NJ senators tout ALTO program as a national model

Recovering addict Josh Copeland talked about his brutal love affair with opioids. He used to live under a bridge in Paterson. He says it’s a rough road that started with his doctor prescribing addictive pain meds.

“I kept coming back and asking for more and they cut me off. And I transitioned over to street drugs,” Copeland said.

“More often than not, it’s people in pain getting hooked on painkillers in their own medicine cabinets, prescribed by their own doctors, that lead to addiction — Percocet, OxyContin, Vicodin and others. Four out of five new heroin users started out initially misusing pain pills,” said Sen. Bob Menendez.

At a news conference in Paterson, doctors from St. Joseph University Medical Center described their program to avoid the pitfall of overprescribing opioids. They called it ALTO — Alternatives to Opioids. It’s been so successful over the past two years, there are bills now pending in both the House and Senate promoting ALTO as a national model.

“Providing emergency rooms across the country with a blueprint for preventing countless overdoses from happening in the first place,” said Rep. Bill Pascrell.

“The entire team here at St Joe’s saw the crisis and they responded. They didn’t just sit back and curse the darkness, they put forth light,” Sen. Cory Booker said.

“We added more tools to the toolbox. We have many more weapons now to manage pain. And the last thing I go for now is Percocet,” said Dr. Mark Rosenberg, chairman of emergency medicine at St. Joseph’s.

St. Joe’s runs the busiest emergency department in New Jersey, the fourth busiest in the nation. Since 2016, ALTO helped reduce the number of opioid prescriptions issued here by 83 percent. Instead, doctors might target pain with nitrous oxide, or laughing gas. They can inject a nerve block, and often doctors layer different therapies. The hospital reports up to 75 percent of patients achieve adequate pain relief with alternatives to opioids.

“And they are substitutes that work. They are not just removing opioids and saying, good luck,” said the medical director of the emergency medicine pain management program at St. Joseph’s, Dr. Alexis LaPietra. “We are using something that we know will provide effective relief and has been studied.”

Four other hospitals now use St. Joe’s ALTO model. Copeland’s now a recovery coach and lives in an apartment over the bridge he used to call home. He welcomes the ALTO bills as a way to refocus the medical community and its patients.

“I feel if the doctor was more educated on the truth, the patient was more educated on the consequences, I feel like everybody would have been in a better place,” Copeland said.

The ALTO protocols are part of a legislative package slated for discussion in a Senate committee Tuesday. There’s still no estimate for how much it would cost to implement the program nationwide.

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