249574 Energizing the Community to Reduce Drug Overdoses: The Project Lazarus Model

Monday, October 31, 2011: 3:10 PM

Catherine (Kay) Sanford, MSPH , Retired epidemiologist, Durham, NC
Nabarun Dasgupta, MPH , Department of Epidemiology, UNC School of Global Public Health, Chapel Hill, NC
Fred Brason, Chaplain , Wilkes Healthy Carolinians Council, Project Lazarus, Northwest Community Care Network, N. Wilkesboro, NC
Background: In response to one of the country's highest mortality rates from drug overdoses, Wilkes County, North Carolina developed Project Lazarus, a prevention program based on three premises: 1) communities are ultimately responsible for their own health, and 2) while programs need public health steps, 3) they must also have a safety net that includes supply, demand, diversion and harm reduction. Methods: Starting in 2007, Project Lazarus created an iterative model for preventing prescription opioid overdose deaths: 1) community activation and coalition building, 2) epidemiologic monitoring using surveillance data, 3) prevention of overdoses, 4) use of rescue medication and education for reversing overdoses by community members, and 5) program evaluation. Community advisory boards play the central role in intervention development and implementation. Results: The Wilkes overdose death rate dropped from 46.6 per 100,000 in 2009 to 28.5. In 2010 emergency care for substance abuse and accidental poisonings decreased 13%. Currently, more than 70% of controlled substance prescribing clinicians are registered to use the state's prescription monitoring program. The matching of medical examiner investigations to the state's prescription monitoring registry indicated that the number of victims who received prescriptions for the opioid implicated in their fatal overdose from a Wilkes County physician decreased from 82% in 2008 to 10% in 2010. Conclusions: After 3 years, Project Lazarus has begun to reduce the burden of opioid overdose mortality. However, public health programs must openly acknowledge the difficulties in changing behavior and set realistic time frames for intervention to take effect.

Learning Areas:
Administer health education strategies, interventions and programs
Advocacy for health and health education
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs

Learning Objectives:
1. List the 5 community activities that constitute the Project Lazarus model. 2. Describe three typical data sources to monitor program outcomes. 3. Identify at least 3 potential community partners that might be used in your community to implement a drug overdose prevention program.

Keywords: Community Health, Drug Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an injury epidemiologist with a research and program background in drug overdose prevention and harm reduction
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Purdue Pharma LP overdose prevention Independent Contractor (contracted research and clinical trials)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.