What can communities do?

The Project Lazarus public health model is based on the premises that drug overdose deaths are preventable and that all communities are ultimately responsible for their own health. The model components: (1) community activation and coalition building, (2) monitoring and epidemiologic surveillance, (3) prevention of overdoses through medical education and other means, (4) use of rescue medication to reverse overdoses by community members, and (5) evaluation of project components. The last four steps operate in a cyclical manner, with community advisory boards playing the central role in developing and designing each aspect of the intervention.

Our experience has shown us that the central role of the community advisory boards cannot be emphasized enough. In general the boards are made up of clinicians, parents, health officials, faith community representatives, school and college officials, law enforcement and others. They dictate the specific mix of overdose prevention interventions for their local area. Our national presence gives us access to resources that coalitions would not be aware of, and our practical experience helps us guide the formation and sustainable development of these groups. 

Here are some some of the activities that we have done in Wilkes that we can help you do in your community.

Community organization and activation

1. Town hall meetings
2. Specialized task forces
3. Build community-based leadership
4. Coalition building
5. “Managing Chronic Pain” toolkit assembled

Prescriber education and behavior

1. One-on-one prescriber education on pain management (“academic detailing”)
2. Continuing medical education sessions on pain management
3. Licensing actions against criminal prescribing
4. Promotion of CSRS

Supply reduction and diversion control

1. Hospital ED opioid dispensing policy modified (e.g., limits on amount dispensed at once, required check of CSRS for hospital ED admissions)
2. Unused medication take-back events by sheriff and police departments, with support from DEA and SBI
3. Fixed medicine disposal sites at law-enforcement offices
4. Hiring and training of drug diversion specialized law-enforcement officers

Pain patient services and drug safety

1. Medicaid policy change: mandatory use of patient-prescriber agreements and pharmacy home
2. Support groups for pain patients
3. ED case manager for Medicaid beneficiaries with chronic pain
4. Vetting of local pain clinics and facilitation of specialized pain clinic referrals

Drug treatment and demand reduction

1. Drug detox program
2. Negotiation and support for opening of satellite office-based drug treatment clinic (buprenorphine)

Harm reduction

1. Naloxone prescription
2. Drug user education on overdose prevention and response

Community-based prevention education

1. School-based education, including pledge cards
2. Red Ribbon campaign - warnings not to share attached to dispensed prescription packages
3. Billboard containing message against sharing medications
4. Presentations at colleges, community forums, civic organizations, churches, etc.
5. Radio and newspaper spots