Project Lazarus (Archived)

A Community Response to Chronic Pain Treatment

In January 2012, CCNC kicked off a statewide chronic pain initiative, building on the success of the Project Lazarus pilot project in Wilkes County which began in mid-2000s. In January 2013, CCNC received a 1.3 million dollar grant from the Kate B. Reynolds Charitable Trust, including a match from the Office of Rural Health, intended for further implementation of the Wilkes County Project Lazarus Pilot.

CCNC adopted the Project Lazarus hub and spoke model and began our work establishing community coalitions.  As of June 2016, 74 counties throughout North Carolina had established and maintained community coalitions. 

Project Lazarus Toolkits

To assist partners in this initiative, CCNC developed a series of toolkits aimed at providing information and resources to key players in chronic pain treatment:  care managers, emergency room physicians and primary care providers.  Kits were distributed to Chronic Pain Initiative Coordinators in each of CCNC's 14 local networks.  These documents can be downloaded in PDF form via the links below:

Project Lazarus Training

Project Lazarus conducted both clinical training and community training sessions.

  • Clinical training was aimed at providing guidance to clinicians and prescribers on the medical assessment and treatment of chronic pain and the use of opioids. Attendees included care managers, primary care physicians and emergency room physicians and dentists.
  • Community training broadened awareness of unintentional poisonings and chronic pain issues, and bolstered community involvement in prevention and early intervention. Attendees included a broad range of community partners including law enforcement, public health, schools, hospitals and faith based organizations.

Background:  The Wilkes County Experience

CCNC's statewide program was modeled on a highly successful overdose prevention program pioneered in Wilkes County, North Carolina. The program began with a series of public meetings organized by the Wilkes County Health Department to heighten community awareness of the county’s exceptionally high rate of mortalities attributable to overdoses of prescribed opioid pain relievers. In 2008, Project Lazarus, a secular, non-profit drug overdose prevention program, was formed to develop and disseminate a set of strategic action plans for the community and tool kits and medical training for local medical care providers to address opioid misuse and abuse.

An evaluation published by members of the Project Lazarus study team found that the implementation of their program in  Wilkes County generated a 47% reduction in the overdose death rate from 2009 to 2010. More recent data show that the overdose death rate in Wilkes County decreased by 69% between 2009 and 2011, from 46.0 to 14.4 per 100,000 per year, even as the level of opioid prescribing remained above the state average. Substance abuse-related ED admissions dropped by 15.3% from 2008 to 2010, in marked contrast to an increase in such admissions statewide of 6.9% over this period. Most remarkably, in 2011 not a single prescription overdose decedent received a fatal prescription from a Wilkes County prescriber, down from 82% in 2008. As of 2010, 70% of the county’s prescribers were registered with the State’s prescription drug monitoring program, compared to a statewide average of only 26%.  Data from Wilkes County suggest that the Project Lazarus had an impact within two years of its initiation, and that strong effects were apparent by the third year.

Project Lazarus in the Media