For years, the country’s opioid crisis has quietly escalated. From 1999 to 2012, deaths from common opioid medications increased by 400 percent. Additionally, accidental drug overdose is currently the leading cause of injury-related death in the country for people between the ages of 35 and 54.
North Carolina is no exception. In 2014, more people in North Carolina died from drug overdoses than car accidents.
Some blame decades of overprescribing opioids for the epidemic. Others blame law enforcement for not controlling the influx of cheap heroin. But according to community health advocate Anne Thomas, the “blame game” isn’t helpful. “Everyone is part of the problem. And everyone is part of the solution.”
Anne Thomas is the current Chair of the Foundation’s Board of Directors and a consultant for the Chronic Pain Initiative and Project Lazarus. She supports communities in over 30 North Carolina counties who are building capacity to address the opioid epidemic and manage chronic pain effectively.
“Communities are best poised to solve their community health problems because they know their resources, they know their own culture,” said Thomas. “They know what things are possible, where there’s support, and where there’s resistance.”
The Chronic Pain Initiative and Project Lazarus is a two-year project funded by the Kate B. Reynolds Charitable Trust. The Foundation partners with the NC Office of Rural Health and Community Care of North Carolina to administer this statewide collaborative around opioid prescription management.
Project Lazarus is based on a successful model developed in Wilkes County aimed at preventing overdoses and meeting the needs of those living with chronic pain. The model includes the use of toolkits for clinical and community training. The toolkits are a range of guidelines for community action, education and for assessing pain and prescribing medication safely.
Thomas’s work is with community engagement. She provides technical assistance to help communities create and maintain local coalitions. She assists them with developing locally identified needs and locally tailored drug overdose prevention programs and connects them with state and national resources. This work includes identifying stakeholders who need to be at the table, leveraging resources or providing educational materials to boost awareness. “Many times they have the resources right there in their community, it’s just helping them explore and navigate them,” said Thomas.
One of the premises of the project is that change is possible with community engagement. Thomas says this means engaging with traditional and nontraditional partners. “We try to bring everyone together and engage the entire community,” said Thomas. Many coalitions are made up of parents, school systems, law enforcement, public health, businesses, churches, pharmacists and the medical community.
Thomas said that regional alliances can have a big impact. A cluster of seven counties in the northeastern part of the state have a coalition called the Albemarle Region Project Lazarus Coalition. The coalition includes Currituck, Camden, Pasquotank, Perquimans, Gates, Chowan and Bertie counties. Because of their shared resources, the alliance distributed effective messaging around safe opioid medication use and disposal.
They also organized drop boxes for unused prescription medication and purchased two incinerators for disposing them. They organized training in naloxone—a drug that reverses opioid overdoses—for emergency first responders. The alliance has partnerships with the school system to train school resource officers and school staff in providing prevention education. They work with community colleges to provide addiction education in the health curriculum as well as with law enforcement and the public health department.
“Rural communities have scarce resources,” said Thomas. “So creating economies of scale and scope by sharing resources and getting more people at the table is really effective.”
Thomas says communities can accomplish a lot by setting goals, assigning roles and developing strategy. “People don’t want to come to the table to just talk about something,” she said. “They’d rather be doing something. And when the doing starts to happen, people get involved.”
To learn more about the Chronic Pain Initiative and the Project Lazarus model, visit:
For more information on North Carolina’s opioid epidemic, read “Policy for the Use of Opiates for the Treatment of Pain”.