252252 Replication of Project Lazarus comprehensive community based model to reduce opioid medication overdoses among active duty soldiers determined to be at risk within select US military bases by implementing the naloxone rescue component as Standard Operating Procedure

Tuesday, November 1, 2011: 11:10 AM

Fred Brason II, Chaplain , Project Lazarus President & CEO / Chronic Pain Initiative Project Director, North Carolina Community Care Network, Moravian Falls, NC
Improvements in battlefield protection and evacuation have led to higher survival rates after combat injury during OIF/OEF than in previous military actions. A higher survival rate has resulted in the need for expanded management strategies for pain resulting from battlefield injuries, specifically blast injuries. Chronic pain is a common occurrence among combat-injured soldiers, as well as a common co-morbid condition in soldiers suffering from post-traumatic stress disorder (PTSD) and/or traumatic brain injuries (TBI). The Military Traumatic Brain Injury (TBI) Task Force (2007) reported that 30% of those treated for combat injuries have TBI, and many more exhibit subclinical TBI symptoms. TBI, PTSD and chronic pain are inseparable conditions that must be managed simultaneously.

The effectiveness of opioid treatment for chronic pain in this population is an area of active research further complicating clinical practice. Opioid treatment is not without risks, and the active duty population has elevated risk factors for experiencing chronic pain as well as prescription opioid addiction, abuse, misuse, overdose, and death compared to their civilian counterparts.

Currently, there are few public health initiatives to address the epidemic of fatal overdoses from prescription drugs. Operation OpioidSafe of Ft Bragg, NC is based upon work conducted by the traditional community-based public health intervention by Project Lazarus of Wilkes County, NC. The most novel aspect of the program is the provision of rescue medication (naloxone) as a safety net for those who use opioids and are not willing or capable of responding to efforts to prevent opioid overdose and abuse.

Learning Areas:
Public health or related public policy

Learning Objectives:
Describe US Military implementation of intranasal naloxone distribution among active duty soldiers; causes for, strategy of and educating and engaging family, peer and superiors for administration.

Keywords: Drug Abuse Treatment, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Fred Wells Brason II is qualified to present as abstract Author as he is the President/CEO of Project Lazarus, a community opioid overdose prevention model and Project Director, Chronic Pain Initiative of the Community Care Network of NC, North Carolinaís Medicaid Management System. Project Lazarus has collaborated with Womack Army Medical Center of Ft. Bragg Army base, NC and Ft. Campbell in KY to establish Operation OpioidSafe to prevent active duty soldiers accidental poisoning form opioid medication. Fred serves on the SAMHSA/CSAT Emerging Opioid Overdose Surveillance Group, is a member NC Division of Medical Assistance Task Force for misuse, abuse and diversion of prescription narcotic drugs, Governorís Focus Group on Veterans, Military Service members and their families, the National Association of Drug Diversion Investigators (NADDI), serves on the Advisory Board for the NC Controlled Substance Reporting System and Co-Chairs the SAMSHA/ASTHO/NASADAD expert panel for OTP prescriber toolkit publication. Preliminary unadjusted data for Wilkes County, home of Project Lazarus, reveals that the overdose death rate per 100,000 for accidental drug overdoses dropped from 46.6 deaths in 2009 to 27.0 in 2010. There was a decrease in the number of victims who received prescriptions for the substance implicated in their fatal overdose from a Wilkes County physician; in 2008, 82% of overdose decedents received an opioid analgesic prescription from a Wilkes prescriber, compared with 10% in 2010. Additionally, Emergency Department visits for substance abuse and/or accidental poisoning decreased by 13% from 2009 to 2010.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Purdue Pharma L.P. Opioid Overdose Prevention Consultant and Unrestricted educational grant for Project Lazarus

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.