Project Lazarus: community-based overdose prevention in rural North Carolina
Abstract
BACKGROUND: In response to some of the highest drug overdose death rates in the country, Project Lazarus developed a community-based overdose prevention program in Western North Carolina. The Wilkes County unintentional poisoning mortality rate was quadruple that of the state's in 2009 and due almost exclusively to prescription opioid pain relievers, including fentanyl, hydrocodone, methadone, and oxycodone. The program is ongoing. METHODS: The overdose prevention program involves five components: community activation and coalition building; monitoring and surveillance data; prevention of overdoses; use of rescue medication for reversing overdoses by community members; and evaluating project components. Principal efforts include education of primary care providers in managing chronic pain and safe opioid prescribing, largely through the creation of a tool kit and face-to-face meetings. RESULTS: Preliminary unadjusted data for Wilkes County revealed that the overdose death rate dropped from 46.6 per 100,000 in 2009 to 29.0 per 100,000 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 a prescription for an opioid analgesic from a Wilkes prescriber compared with 10% in 2010. CONCLUSIONS: While the results from this community-based program are preliminary, the number and nature of prescription opioid overdose deaths in Wilkes County changed during the intervention. Further evaluation is required to understand the localized effect of the intervention and its potential for replication in other areas.
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Successful strategies to reduce opioid overdoses include wider implementation of rescue medications such as naloxone to reverse opioid overdose and enhanced access to drug treatment with medications such as buprenorphine.
“Successful strategies to reduce opioid overdoses include wider implementation of rescue medications such as naloxone to reverse opioid overdose and enhanced access to drug treatment with medications such as buprenorphine (Albert et al., 2011; Centers for Disease Control and Prevention, 2012; Cornish et al., 2010).”
From National trends in pharmaceutical opioid related overdose deaths compared to other substance related overdose deaths: 1999-2009. (2013) · cites this paper as Albert et al., 2011
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- Authors
- Albert, S., Brason, F. W., Sanford, C. K., Dasgupta, N., Graham, J., & Lovette, B.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Brason, Fred W.
- Venue
- Pain Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-06
- Volume
- 12
- Issue
- suppl 2
- Pages
- S77-S85
- ISSN
- 1526-2375 (ISSN-L)
- 1526-4637
- OpenAlex
- W2157551435
- Cited by
- 210
- References
- 29
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 3 · 2022: 18 · 2021: 9 · 2020: 17 · 2019: 19 · 2018: 11 · 2017: 23 · 2016: 20 · 2015: 27 · 2014: 18 · 2013: 19 · 2012: 8
- FWCI
- 14.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Keywords
- opioid overdose prevention, fentanyl, hydrocodone, methadone, oxycodone, community-based intervention, Wilkes County, North Carolina, opioid prescribing, chronic pain management, primary care provider education, naloxone, overdose surveillance, opioid overdose deaths
- MeSH terms
- Analgesics, Opioid, Humans, Methadone, Naloxone, Narcotic Antagonists, North Carolina, Patient Education as Topic, Risk Factors, Rural Population, Social Welfare, Prescription Drugs, Drug Overdose
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