ER reduces opioids by more than half using laughing gas

A hospital in New Jersey has halved the rate of opioid prescriptions since 2016 using dry needles and laughing gas to treat pain from broken bones and muscle spasms.

St. Joseph’s University Medical Center in Paterson, New Jersey launched an Alternative to Opiates program in 2016 that uses trigger point injections and a local anesthetics to relieve pain in ER patients.

More than 115 Americans die from an opioid overdose each day, and the crisis has been linked to hospitals since the drugs are commonly prescribed for chronic pain.

Doctors claim laughing gas and dry needles are more effective than opioids and hope similar programs will be implemented at hospitals across the country.  

Doctors at St. Joseph's University Medical Center are substituting opioids with other pain-relieving methods like laughing gas and dry needles

Doctors at St. Joseph's University Medical Center are substituting opioids with other pain-relieving methods like laughing gas and dry needles

Doctors at St. Joseph’s University Medical Center are substituting opioids with other pain-relieving methods like laughing gas and dry needles

Dr Mark Rosenberg, chair of emergency medicine, told Daily Mail Online he and his colleagues created the program after they realized chronic pain was one of the reasons most patients came to their emergency department.

‘We wanted to develop an aggressive acute pain management program that focused on evidence based principles but avoided opioids,’ Dr Rosenberg said.

Since the implementation of this program, he said there’s been a 57 percent drop in the ER’s opioid prescriptions. 

ER patients at this hospital are given laughing gas, or nitrous oxide, and dry needles — which are inserted into the skin or muscle — to treat painful symptoms of various diagnoses, including kidney stones and muscle spasms, NPR reported.

Laughing gas is a painkiller and sedative agent commonly used in dental offices. However, in recent years it has appeared in ambulances to help relieve patient’s pain and anxiety.

Dr Rosenberg, who helped launched the Alternative to Opiates program in 2016, said dry needles and novocaine like injections — a local anesthetic drug – into an area or muscle spasm provides great relief for patients.

These methods, which can be used in combination or separately, can treat migraine headaches, back pain, fractures and ‘many other pain symptoms,’ Dr Rosenberg said.

Jonathan Milton, of Jersey City, New Jersey, became a patient of the Alternative to Opiates Program after suffering a muscle spam from his left hip down to his leg due to a fall.


Prescription opioids and illicit drugs have become incredibly pervasive throughout the US, and things are only getting worse.  

In the early 2000s, the FDA and CDC started to notice a steady increase in cases of opioid addiction and overdose. In 2013, they issued guidelines to curb addiction. 

However, that same year – now regarded as the year the epidemic took hold – a CDC report revealed an unprecedented surge in rates of opioid addiction.

Overdose deaths are now the leading cause of death among young Americans – killing more in a year than were ever killed annually by HIV, gun violence or car crashes.

Preliminary CDC data published by the New York Times shows US drug overdose deaths surged 19 percent to at least 59,000 in 2016.

That is up from 52,404 in 2015, and double the death rate a decade ago.

It means that for the first time drug overdoses are the leading cause of death for Americans under 50 years old.

The data lays bare the bleak state of America’s opioid addiction crisis fueled by deadly manufactured drugs like fentanyl.

‘I was so much in pain — tears were coming out my eyes,’ the 43-year-old told NPR.

Milton previously visited that ER a shoulder sprain in 2011 and was prescribed Percocet, an opioid — since that was the hospitals primary way of dealing with chronic pain back then.

But this time, doctors gave him a patch of lidocaine — medication used to numb tissue in a specific area — and told to take Motrin or Tylenol and to stretch.  

He left the hospital that day with no opioids.

‘The goal [of the Alternative to Opiates program] is to give Emergency Physicians more options,’ Dr Rosenberg said. ‘The real goal is to uses a multi-model approach to managing pain. A layering of treatments.’

Doctors at the hospital said dry needling, which can also be used to treat muscle spasms, is more effective than an opioid pill. 

‘Because [muscle spasms are] so contained, it’s hard for that medication to actually get into the spasm,’ Dr Alexis LaPietra, the medical director of pain management in the emergency department, told NPR.

She also said that, unlike an opioid pill, dry needles can effectively stop the spasm and pain by breaking up the muscle tissue.

Dr Rosenberg told Daily Mail Online that laughing gas and dry needles are just an example of many treatments that they use.

Other methods include music — they have a harpist roam the halls while playing tunes to soothe the patients — warm compressors, and ultrasound to find nerves so they can inject numbing agents, NPR reported.  

The doctors are continuing to investigate other pain-relieving approaches like acupuncture and spinal manipulation, or a technique that combines moving and jolting joints, massage, exercise, and physical therapy.

Pranic healing — a natural healing technique that uses breathing to treat illnesses — is also being explored, he said.

‘We have to go back to times when things were a little more simple,’ LaPietra said. ‘Those easy, at-home techniques — good patient education, really — they help a lot with some of that pain that patients have to deal with when they go home.’

Dr Rosenberg said the program can help curb the opioid crisis and would like for the program to expand to other hospitals. 

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