This publication of the Bureau of Justice Assistance (BJA) Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) discusses the implementation of alternatives to opioids (ALTO) programs.
In this publication, the Bureau of Justice Assistance (BJA) Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) discusses alternatives to opioids (ALTO) programs in New Jersey, Colorado, Michigan, Illinois, and Wisconsin. Prescribing opioids to patients increases their risk for long-term opioid use and misuse, and this risk may be greater among certain population groups, such as those with a history of substance use or a mental health diagnosis. In the past five years, this knowledge has resulted in practitioners and policymakers establishing new guidelines for opioid prescribing. In addition, multiple hospital organizations have implemented alternatives to opioids (ALTO) programs. These programs emphasize the use of nonopioid therapies as a preferred first-line treatment for pain. This article discusses three ALTO programs and provides examples of nonopioid therapies that are being used to effectively treat pain. Because people in substance use disorder treatment or recovery are vulnerable to long-term prescription opioid use and misuse, they may wish to avoid opioids when being treated for pain. Therefore, it is important that they be aware of ALTO programs and be empowered to advocate for their adoption when interacting with medical professionals. Individuals who work with this population in different settings also may benefit from this information, as well as those in emergency department (ED) and inpatient medical settings interested in implementing an ALTO program.