A nonprofit program credited with reducing prescription drug overdose deaths by 69 percent in one North Carolina county is going statewide this year with a $2.6 million grant from state and private sources.
Community Care of North Carolina will oversee the expansion of Project Lazarus, which has helped bring down Wilkes County’s soaring overdose death rates, said Michael Lancaster, director of behavior health for Community Care, a network of medical providers and services. Project Lazarus promotes safer practices surrounding how drugs are prescribed by doctors, dispensed by pharmacies and stored by consumers.
“The program was so successful in Wilkes County that we are ready to take it statewide and see if we can make it work in urban as well as rural areas,” Lancaster said.
Deaths from prescription drug overdoses – also known as unintentional poisonings – are rising faster in North Carolina than in the rest of the nation. Overdose rates increased by more than 300 percent between 1999 and 2011, the most recent figures available.
The N.C. Department of Health and Human Services reported 297 overdose deaths in 1999 and 1,140 in 2011. Health officials say most of the deaths involved opioid pain medications such as oxycodone, methadone and hydrocodone.
Project Lazarus was lauded by Gil Kerlikowske, director of U.S. National Drug Control Policy, in a report the White House submitted to Congress this week. Kerlikowske said a visit to Wilkes County last August to see the project at work led him to focus on the prescription overdose epidemic in his latest report.
A dramatic change in Wilkes
Wilkes County has been especially hard hit by the problem, said Project Lazarus founder and director Fred Brason II.
The county had the highest rate of overdose deaths in the state before Project Lazarus was started. In 2009, there were nearly 47 deaths per 100,000 residents compared with 11 per 100,000 statewide.
However, between 2009 and 2011, the overdose rate in Wilkes County fell to about 14.3 per 100,000 residents, while the statewide rate edged up slightly to 11.8.
Brason said nearly three-quarters of lethal overdose cases are linked to family members or friends of the victim. The drugs may have been stolen, illegally sold or shared.
“The key elements in the program involve public awareness, not only of the issue but the behaviors people have that contribute to the problem,” Brason said.
The N.C. Child Fatality Task Force drew attention to drug overdoses earlier this year in its annual report, which noted the number of overdose deaths for children and teens was up even though overall child fatalities were falling. Drug abuse is surpassing motor vehicle crashes as the leading cause of injury death among all age groups in the country, the report states.
Statehouse joins the fight
Legislation filed in General Assembly this session also addresses the issue. The Good Samaritan law signed by Gov. Pat McCrory earlier this month gives protection from prosecution on certain drug- and alcohol-related charges to people who seek medical help for themselves or another person experiencing an overdose. Brason said the measure should help encourage bystanders to call for medical help for overdose victims.
A second piece of legislation still under debate requires pharmacies, emergency rooms and other dispensaries to report to the state within three days of filling a controlled substance prescription. That measure would provide a more efficient way to keep track of patients who obtain multiple prescriptions over a short period of time, said Brason, who backs both bills.
“The important factor on all fronts is community- and state-level collaboration, and we are now achieving that in North Carolina,” Brason said.
Project to distribute ‘tool kits’
Under Project Lazarus, counties will receive between $7,000 and $10,000 each to implement programs for public education and distribution of “tool kits.”
Pill take-back days are a way communities can encourage citizens to turn in unneeded medications and prevent them from falling into the wrong hands, said Lancaster of Community Care.
Patients will receive tips for safely storing their prescriptions, and doctors will learn better techniques for keeping track of medicines once they are prescribed, he said.
Emergency departments also will be encouraged to adopt a case management referral system for patients suffering from persistent pain.
The expanded program is being paid for through grants from the Kate B. Reynolds Trust and the state Office of Rural Health. The program will award $10,000 each to 30 of North Carolina’s lowest-income counties, according to the terms of the Kate B. Reynolds Trust grant. The other counties will receive $7,000 each, Lancaster said.
He said each program will be operated through an existing agency, such as a health department, sheriff’s office or school system, based on local community needs.