Project Lazarus – The Chronic Pain Initiative
Project Lazarus began in Wilkes County, North Carolina in 2005 when major issues with misuse and abuse of prescription medications that lead to unintentional poisonings from prescription drug overdoses were discovered. Accidental overdose now surpasses automobile fatalities in the US as the leading cause of death. The counties in our network, Cleveland and Rutherford, have twice the rate of the US for these unintentional deaths because prescribing is higher in poverty distressed communities.
Statistically, in North Carolina, overdose death, which are classified as accidental poisoning, are in line with those across the country just below the national average. These accidental deaths cross all age and socio-economic groups and many of these deaths could have been prevented in some form or fashion.
Problems from misuse and abuse of prescription pain medications include increasing hospitalization rates from unintentional overdose, the impact on communities of the problem crossing all ages and socio-economic groups, and the lack of treatment facilities and other resources for those who become addicted. There is also a need for those patients with legitimate chronic pain having access to appropriate medications and rehabilitative resources.
Because of these issues prescribing providers face problems of either prescribing not enough medication resulting in continued pain and suffering or prescribing too much medication resulting in misuse, abuse, overdose, or diversion. These problems have caused a major shortage of medical providers willing to provide pain medication and management to any patients. There is a major shortage of available treatment facilities or resources for those who become addicted as well.
The Community Care of North Carolina program has seen these problems and these needs and has based its Chronic Pain Initiative on the Project Lazarus platform which focuses on appropriate assessment, management, and treatment of chronic pain. The Chronic Pain Initiative is a “community” initiative because the entire community i.e. medical community, law enforcement, Community Care, and other community stakeholders, must be involved to effect change. Community Care realizes the needs to tighten access to these medications but at the same time those with dependence and addiction, who can no longer get their supply, need access to treatment.
The Project Lazarus Chronic Pain Initiative will strive to bring awareness to prescribing providers to help them learn appropriate assessment, management, and treatment of chronic pain. It will give them tools like the Controlled Substance Reporting System (CSRS) and Provider Portal to enable providers to check patient medication records to help ensure patients are getting only the prescriptions they need to help control their pain. These tools help them to check what medications the patient has been prescribed and if any other provider is also prescribing pain medication so they can prescribe accordingly. The initiative will strive to give patients with chronic pain access to appropriate pain medications while educating them on how to use them wisely to avoid overdose or diversion.
The initiative will help local law enforcement by controlling the amount of pain medications being dispensed which will help keep excess medications out of the wrong hands where it can be misused or diverted. Systems are being set up for proper disposal of unneeded prescription medications including permanent medication collection stations.
Community Care of North Carolina uses the Project Lazarus Chronic Pain Initiative to help find answers to these problems, which will help improve the quality of care Medicaid recipients receive while controlling the skyrocketing cost of medical care for unintentional overdose.