Emergency Physicians Champion Alternatives to Opioids

Emergency physicians worked with Congress to pass opioid legislation critical to improving emergency overdose prevention and care coordination, as well as optimizing pain management in emergency departments. 

ACEP worked closely with Congress to develop the Alternatives to Opioids (ALTO) in the Emergency Department Act (H.R. 5197/S. 2516) and the Preventing Overdoses While in Emergency Rooms (POWER) Act (H.R. 5176/S. 2610) to ensure that emergency physicians are equipped with the tools they need to fight the opioid epidemic from both a prevention and treatment standpoint and provide patients with the care they need.

In a significant victory for emergency medicine and patients, Congress provided funding for these initiatives at the end of 2019. This ensures that the programs can expand into more communities in 2020.  

ALTO makes sure that physicians and others in the emergency department consider non-opioid treatment options (nerve blockers, over-the-counter-medications, or others) first. The program is based on the successful ALTO program developed in New Jersey and recently tested in Colorado.

The POWER Act provides grants to establish policies and procedures for initiating Medication-Assisted Treatment (MAT) in the emergency department. As the Surgeon General writes in Annals of Emergency Medicine:

“Emergency physicians have been and always will be the all-too-necessary safety net for many individuals, and an especially important partner in combating the opioid overdose epidemic. Great strides have been made in a short time, but we cannot become complacent in our fight against an evolving enemy. America’s patients and communities need emergency physicians to redouble their efforts, challenge their colleagues and institutions to do more, and partner to work upstream, now more than ever.”

Efforts like the POWER Act support education and additional resources to help implementation of MAT in the emergency department and develop best practices to provide a “warm handoff,” ensuring a patient is directed to appropriate community resources and providers to stay engaged in treatment.

Emergency physicians are experts in pain management

Many emergency departments are pursuing accreditation in pain management through the American College of Emergency Physicians Pain and Addiction Care in the Emergency Department (PACED) program. 

These emergency departments are establishing and meeting the standards for the highest-quality addiction and pain management. These programs guide efforts to reduce the need for additional ED visits and provide effective treatments for pain and addiction while minimizing the use of opioids.

There are three levels of PACED accreditation, culminating in a Gold Level award that indicates an emergency department is led by a collaborative multidisciplinary team within the hospital and community, has developed and deployed a comprehensive program for patients suffering from pain or addiction, and meets the highest standards for safety and quality in treatment, protocols, training and resources.

Advocating for Better Patient Care

The American College of Emergency Physicians (ACEP) is working hard to protect vulnerable patients, especially those struggling with mental health challenges and/or substance or opioid misuse.

Emergency physicians continue to push for additional resources for communities nationwide to encourage collaborative care in and out of the emergency department. If a patient does require emergency care for an overdose, initiatives like the PACED program rely trained emergency physicians being able to administer Medication Assisted Treatment (MAT) to patients who need it.

These efforts require increasing access to naloxone and changes to the waivers and certifications that enable doctors to provide lifesaving care as soon as it is needed at the emergency department.

ACEP is proud to continue working with Congress, regulatory agencies and others to make sure that every patient can get the care they deserve anytime they need it, during the pandemic and beyond. Emergency physicians are proud of the progress being made to fight the opioid epidemic. But there is still much work to be done.

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