Ten hospitals in Colorado participated in a 6-month pilot project (Colorado Opioid Safety Collaborative) to reduce opioid use when patients present to the emergency department (ED) with pain. Their goal was to reduce use by 15%, but instead the reduction was 36% on average. The overall decrease amounted to 35,000 fewer opioid doses than were prescribed during the same period in 2016.
When first-line painkillers, such as ibuprofen or acetaminophen, didn’t work for patient pain, rather than turning to the usual second choice—opioids, such as oxycodone, hydrocodone, or fentanyl—providers now try to less addictive alternatives, such ketamine and lidocaine.
According to Claire Duncan, a clinical nurse coordinator at Swedish Medical Center near Denver, the program requires a culture change. Staff are encouraged to change the conversation from pain medication only, to alternatives that help patients better understand and cope with their pain.