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Bicameral, Bipartisan Coalition Introduces Alternatives to Opioids in the Emergency Department Act

Bill based off success of New Jersey program

March 12, 2018
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WASHINGTON, D.C. – U.S. Senators Cory A. Booker (D-NJ), Shelley Moore Capito (R-WV), Michael F. Bennet (D-CO), and Cory Gardner (R-CO) along with U.S. Representatives Bill Pascrell, Jr. (D-NJ-09), David B. McKinley (R-WV-01), Diana DeGette (D-CO-01), and Scott R. Tipton (R-CO-03) introduced legislation to help boost hospitals’ resources in the fight against opioid addiction.


After years of ravaging communities across America, the opioid epidemic is showing no signs of abating. Over 100 people die each day from opioid overdose. Forty percent of these deaths involved a prescription opioid. More than 200 million opioid prescriptions are written in the United States each year. As a first line of defense against the opioid epidemic, emergency rooms are well positioned to be laboratories of new innovations and procedures to combat the crisis. At the same time, because of the short-term nature of the care they provide, emergency rooms are often highly susceptible to doctor-shopping.


Eager to try fresh approaches to address this epidemic, emergency departments in several states have developed effective programs that have drastically reduced the use of opioids. St. Joseph’s Medical Center in Paterson, New Jersey created the Alternatives to Opiates (ALTO) program, which decreased emergency department opioid prescriptions by nearly 60 percent in its first year alone. The Colorado Hospital Association saw similar success with its program, decreasing opioid usage by 36 percent in six months.


The Alternatives to Opioids (ALTO) in the Emergency Department Act would establish a demonstration program to test alternative pain management protocols to limit to use of opioids in hospital emergency departments. The legislation would provide grant funding to build these programs. Following the completion of the program, the Secretary of Health and Human Services will submit a report to Congress on the results of the program and issue recommendations for broader implementation.

“Our nation’s opioid epidemic continues to cause extraordinary pain and suffering, and is tearing families and communities apart,” said Sen. Booker. “To combat this public health crisis we need to invest in promising, innovative models. Our bipartisan bill, built on the success of a program in New Jersey, would not only help prevent addiction by reducing the number of opioid prescriptions written in emergency rooms, but it would also help us better understand safe and effective alternatives to prescribing opioids.”   

“Tackling the opioid epidemic will require an all-hands-on-deck approach, and the ALTO in the Emergency Department Act is another tool that will help in the fight,” said Sen. Capito. “Millions of opioid prescriptions are written each year, and a significant portion of opioid overdose deaths involve these prescription opioids. There are alternatives to treating pain that can help save lives, and that is exactly what our bill aims to do. By helping to explore non-opioid pain treatments, I am hopeful this bill will help decrease opioid usage in West Virginia.”

“In Colorado, our communities are being ripped apart by opioid addiction, but they are also seeing promise in new approaches to combat this epidemic,” said Sen. Bennet. “We need to invest in data-driven, innovative programs like the Colorado Opioid Safety Collaborative Pilot—which has successfully used alternatives to opioids as first-line treatment for pain. Let’s pass this bipartisan bill to expand these programs and help decrease opioid usage across the country.”

“We all know people that have been impacted by the opioid epidemic in Colorado, and we need to look at every possible action we can take to fight it,” said Sen. Gardner. “While much more needs to be done to stop this problem in our communities, this legislation takes a step in the right direction by creating an avenue to expand models that lower the use of opioids in our emergency departments to treat pain with alternative methods that have been successful in Colorado as well as other states.”

“I believe this will be a critical step in fighting the opioid scourge that is devastating communities across my district and the nation,” said Rep. Pascrell. “Pioneered at St. Joseph’s Medical Center in my hometown Paterson, New Jersey, their approach has shown dramatic results in keeping unnecessary opioids out of patients’ hands. Our legislation would take the St. Joe’s ALTO model nationwide, providing emergency rooms across the country with a blueprint for preventing countless overdoses from happening in the first place.”

“The opioid epidemic is ravaging rural communities across the nation. Too many families have seen their loved ones fall into a downward spiral after becoming addicted to painkillers, robbing them of their God-given potential,” said Rep. McKinley. “This legislation will help prevent the overprescribing of opioids and expand the development of alternative methods of pain treatment in our hospitals.”

“Colorado has been a pioneer in the prevention and treatment of opioid abuse, including an ALTO pilot that produced impressive results,” said Rep. DeGette. “This bipartisan, bicameral legislation is a logical next step. We’ve already saved lives and reduced the burden on hospital emergency departments in my state; time to take that success nationwide.”


“Opioid abuse in America is a multifaceted issue, however opioid addiction often stems from prescribed pain medication,” said Rep. Tipton. “The ALTO program offers a unique solution to the opioid crisis by offering non-opioid pain treatments in emergency departments across several states, including Colorado. So far this program has had success across our state in considerably decreasing the use of narcotics, and I look forward to seeing this program implemented in more emergency departments across the nation.”

“From a physician’s perspective, the best way to prevent someone from misusing opioids is to avoid prescribing them in the first place,” said Dr. Paul D. Kivela, president of the American College of Emergency Physicians. “However, the number one reason people seek emergency care is because of pain.  The Alternatives to Opioids (ALTO) program developed in the St. Joseph’s emergency department in New Jersey gives physicians innovative tools to help manage pain without resorting to opioids.  This legislation will help ensure the ALTO program is made available to more patients, in more hospitals, in more states and will help stop opioid addiction from starting.”

A report issued this week by the Centers for Disease Control found that emergency room visits stemming from opioid overdoses rose approximately 30 percent between July 2016 and September 2017. The report noted that abuse is affecting all age groups and in all geographic regions in the nation, with the acting head of the CDC saying the epidemic is getting ‘worse.’

This bill is endorsed by the American College of Emergency Physicians, St. Joseph’s Regional Medical Center, America’s Essential Hospitals, the New Jersey Hospital Association, and Colorado Hospital Association.


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