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124X – Addressing the Opiate Crisis: ALTO and ERAS—Novel Approaches to Avoiding Narcotics

Wednesday, March 25th

About the Session

Opiate use and drug-related mortality in America has reached an all-time high with over 70,000 deaths in 2017 and 11.4 million people actively using opioids. Many clinical providers, health systems and state and federal agencies are now examining ways to dramatically curb opioid prescriptions. The ED is one clinical area that is faced with many patients with acute painful medical conditions and injuries. For many patients this can be their first exposure to opiates, making alternative strategies of particular importance in the ED. Perioperative use of opiates can be reduced with an Enhanced Recovery After Surgery (ERAS) program that improves the patient experience and reduces the length of stay.

This seminar will discuss the innovative ERAS and ALTO (Alternative to Opiates) programs. The ALTO program was able to reduce opiate prescriptions by nearly 50 percent with no significant change in pain scores and patient satisfaction at one medical center. This multimodal program uses novel approaches such as ultrasound guided regional anesthesia to block a local body region before painful procedures. In addition to better pain control, this approach significantly decreases hospital length of stay by avoiding deep sedation and requisite monitoring. Find out how the ALTO and ERAS programs have many benefits for patients, clinical providers and health systems.

Learning Objectives:

  • Recognize the unique analgesia needs of the ED and operating room.
  • Examine the benefits of two opiate sparing protocols.


Presented By

Diku Mandavia, MD

Senior Vice President/CMO
FUJIFILM Healthcare

Mark Rosenberg, MD

Chairman, Emergency Medicine
St. Joseph's Healthcare System

Alexis LaPietra, DO

Director, Emergency Medicine Addiction & Mental Health Fellowship
St. Joseph's Healthcare System

Theresa Bowling, MD

Assistant Professor, Anesthesiology
Netter School of Medicine, Quinnipiac University