When Nicole Hayes went home from the hospital with her first baby in 2015 after an emergency C-section, the obstetrician gave her a prescription for a bottleful of painkillers.

In April, when Hayes gave birth to twins, the discomfort following their delivery via Caesarean was worse. But this time, instead of opioids, her doctor ordered a steady regimen of Tylenol and Motrin — a combination that muted the pain without risk of addiction.

Hospitals are now on the front lines of fighting the opioid epidemic, choosing ways to treat pain without causing addiction.

With one in five patients who use opioids for 10 days — even as directed — likely to be using them a year later, the drugs doctors use to address pain are judged not only for the comfort they provide, but for their potential harm as gateways to addiction.

St. Joseph's University Medical Center in Paterson pioneered the use of opioid alternatives to treat pain in its emergency department, an effort that has been nationally recognized. Now the drive to reduce opioid prescriptions has spread to obstetrics, dentistry and other medical specialties at the hospital.

Nerve blocks, trigger-point injections, lidocaine patches and even nitrous oxide — laughing gas — are replacing prescriptions for OxyContin or Vicodin. And old medicines— ibuprofen and acetaminophen — are being used in combination.  

Just last week, the U.S. House of Representatives passed a measure that would fund the expansion of St. Joseph's Alternatives to Opioids (ALTO) program as a model for emergency departments nationwide.

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