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Understanding Pain: What to do about it in less than five minutes?
New evidence based approaches to chronic pain management.
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CCNC and Project Lazarus: Chronic Pain and Community Initiative
Community Care of North Carolina (CCNC), in conjunction with non-profit organization Project Lazarus, is responding to some of the highest drug overdose death rates in the country through its Chronic Pain Initiative (CPI).
Goals:
- Reduce opioid-related overdoses
- Optimize treatment of chronic pain
- Manage substance abuse issues (opioids)
The Wilkes County Experience
The CPI approach is modeled on a highly successful Wilkes County overdose prevention program known as Project Lazarus. 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 (see graph below), 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%.
Evidence exists that the Wilkes County approach is changing conditions in ways that will reduce misuse, abuse, diversion and overdose from prescription opioids.
- Changes in how medical professionals manage chronic pain patients and monitor their prescription use.
- Change in policy and practice within ED of Wilkes Regional Medical Center
- Increased access to Naloxone and understanding of when and how to use
- Pill take-back days
- Community awareness, coalition building for community education
For more information contact: Jeff Pruett, Chronic Pain Program Specialist | [336] 235-0930 Ext: 334