March 10, 2016
More than 44 people die every day in the United States from overdosing on prescription painkillers, according to the Centers for Disease Control and Prevention (CDC). Drug Free MHC, Piedmont Community Services and partners across the region are stepping up the fight against prescription drug abuse in Martinsville and Henry County.
“Every community in the U.S. has issues with prescription drug abuse – this is a multi-generational epidemic. We have to reach every person of every age,” said Fred Wells Brason II.
Brason led a seminar Wednesday, March 9 at New College Institute detailing the program Project Lazarus, and how it worked to reduce the drug poisoning mortality rate in Wilkes County, N.C. by 69 percent in four years.
Brason said in 2004, nobody was talking about prescription medications or heroin abuse outside of urban areas. Coming from a background as a hospice director who took care of patients in their homes, Brason said he started to have issues with prescription medications.
“Many (prescription drugs) for those patients ended up getting sold and they were abused – I could no longer safely write prescriptions for those patients, but that didn’t mean they didn’t need them.”
Brason said many people who wanted to help asked, “What’s the one thing we can do to make a difference?”
“There isn’t one thing,” he said. “It takes everyone in the community, and that’s what we did in Wilkes County. It was our house, and we needed to fix it. No one was coming from Raleigh. No matter what statutes, policies or procedures they enact, we were the ones who had to implement it in our communities.”
According to the CDC, Wilkes County had the third highest drug overdose death rate in the nation. Brason said they immediately went into crisis mode and developed a plan that started with following the trail of prescription drug abuse.
“It starts with a prescription to somebody, somewhere,” he said. “We started to investigate every overdose. If someone died from an accident, we can find that trail. In doing so, we can find an intervention somewhere in that trail to stop someone else from following that path.”
A number of reasons lead to prescription drug abuse, including patient misuse, family and friends sharing to self-medicate, accidental ingestion or recreational use. Brason said many family members don’t realize sharing certain medications with others is a felony, and that even sharing one pill can lead to an accidental death.
“Prescription drug abuse affects people of all types,” Brason said. “It has nothing to do with age, socioeconomic status, gender, age or race. Some people are crying out for us to help them, and others are crying out that we need to do something. I’m not stepping between a prescriber and a patient, and I’m not saying that prescriptions shouldn’t be written. We’re saying prescriptions should be safe and appropriate.”
Project Lazarus Model
The Project Lazarus model is conceptualized as a wheel with three core components and the spokes, which are initiatives based on specific community needs. The hub includes public awareness, coalition action and data evaluation.
Every subset of a community needs to be involved in the model, according to Brason. He mentioned a variety of subsets including faith-based communities, law enforcement, schools, local government, hospitals and medical practices. He said they distributed fact sheets to each subset detailing why they’re needed and what they can do to help.
“That’s how we begin to change our community,” Brason said. “Addiction drives behavior and gets people to do things they never thought they would do in their entire lives. How do you change the individual? You don’t. You change the village with messaging, materials and capitalizing on the resources you have. As a community, admit you have a problem and take ownership. If you don’t get it on top of the table, you’ll never deal with it.”
A variety of initiatives started through Project Lazarus in Wilkes County led to increased community education, changes in how medications are prescribed in emergency rooms, alternative treatments for chronic pain, an increase of pill drop off locations and many other positive outcomes. Brason said what really made a difference was having a solid safety net in place.
“When we started, this wasn’t easy,” he said. “We had some angry people in emergency departments telling us their patient satisfaction scores were down and complaints were up. But they stuck with it for a year. After that, visits went down, revenues went up, and we made sure a case manager was available to get appropriate referrals. You have to get that network together.”
Part of that network in Wilkes County is Lazarus Recovery Services, a program that helps people get or stay in recovery. It provides housing, food, job placement assistance, and assistance for individuals whose children were placed in another home by social services. Brason said the program utilizes peer support specialists, who can offer patients in need someone to talk to who knows exactly what they’re going through.
Rounding up his talk was a brief overview on naloxone and how it’s used on people who have overdosed on opioids.
“The side effect of opioid overdose is respiratory depression – they stop breathing,” Brason said. “Many people in Wilkes County died at home and never made it to the ambulance or the emergency room. It can take an hour to get from one end of the county to the other.”
Brason said it’s important to educate lawmakers and the public on prescribing naloxone to people who may be at risk for opioid overdose. He said it also should be made available to their family members, friends, and others who know someone at-risk.
“We had a mother who called us irate because she told us naloxone enabled drug users,” Brason said. “But in the same call, she told us how her son overdosed and was revived. Public education on this is necessary. You have nothing to lose by prescribing it – you can save a life. There’s a lot more to lose by not getting it.”
Moving forward in MHC
“I hope going forward that we’ll be able to put this information to use so we can better impact our community, he said. “One thing I’ve noticed about this community is that we’re great at coming together and identifying the problem, but we need to become better at doing something to fix the problem. We have the action steps and information, so we have to find a solution.”
For Mary Kate Dillon, coordinator of Partnership for Success at Piedmont Community Services, having Brason to speak to the community was a catalyst for moving forward in Martinsville and Henry County.
“I think we’ll definitely use Project Lazarus as a guideline of something that works,” she said. “Moving forward, we’ll be using this entire first year for the assessment phase. Implementation most likely won’t happen for about two and a half years. But we’re all ready to get going.”
Around 50 people attended the morning seminar including representatives from public safety, public health, law enforcement, recovery and treatment programs, the faith-based community and the military.
“We had a great cross-section of many groups from throughout our community in attendance today,” said Bonnie Favero, prevention manager at Piedmont Community Services. “We’re excited to start working on this issue in our community with so many partners.”
Wednesday evening, Brason joined Dr. Anthony Dragovich in a training seminar for health care providers that focused on evidence-based methods for health care professionals to reduce harm and overdose from prescription medications.
Dragovich is a board-certified anesthesiologist and pain medicine physician, working to further medical understanding of pain medicine and public awareness.
A federal Drug Free Community Support grant of $625,000 and a SAMHSA Partnership for Success grant of $500,000 were awarded to FRESH Coalition and Drug-Free MHC to reduce substance abuse and drug overdose deaths throughout the area. These events were sponsored by Drug-Free MHC and the Harvest Foundation.
Select News Year: