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Manatee Memorial has seen a dramatic reduction in opioid use. Here's how it happened.

With its emergency room changing how and when it prescribes opioids, Manatee Memorial has seen a dramatic decrease in their use.

In February, Manatee Memorial Hospital and Lakewood Ranch Medical Center began implementing a new method in their Emergency Care Center ALTO, or Alternatives to Opioids. In that time, Manatee Memorial has seen a 36 percent reduction in the amount of hydrocodone, hydromorphine, morphine and oxycodone it has dispensed or prescribed in its emergency department.

Manatee Memorial boasted its success using the program during a visit Monday from Congressman Vern Buchanan, R-Longboat Key.

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Manatee Memorial Hospital staff and leadership discuss their response to the opioid crisis with Congressman Vern Buchanan, describing their ALTO Program through the Emergency Care Center. Tiffany Tompkins ttompkins@bradenton.com

Hospital staff discussed how opiods no longer are a first-line of defense. To implement the protocols, emergency care staff were trained in the new protocols. But it is not just about educating staff; patients are also being educated when they come into the emergency care center.

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"There's a whole host of therapies out there so just not jump to the opioid right away," said Dr. Candace Smith, chief nursing officer.

Examples of the alternatives are intravenous lidocaine for renal colic pain or Tylenol, non-steroidal anti-inflammatory and topical pain killers such as a patch for lower back pain. When opioids are prescribed, those prescriptions are limited to a three-day supply, a change made even before Gov. Rick Scott signed legislation into law making that a state-wide standard.

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Manatee Memorial Hospital CEO Kevin DiLallo discusses their response to the opioid crisis with Congressman Vern Buchanan, describing their ALTO Program through the Emergency Care Center. Tiffany Tompkins ttompkins@bradenton.com

"If we can reduce the amount of these drugs that they're administering ... you're going to kill a lot less people because what I heard today, 5 or 10 percent of people that take the first drug can very well get addicted and could be dead in a short period of time," Buchanan said. "These drugs are highly addictive."

In addition to the prevention initiatives in educating providers and the community, the multi-pronged approach includes changing protocols and medication assisted treatment for pain management, community outreach on the alternatives to opioids and outreach for pregnant women to prevent the number of infants born with neonatal abstinence syndrome.

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Manatee Memorial Hospital CEO Kevin DiLallo discusses their response to the opioid crisis with Congressman Vern Buchanan, describing their ALTO Program through the Emergency Care Center. Tiffany Tompkins ttompkins@bradenton.com

Within the first two weeks of implementing the new approach, Manatee Memorial saw a 13 percent decrease in opioid use.

But there is more that needs to be done, Smith explained. If other local hospitals or medical providers don't adopt similar protocols, patients will be able to "doctor shop," bouncing from one provider to the next until they get the amount of drugs they want.

"We have to educate the community and give them options, give them a place to go," Smith said.

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Manatee Memorial Hospital Chief Nursing officer Candace Smith, right, and leadership discuss their response to the opioid crisis with Congressman Vern Buchanan, describing their ALTO Program through the Emergency Care Center. Tiffany Tompkins ttompkins@bradenton.com

To get there, funding is needed, she explained. Funding would allow the hospital to host community coalition sessions and help orchestrate regional summits to share and standardize best practices.

Buchanan agreed that more needs to be done.

"I think we need more help here than anywhere else," Buchanan said.

Staff also have been working with Medicaid providers and commercial insurance companies.

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