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RURAL HEALTH IS COMPLETE!
At the conclusion of the written exam, I wish I would have paid more attention to my high school kids for the last 8 years when they tried to teach me Twitter abbreviations! Haha. (I know at least Jerry understands my pain.)
#OldFarts #TooMuchToSay #StructuralViolence #YouAreFreeButNotAsFreeAsYouThink #TheAmericanDreamIsDead
Team Lazarus Finishes Strong
Campbell University, Master’s of Public Health, Team Lazarus has been working hard this semester to educate ourselves and the community. The people of Harnett County are facing an epidemic of prescription medicine abuse and misuse. Project Lazarus is a nonprofit organization that has teamed up with the Harnett County Health Department to bring awareness to this major issue facing North Carolina. The Campbell University Team Lazarus has met with community professionals, such as nurses, physicians, emergency medical personnel, hospice workers, social workers, law enforcement, and school officials. We have also had the pleasure of working with community members at local churches. Team Lazarus has been working hard to create a partnership with Campbell University, the Harnett County Health Department, Project Lazarus, and the Harnett County community. Community member involvement is the only way to truly help the community.
This semester, Team Lazarus has been working on taking the knowledge we have gained and applying it to the needs of the community. We have held meetings with professionals, helped create an educational website for the Harnett County Health Department, created church bulletins, formed partnerships with churches, created a public service announcement for the local newspaper, and found important documentaries that can be used for educational purposes. We were hoping to be a part of the grant proposal from Harnett County to Project Lazarus, but there has been a delay in the process. When the grant paperwork comes in, we will unfortunately no longer be working with these preceptors. The grant was to be used in whatever way the community professionals thought it would help. Many people we met with wanted to gain easier access to Naloxone and some even wanted to be able to carry it with them. Others thought billboards and marketing were important. We discovered that many community professionals wanted more medicine drop boxes around the county with easier access to them for elderly. Brochures will be made to distribute to elderly patients with multiple medications to explain the risks of taking them wrong or leaving them around the house. Brochures for adolescents was seen an important need as well.
Many studies have shown that rurality plays a crucial role in prescription medicine abuse. Rural adolescents are more likely than urban youth to begin nonmedical use of prescription medication. Some studies have found that this is because of the geographic isolation causing lack of option for other street drugs or lack of knowledge that prescription medication is dangerous. People that reside in rural areas have been shown to have a greater amount of pain. Rurality brings about many hard labor jobs with lower health outcomes. Pain has become a part of the everyday lives of many residents in rural America. This pain issue brings more prescription pain medications into the area, which creates options for abuse and misuse of these medications. With the economic strain that is seen in rural America, the family structure is being destabilized. There are higher divorce rates, more women having to work, more single-parent homes, and less parent involvement, all causing a great deal of struggle for rural youth. Without proper guidance, more youth are turning to risky behaviors, such as drug use, at earlier ages.
The learning we have been doing has helped me to gain a better understanding of the community I now live in, and the needs of that community. I feel our work with Project Lazarus and the Harnett County Health Department will make a difference in the community. I know that I feel more educated on the reality of prescription medicine abuse. I have also learned a great deal about public health and the importance of knowledge and partnerships. We feel the partnership created between public health officials and the community is the only way to discover the true needs of the community and how we can help them.
As my time ends with Team Lazarus I would like to thank the community members we were able to meet with and all of the information they brought to the table. I would like to thank Ms. Debra Hawkins and Mr. John Rouse, of the Harnett County Health Department as well as Project Lazarus of North Carolina. And I would like to thank my peers and professors at Campbell University, including my five teammates and Dr. Tillman for the opportunity to work with you all. I feel I have gained a better understanding of public health as a career and as a need in community health.
Last cold night in NOLA at APHA convention. Feeling fortunate for good times, good learning, good friends, good food and good connections made!
My learning via Team Lazarus
Project Lazarus is a nonprofit organization that works to prevent drug abuse of all types in the state of North Carolina. Team Lazarus has been focused on prescription medicine abuse and misuse in Harnett County. I have taken an interest in the rising numbers of adolescent nonmedical use of prescription medication. I worked in a high school for the past eight years before furthering my education at Campbell University. During those eight years, I was not only the athletic trainer for the sports teams, but a mentor and a safe place to come for many students at that school. I was one of the people the kids knew they could turn to for advice, a shoulder to cry on, or even something that scared them. Because of that, I was informed on many levels of the behaviors of my athletes and their friends. I always did my best to steer them away from risky behavior but at minimum tried to make them understand they had to be as safe as possible in their behaviors.
I remember one young man that came into the athletic training room with nausea, dizziness, and confusion. Within moments he became unconscious and non-responsive. I called emergency medical services immediately and monitored his slow and week pulse and breathing. Word spreads fast at a high school. Immediately one of his friends came in and told me what we had already expected. I then had to call his mother back, who was driving to meet him at the hospital, ask her to pull over and listen to me. Her son was high and no one knew on what. Thankfully he was treated and released with no long-term damage from that single situation.
Another student had badly injured himself during a practice. I phoned for emergency medical services and the injury was resolved soon after. He was given a prescription for an analgesic and I did not see much of him for a couple months. Another student came into my room months later complaining about the first kid and how much he had changed since the surgery. Again, word travels fast in a high school and I was told by numerous kids that the injured athlete had become addicted to his pain medication. His parents had cut off the supply so he was searching in other places. The parents, student, councilors, and myself had many conversations that followed across the rest of his time at the school. A few years later I came into work to find out this young man had done something while he was high and was now in a coma. Within days there was no brain activity and his family had to watch their eighteen-year-old son die in a hospital bed.
The tragedy of this situation is a reality that many people face regularly. I did not realize until my work with Team Lazarus, just how prevalent this situation is. According to the Project Lazarus website, in the United States in 2008 there were 36,450 deaths caused by drug overdoses. Of those deaths, 20,044 were due to prescription medications. After doing more research I read that, during 2002 to 2005, on an annual basis, an average of 4.8% of persons 12 years or older were using prescription pain medication in a nonmedical manner within the past year. In a study comparing rural to urban prescription drug users, rural users were found to have significantly higher odds of snorting OxyContin that urban users. While the number of users are on the rise, the facilities in rural areas have not increased. The health disparities continue to become relevant when drug prevention and treatment centers are few and underutilized when facilities are present.
As if these numbers are not enough of a problem, adolescent drug use has increased from 1.1 million young people in America in 1992 to 2.6 million in 2005. From the years 1992 to 2003, nonmedical prescription medicine use among those under the age of 18 years has increase 212%, 2.6 times higher than users above the age of 18 years. In a national survey of high school senior students throughout the United States, nearly 1 in 8 reported nonmedical use of prescription opioids in their lifetime. Research correlates those using prescription drugs early in life have a higher risk of developing prescription drug addiction or dependence.
The rise of nonmedical use of prescription medication of the rural American youth is reaching epidemic levels and the death rate continues to climb. Something must be done. And must be done quickly. I am honored to have been a part of Project Lazarus and hope their work continues into the community of Harnett County to reach the adolescent population.
References
Community Care of North Carolina. Project Lazarus. Project Lazarus Web site. http://projectlazarus.org. Accessed November 1, 2014.
Hall AJ, Logan JE, Toblin RL, et al. Patterns of abuse among unintentional pharmaceutical overdose fatalities. JAMA : the journal of the American Medical Association. 2008;300(22):2613-2620.
Li L, Zhang X, Levine B, Li G, Zielke HR, Fowler DR. Trends and pattern of drug abuse deaths in Maryland teenagers. J Forensic Sci. 2011;56(4):1029-1033.
Oser CB, Leukefeld CG, Tindall MS, et al. Rural drug users: Factors associated with substance abuse treatment utilization. Int J Offender Ther Comp Criminol. 2011;55(4):567-586.
Burton LM, Lichter DT, Baker RS, Eason JM. Inequality, family processes, and health in the “New” rural America. Am Behav Sci. 2013;57(8):1128-1151.
Moon MA. Rural adolescents more likely to abuse prescription drugs. Clinical Psychiatry News. 2011;39(1):17-17.
Havens JR, Young AM, Havens CE. Nonmedical prescription drug use in a nationally representative sample of adolescents: Evidence of greater use among rural adolescents. JAMA.2011;305(19):1946.
Momper SL, Delva J, Tauiliili D, Mueller-Williams AC, Goral P. OxyContin use on a rural Midwest American Indian reservation: Demographic correlates and reasons for using. Am J Public Health. 2013;103(11):1997.
Young AM, Glover N, Havens JR. Rural adolescents' nonmedical prescription drug use: Implications for intervention. The Prevention Researcher. 2012;19(1):7.
J Adolesc Health. 2009 Apr;44(4):407-9. doi: 10.1016/j.jadohealth.2008.08.010. Epub 2008 Nov 7.
Campbell University has access to this. Just incase you are interested.
Watch Oxyana Online | oxyana | Oxyana (2013) | Director: Sean Dunne | Cast:
A must watch for further understanding of prescription drug abuse in rural areas and how it directly affects the community members!
Teen Cyrus Stowe films a short documentary "Out of Reach" about prescription drug abuse among adolescents in his community.
This past week we continued to research information and links for the Health Department website. It's all about prescription medicine abuse. We wait on word that our church bulletin is ready to be handed out.
This week...
Website info for Team Lazarus. Time to find good information for people to educate themselves on prescription med safety in Harnett County.
CU Team Lazarus Gets Published
We heard word that the PSA we worked on has been placed into the local newspaper! Great job team!!!
CAMPBELL UNIVERSITY PUBLIC HEALTH brings awareness to UNITED FARM WORKERS www.ufw.org Integrity: Doing the right thing even when no one is looking Si Se Puede® Attitude: The embodiment of a personal and organizational spirit that promotes confidence, courage and risk taking Innovation: The active pursuit of new ideas Non-Violence: Engaging in disciplined action Empowerment: A fundamental belief in and respect for people
Real Food. Just Food. Yesterday kicked off the canned goods collection to support the Harnett Food Pantry! Thanks to the PSEB Talent Show last night we have at least one entire bin full! We still have boxes set up until Wednesday afternoon in the lobbies of Maddox, Levine, and C Rich. Wear your red today to support United Farm Workers! Don't forget to take some pictures! #CUFoodDay
Hard Work Paying Off
We are excited to be done with our tasks thus far. We are waiting to hear from our preceptors to see how we did! Can't wait to work with the community some more.
This past week we have been working hard to finish our church bulletin, PSA, start up our tumblr page, and gather information on prescription drug abuse and the resources we have in Harnett County. As we move ahead we will have a better idea how the community feels about the prescription drug...
Project Lazarus officially has a Tumblr page! Check out projectlazarusharnettcounty.tumblr.com for more information from our practicum group on Prescription Drug Abuse with an emphasis on teens!
Team Lazarus In Action Mid-Semester
As mid semester approaches, Team Lazarus is finding itself performing new and interesting tasks to help move the program forward. Our previous concerns of how to get information to the community about this program are being calmed by these tasks. Community education is important, but is not the only answer to the issues at hand when it comes to prescription medicine abuse and overdose. We must start with education and lead to creative and insightful solutions to help decrease the problem in Harnett County.
The tasks given to us by our preceptors at The Department of Health in Harnett County have been exciting to work on. We have been asked to create lists of local churches and create bulletins for its people, create lists of prescription medicine drop boxes and medicine drop off events across Harnett County, start preparation for a public service announcement, find website resources for the public, and create fliers for distribution. With these tasks at hand we are finally able to take all the research we have been doing and put it to good use. We have started with a divide and conquer technique for the work and now plan to begin organizing the material for final approval from out preceptors.
Much of our education has been through personal research and meetings. We have been fortunate enough to meet with representative from the Harnett County Sheriff Office and Harnett County EMS. Our main meeting was with professional members of the community and representatives of Project Lazarus at the state level. Through these meetings along with our own research, we are now armed with enough personal education to pass along to community members. All challenges we have felt in the past of not working with the community will hopefully be behind us.
As discussed in past posts, Project Lazarus is designed to help educate the people of North Carolina on the dangers of prescription medicine overdose and abuse, as well as taking these dangerous medications out of the hands of those that abuse them. Another goal is to get Naloxone into the hands of those that may need it quicker. Naloxone is an "overdose reversal" medication that has only mild side-effects and can safely be placed in the hands of non-medical people. Project Lazarus has worked hard to get this medication listed as over-the-counter to make it more accessible to those in need. Many of the locations Project Lazarus works in are rural areas. Some rural areas have a higher rate of prescription drug overdose. In fact, Harnett County is at "epidemic levels" of prescription drug overdose. This topic has peaked my interest and I plan to write my literature review project on this topic in the teen population. We have learned that people living in rural areas have higher rates of unhealthy behaviors including higher tobacco, alcohol, or drug abuse, along with lower nutrition, increased poverty rates, and lower education achievements than urban people. Most problems can be lead back to geographic isolation directly or indirectly. Because we cannot change the isolation, nor would the people of the community generally want us to, we must find ways to overcome the health concerns in another way. Of course the natural answer is education. We must educate the people of the health hazards involved with prescription medicine abuse or misuse. But that is never the only answer and sometimes not even the best solution. Many people know the dangers and still abuse. We must work with community members that see these problems daily among neighbors, coworkers, family members and much more. This is one reason to reach out to the local churches for help. How can we help the people of their church? We need to work with the people in the school systems, as well as working with parents, friends, and long standing citizens of Harnett County.
As we being the process of educating the people, we will hopefully begin to reach out more to the community members themselves further information on how we can help them.
I am excited to continue with Project Lazarus and what it stands for. We all hope to make a difference in Harnett County to even just a few people. We are grateful for this opportunity and looking forward to see where it takes us next.
Dr. Drew video & resources on Rx Drug sharing for teenagers
Pop culture icon Dr. Drew is featured in a new video from Smart Moves, Smart Choices that could be useful if you’re talking to your teenagers about why not to share their medications.
