Lazarus Families in Recovery Support Together (Lazarus FIRST) - Project Lazarus will implement Lazarus FIRST (Lazarus Families in Recovery Support Together), a family-centered treatment and recovery program serving children, adolescents, young adults, and their families/primary caregivers affected by substance use disorder in Wilkes and Yadkin Counties, North Carolina. Over the five-year project period, Lazarus FIRST will enroll 490 unduplicated individuals, pairing Family-Centered Peer Recovery Coaching, trauma-informed youth and young adult mentoring, and evidence-based parent education to strengthen families, expand access to treatment and recovery support services, and reduce the substance use burden driving the region’s elevated overdose rates and child-welfare system involvement. The population of focus spans children and adolescents (ages 0–17), young adults (ages 18–25), and their families, reflecting the local age distribution in which residents under 18 make up roughly 20 percent of both counties. Lazarus FIRST will serve residents of Wilkes and Yadkin Counties, two neighboring, entirely rural counties in northwestern North Carolina with a combined population of approximately 104,000. The program will enroll 50 unduplicated individuals in Year 1 (30 children, adolescents, and/or young adults 0–25, and 20 parents/primary caregivers) and 110 individuals annually in Years 2 through 5 (80 children, adolescents, and young adults, and 30 parents/caregivers), for a project lifetime total of 490 unduplicated individuals. Clinically, the population of focus presents primarily with opioid and alcohol use disorders, frequently with untreated co-occurring mental health needs, consistent with the counties’ persistently elevated overdose mortality and alcohol-attributable mortality. System involvement is substantial: parental substance use accounts for 62 percent of foster care entries in Wilkes County and 50 percent in Yadkin County, and Project Lazarus’ jail-based reentry program has served 155 incarcerated parents responsible for 331 minor children. Lazarus FIRST will address these needs through Family-Centered Peer Recovery Coaching, Youth Services Advocate mentoring using Mentoring Central’s research-based curricula, the Botvin LifeSkills Parent Program, and wraparound case management. Enrolled individuals are screened using the TAPS and S2BI tools, referred for a full SUD/COD diagnostic assessment, and connected to treatment providers offering FDA-approved medications for opioid and alcohol use disorder (MOUD/MAUD), along with naloxone education and distribution. The project’s goals are to: (1) establish program infrastructure and begin services within four months of award (2) enroll and retain unduplicated children, adolescents, young adults, and families in comprehensive treatment, recovery, and wraparound services; (3) ensure every enrolled individual has an individualized treatment/recovery plan as indicated, including MOUD/MAUD referral when clinically indicated, and naloxone education; (4) and expand the service-partner network by at least four organizations by September 29, 2028. Measurable objectives advance SAMHSA’s Strategic Priorities by preventing substance misuse through Botvin-based family and youth education (Prevention of Substance Use and Addiction); increasing linkage to evidence-based treatment through TAPS/S2BI screening and MOUD/MAUD referral (Treatment for Mental Illness and Complex Needs); sustaining peer-supported aftercare to help families achieve long-term recovery and self-sufficiency (Recovery, Sobriety, and Self-Sufficiency); and centering parents and caregivers in every care decision (Parental Rights and Family Engagement). Progress will be tracked monthly using SMART, Project Lazarus’ HIPAA-compliant electronic medical record, comparing enrollment, service delivery, and completion rates against these objectives.
