A growing number of hospitals across the country are rewriting protocols and retraining staff in an effort to minimize opioid prescriptions, PBS NewsHour reports. The changes are most pronounced in emergency departments.

At the University of Kentucky Albert B. Chandler Hospital, emergency room doctors used to give opioid painkillers right away. Dr. Phillip Chang, the hospital’s chief medical officer, says now doctors, pharmacists and nurses use non-opioid pain relievers like Advil or Tylenol first. They try multiple regimens before considering opioids.

In a study of 900 patients treated at the hospital after the new policies were implemented, the trauma unit almost halved the amount of opioids given to patients who had no prior history of chronic opioid use. But there was little change in prescriptions for patients who were already chronically using opioids before admission. The hospital is now training ER doctors to prescribe fewer opioids for drug-dependent patients, and guiding them toward substance abuse treatment when they leave the hospital.