The New Jersey hospital isn't doing anything ground breaking. I've worked in a couple of ER's that tout "no narcotic" treatment. There are truths and lies with all of it. There will ALWAYS be that one Doc that gives them, and the masses will learn what he or she drives to work. There also will be that one Doc that adheres to the policy and will send home that fractured tib/fib with ibuprofen that you will get to see again because their pain is out of control. Did it change drug seeking behaviors? Not that I saw. It may have decreased a few lortab on the streets, but why buy lortab when heroine is dirt cheap? Tramadol is the new pain med in the ER. I just long for the days of common sense, when you could look a patient in the eye and say "you stubbed your toe....it doesn't require an opioid and when follow up with you PCP meant something.