Pascrell, Booker Reintroduce Legislation to Extend Alternatives to Opioids Program

Bipartisan Pascrell-authored bill would reauthorize existing ALTO program at $10 million per year for five years

WASHINGTON, DC – U.S. Rep. Bill Pascrell, Jr. (D-NJ-09) and U.S. Sen. Cory Booker (D-NJ) today introduced legislation to officially reauthorize the Alternative to Opioids (ALTO) in the Emergency Department program at $10 million annually over five years. The ALTO program was originally authorized in 2018 by a Pascrell measure that was included in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271). In the House, the legislation is sponsored by Reps. Pascrell, David McKinley (R-WV-01), Diana DeGette (D-CO-01), and Brad Wenstrup (R-OH-02) and in the Senate by Sens. Booker (D-NJ) and Shelley Moore Capito (R-WV).

“The ALTO program we created is an essential tool in our longstanding fight against the opioid crisis. We must continue to fund this lifesaving program with every dollar it needs,” said Rep. Pascrell, the primary House sponsor of H.R. 5197 which established the ALTO demonstration program. “Since 2018, our ALTO legislation has provided a ground-breaking preventative blueprint for hospitals and health care providers across America as they grapple with the opioid epidemic. This program is progressive and forward-looking. Most importantly, it will protect American lives.”

“Successfully addressing the devastating effects and unimaginable pain caused by the opioid epidemic requires a holistic and innovative response such as the one pioneered by St. Joseph’s Medical Hospital in New Jersey for years,” said Sen. Booker. “I’m proud to introduce legislation that will ensure St. Joe’s innovative program can continue to be a blueprint of success for communities, helping us reduce the number of opioid prescriptions written in emergency rooms across our nation.”

“Emergency physicians on the frontlines of the opioid epidemic can attest firsthand at the proven success of the Alternatives to Opioids (ALTO) program,” said Mark Rosenberg, DO, MBA, FACEP, president of the American College of Emergency Physicians (ACEP). “As our communities and families confront the challenge of  opioid use disorder (OUD), the bipartisan ALTO in the Emergency Department Reauthorization Act of 2021 will better equip us with the tools we need to help our patients and communities struggling with opioid use disorders–and most importantly–prevent OUD before it even starts. Personally, I am proud and grateful to continue working with my friends, Representative Pascrell and Senator Booker, to reauthorize this lifesaving program that we originally began right here in New Jersey, and also thank Representative McKinley and Senator Capito for their continued bipartisan leadership on this bill. On behalf of ACEP, I extend our deepest thanks for their tireless efforts to ensure that more Americans have access to the appropriate care they need and deserve.”

In 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded $4,750,000 to ten hospitals and emergency departments across the country for ALTO Demonstration Program. The legislation introduced today will make ALTO a permanent program and provide funding for more hospitals and emergency departments to develop and implement alternatives to opioids for pain management.

As a first line of defense for combatting the opioid epidemic, emergency departments are well-positioned to be laboratories of new innovations to combat the crisis. Eager to try fresh approaches to address the epidemic, the team at St. Joseph’s Medical Center in Paterson, New Jersey, led by its chairman of emergency medicine, Dr. Rosenberg and CEO Kevin Slavin, created the ALTO program. ALTO utilizes non-opioid protocols instead of painkiller prescriptions to treat acute pain. St. Joseph’s launched its ALTO program in 2016, and two years later the number of opioid prescriptions written had decreased by more than 80 percent. In January 2020 alone, St. Joe’s engaged 80 people in the emergency department for recovery support services for opioid use disorder and the hospital is also dispensing Narcan kits for patients who are at high risk for opioid overdose. The model has been so successful that St. Joseph’s has expanded the protocol to other departments within the hospital, and Dr. Rosenberg has travelled the country helping other health systems get ALTO programs up and running.

The opioid epidemic continues to claim the lives of thousands of Americans throughout the United States. According to the Centers for Disease Control and Prevention, drug overdose deaths in the United States rose 29.4% in 2020 to an estimated 93,331, including 69,710 involving opioids. In addition, more than 2.2 million people have an opioid use disorder.