Located in the Blue Ridge Mountains of North
Carolina, Wilkes County is in the heart of a
culture that lives in close-knit community that
commonly shares their traditions and personal belongings,
including self-medication practices and prescription
drugs. This, among other reasons, has opened the door for
substance abuse of opioids such as oxycodone,
hydrocodone, fentanyl and methadone.
In 2007, Wilkes County experienced an
average of 28.3 deaths per 100,000 people from
unintentional drug poisoning. In 2009, the county's rates
rose to be four times higher than other North Carolina
counties (46.6 vs. 11.0 per 100,000 population). Deaths
were mainly due to overdoses of opioids, pain relief
medications that are used for both medical and
County Health Department, along with other local
organizations, responded to this problem by starting an
opioid overdose prevention program called Project Lazarus.
Though it began in North Carolina, it has since spread to
24 states as well as other military and tribal groups.
Project Lazarus empowers communities and individuals to
do the following:
Prevent prescription medication overdoses
Present responsible pain management practices
Promote substance abuse treatment and support
General community partners have included law enforcement,
schools, hospitals, faith based organizations, human
service agencies, behavioral and public health
organizations, and substance abuse treatment
Project Lazarus is supported by a number of sponsors and
grant funds and individuals, including:
Co-Founder of Project Lazarus Fred Wells Brason II
speaks to the opioid crisis in Appalachia in this
interview (mp3 file) conducted by Carlyle Ellis on
October 25th, 2017 in Moravian Falls, North Carolina.
Brason II, F., Roe, C., & Dasgupta, N. (2013).
Project Lazarus: an innovative community response to
prescription drug overdose. North Carolina Medical
Journal, 74(3), 259-261.
U.S. Department of Health and Human Services (HHS),
Office of the Assistant Secretary for Health, and the
Office of HIV/AIDS and Infectious Disease Policy (OHAIDP)
by Altarum Institute. (2013). Hepatitis C Virus
Infection in Young Persons Who Inject Drugs.
Albert S, Brason FW II, Sanford CK, Dasgupta N, &
Graham J, Lovette B. (2011) Project Lazarus:
community-based overdose prevention in rural North
Carolina. Pain Medicine.
Albert, S., Brason II, F., Dasgupta, N., & Sanford,
C. (2010). Opioid drug overdoses: a prescription for harm
and potential for prevention. American Journal of
Lifestyle Medicine, 4(1), 32-37.
Social determinants to addiction, including
unemployment rates, poverty, trauma, and depression
Lack of public transportation in rural areas
Patient access to providers and treatment for pain
Depending on location, state-by-state laws may impact
protections and access to naloxone.
Project Lazarus operates through the following
organizational structure designed to be replicated in any
The steering committee is the group
of liaisons that sustains the ongoing work of Project
Stakeholders are the decision makers from key
sectors that assign resources,
personnel, and finances to the project.
The coalition is formed by
stakeholders who designate a variety of people from each
sector to be involved in Project Lazarus.
The community is the aim of the
project's educational and serving efforts.
Project Lazarus outlines
activities through training and technical assistance
that are made to be replicated in other communities.
The Project Lazarus Model, a more specific form of their
health model, has 3 core components (the hub) that
must always be present, and seven methods (the spokes)
which are adapted based on the speciﬁc needs of a
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.