Physicians and Medical Professionals

Just as the physiological and anatomical bases for pain and addiction share common neurophysiological pathways, the community-level response to prescription opioid use problems must address pain and abuse/addiction simultaneously.

Drawing upon successful public health campaigns in injury prevention, Project Lazarus created a model for preventing prescription opioid overdose deaths that includes the following 5 components: 1) community activation and coalition building, 2) monitoring and surveillance data, 3) prevention of overdoses, 4) use of rescue medication for reversing overdoses by community members, and 5) evaluating project components. The last 4 steps operate in a cyclical manner, with community advisory boards playing the central role in developing and designing each aspect of the intervention. 

The 5-component strategy created by Project Lazarus is centered around community activation and a strong coalition of partners who have an active interest in preventing prescription overdose deaths. It capitalizes on using existing data sources to provide perspectives on fatal and nonfatal overdoses and serves as a mechanism to evaluate interventions. The multiple levels of prevention efforts and community-based education are intended to reach medical care providers as well as pain patients and nonmedical drug users without exacerbating stigma. School-based prevention education targets vulnerable populations and aims to shift general patterns of substance abuse. The provision of take-home naloxone acknowledges that prevention efforts can fail or take years to have effect and that overdose deaths can be prevented in the community. Finally, evaluations of specific interventions can provide input on how to improve the services. The overall impact is under evaluation, but initial results suggest that the Project Lazarus model of enhanced and coordinated empowerment in responding to overdoses among law enforcement, physicians, and pain patients may be making headway in reversing Wilkes County’s epidemic of drug overdoses. Target communities for replicating the Project Lazarus model include those with high prescription opioid unintentional poisoning rates and some degree of community awareness and coalition building capacity. Target communities for replicating the Project Lazarus model may include those with high prescription overdose rates, some degree of community awareness and coalition building capacity. The presence of a motivated community organizer, support from the medical establishment, and strong data utilization practices are key components for replication.

The Project Lazarus model has been evaluated in peer-reviewed publications. See the evidence here. Here is a presentation by Bill Matthews, PA on Community-based opioid overdose prevention.