After creating successful opioid-reduction program, DOs share tips

Recognizing the havoc the opioid epidemic was wreaking on their community, Alexis LaPietra, DO, and Mark Rosenberg, DO, recently implemented new treatment protocols for common pain conditions at the nation’s second-busiest emergency room: St. Joseph’s Regional Medical Center in Paterson, New Jersey. The hospital’s new Alternatives to Opioids (ALTO) program advises physicians to pursue non-opioid therapies first for the five most common pain conditions in the ER.

Since launch, the innovative program has landed attention from NPR and the New York Times. In five months, the ER has seen a 38% reduction in opioid use overall, and, according to preliminary data, an up to 75% decrease in opioid use in treating the five conditions for which new protocols were developed, says Dr. Rosenberg, the chair of emergency medicine for St. Joseph’s Health System.

Behind these efforts are two DOs who, a few years ago, had some novel ideas and a desire to make them a reality. Below, Dr. LaPietra, the hospital’s medical director of emergency medicine pain management, and Dr. Rosenberg share their advice for other osteopathic physicians interested in standing out as thought leaders and creating change within their institutions.

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Follow your passion, even if others discourage you

“People told me, ‘there are pain management doctors, why do we need more pain management in the ER?'” Dr. LaPietra says. “Well, apparently we can do better.”

Seek out people who support you

While researching alternative treatments to opioids during a fellowship, Dr. LaPietra began hearing from other physicians with similar interests who offered critical support at a time when she wasn’t sure her efforts would be well-received or popular.

“Don’t be afraid to speak out about what you are doing because you are probably not alone,” she says. “Sometimes we think we’re standing alone, but there’s bound to be somebody out there who will partner with you. Stand up for what you believe in, and people will come out of the woodwork. You may be able to make fantastic changes that you never imagined.”

Consider advocating for change to reduce opioid use at your institution

“Right now, the iron is hot,” Dr. Rosenberg says. “Every single institution in the U.S., every university, every agency is looking for physicians to collaborate and partner with them to decrease the drug problem. You have the chance now to get involved and create meaningful change that will save lives.”

Recognize that change is hard

“It’s hard to implement change,” Dr. LaPietra says. “If people really want to impact their patients’ lives, they have to dig deep for that passion to make change and appreciate that their efforts have the potential to save lives.”

Make it a priority

Set aside time to examine your hospital’s processes and areas that could be improved, Dr. LaPietra suggests, and make time to investigate the literature so you can start to build an evidence base for the changes you’d like to make.

Let your osteopathic training guide your efforts

“When you are a DO, every aspect of your training supports treating the whole patient,” Dr. Rosenberg says. “When we address pain, we consider not just the injury, but the total body’s response to the pain. The osteopathic profession has always looked at the complete patient.”