking steps to help the community combat the ongoing opioid epidemic.
The goal is to improve pain management for patients and return them to a maximum quality of life while recognizing and controlling the inherent risks in prescribing highly addictive medications such as opioids.
Implementing an ER policy such as ALTO can significantly reduce opioid prescriptions, according to The American Journal of Emergency Medicine. This reduction is key to reducing the epidemic and saving lives.
The ALTO process begins by building a coalition of community leaders, healthcare professionals and a multidisciplinary team who will assess issues within the community and develop a common level of understanding to better manage the prevention and treatment of opioid use disorder (OUD).
This coalition of stakeholders includes primary care physicians, pain management specialists, emergency departments, urgent care centers, healthcare systems, law enforcement, emergency medical services, drug enforcement agencies, schools, churches, behavioral health providers, local municipal and/or county leaders, state and federal legislators, nonprofit organizations, and peer-to-peer recovery programs.
“Opioid abuse has become a major health risk and an epidemic,” said Jim Hobbs, an administrator at Bay Area. “By implementing this policy in our emergency rooms, we hope to reduce opioid addiction and save lives.”
Millions of Americans suffer from pain and are often prescribed opioids to treat their conditions. However, the dangers of prescription misuse, opioid use disorder, and overdose have been a growing problem throughout the United States.
• Anyone who takes prescription opioids can become addicted to them. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggle with opioid addiction.
• More than 191 million opioid prescriptions were dispensed to American patients in 2017—with wide variation across states.
• More than two-thirds of drug overdose deaths in 2017 involve an opioid.
• In 2015, Nueces County opioid related deaths were 10.4/100,000, versus the Texas rate of 4.3/100,000; more than 2.5 times the state rate.
According to the Centers for Disease Control and Prevention, of all the people who died of an opioid overdose, 40 percent involved a prescription.
That’s more than 46 deaths every day. The CDC also reports emergency room visits for suspected opioid overdoses have increased by 30 percent in the U.S.