Just before going into jail for the last time, Cynthia Haley snapped a picture of herself.
At the time, she was living in Danville and struggling with addiction. Her substance use had evolved over the years, starting with marijuana in high school and eventually progressing into heroin, meth and crack cocaine, Haley said.
The photo is nearly seven years old now. She had the same blonde hair, but she was noticeably thinner than she is today. Soon after taking the picture, Haley began a 10-month sentence in jail. When she was released, she was finally ready to seek help for her drug addiction.
The Hope Initiative, then a relatively new program in Roanoke, connected her with a treatment facility and helped her navigate the barriers that stood in the way of recovery. For a year, a peer recovery specialist — someone who had experienced addiction firsthand — helped her find transportation, access recovery programs and stay on track.
Today, Haley, 52, works for the same program that helped save her life.
Nearly six years into her recovery, she is just months away from earning a master’s degree in clinical mental health counseling. She also works full time at Bradley Free Clinic, where the Hope Initiative is based.
On any given day, Haley might accompany police officers responding to an overdose in a city park, lead a group therapy session and then help support someone experiencing methamphetamine-induced psychosis. Then she goes home to finish her graduate school assignments.
Some days are exhausting, she said. But helping others strengthens her own recovery.
She sometimes shows her clients that photo from the height of her addiction.
“The people I work with, they’re like, ‘You don’t understand. You look like a teacher,’” Haley said.
But she knows what it’s like to wake up confused in a hospital after an overdose, and she understands the emotions that come with addiction. Now, as a peer recovery specialist with the Hope Initiative, she uses those experiences to empathize with and relate to others who face the same challenges.
This year marks the 10th anniversary of the Hope Initiative. In its first year in 2016, the program helped about 45 people enter treatment. Today, it serves nearly 1,000 participants annually.
A cultural shift in addressing addiction
The first meetings that would shape the Hope Initiative began in fall 2015 when community leaders gathered to discuss how Roanoke could better respond to the opioid crisis.
Among them was then-police Chief Chris Perkins, who had grown frustrated watching his officers repeatedly arrest people struggling with addiction.
“I always said we can’t arrest our way out of this,” Perkins said during an interview in June.
Perkins increasingly viewed addiction as a public health emergency rather than a public safety problem, which was not a popular opinion at the time, he said. He and other community leaders from hospitals, faith communities and local treatment facilities explored ways to connect people directly with treatment instead of cycling them through the criminal justice system.
Underwood remembers attending one of the early planning meetings at the Roanoke Police Department in 2015.
She had been executive director of Bradley Free Clinic for about a year. But she attended the meeting primarily as a mother whose son had died just months before due to an overdose.
Before her son’s death, Underwood said she hadn’t understood addiction or the challenges people face in recovery. As the Hope Initiative grew, she learned much more.
The initiative was built off of a successful model in Massachusetts called the Angel Program, which allowed people to drop off their illicit drugs at the police department without the threat of being arrested. Police would then help connect them to a treatment option.
To Underwood, it made more sense to house the program at the free clinic. Many people with substance use disorder have had negative experiences with law enforcement. Stigma about substance use disorder also still exists among the police force, Perkins said.
With the Hope Initiative, participants don’t have to bring in their drugs, either, Underwood said. All they have to do is call and ask for help and someone would help them find a treatment option that meets their unique needs.
Early on, Underwood volunteered, connecting participants to treatment programs. However, it became apparent pretty quickly, she said, that more specialized care was needed for people who were just entering recovery. In the first year, the group hired its first peer recovery specialist to provide more intensive support.
The Hope Initiative’s emphasis on peer recovery specialists was unusual when the program launched in 2016, Underwood said. Since then, she has watched a broader network of addiction and mental health services and the use of peer recovery specialists emerge across the Roanoke Valley.
“It launched a movement to address addiction and substance use and mental health in our community,” Underwood said. “It was the start of an amazing community effort.”
New programs like Virginia Harm Reduction and the drop-in center came to be since the Hope Initiative launched. More treatment facilities have come to the valley as well, Underwood said.
‘Jail did not cure me of my addiction’
The help of peer recovery specialists was critical for Haley.
“In addiction, your whole life falls apart. You lose your basics,” Haley said. She didn’t know where her birth certificate was and didn’t have health insurance or transportation. “All these things a normal person would consider basics I had lost along the way.”
She needed to find a treatment facility that would accept an uninsured patient. She also needed a fresh start away from Danville, where she’d grown up.
“I knew all the wrong people in Danville,” Haley said. “I was always going to be a drug addict there. Even with the best intentions, that’s how people saw me.”
With help from a peer recovery specialist, Haley entered treatment. Eventually, she joined the Hope Initiative as a peer recovery specialist herself.
She spent many years trying to understand why she fell into addiction.
Her story didn’t fit the narrative many people expected. She grew up in an affluent family in Danville, attended private school and graduated from college. Yet her substance use gradually escalated, culminating in a decade of addiction, repeated jail stays and, eventually, a career built around recovery.
It started with a joint and a red Solo cup at high school parties, she said. She woke up for class every morning, eventually graduated from college and later held down a job in television even as her substance use progressed to cocaine.
When cocaine damaged the inside of her nose, her boyfriend at the time suggested they smoke it instead. This conversion of the drug turns it into crack cocaine, a highly addictive stimulant. Haley was in her 30s. The addiction that followed consumed much of the next decade of her life.
“I had pretty much lost who I was as a person,” Haley said. “And my family, they thought, along with a lot of people during that time, that addiction was a matter of willpower, it was a moral deficiency.”
She cycled in and out of jail. Each time she was released, she quickly returned to using drugs. Her family struggled to understand why she was struggling.
“I did not like jail, but going to jail did not cure me of my addiction,” Haley said.
It took years for Perkins, the former police chief, to come to the same conclusion.
A turning point in Roanoke’s police department
Before helping launch the Hope Initiative, Perkins worked on police narcotics teams in other states. He understood the law enforcement mindset that every drug-related problem required an arrest.
He and his colleagues spent entire shifts tracking down people involved in drug-related crimes, only to watch the cycle continue. One officer compared arresting a drug dealer to emptying the ocean one teaspoon at a time, Perkins said.
A turning point came when he had to tell a mother that her son had died from an overdose. He began to wonder what might happen if some of the time and resources devoted to drug enforcement were redirected toward helping people access treatment and healthcare.
“Think about the time spent dealing with addiction when you could be out here addressing some of the other things that really need our focus, like violent crime,” Perkins said.
The idea was not immediately popular. Perkins faced skepticism from both community members and fellow officers. He had to persuade them that addiction was fundamentally a public health issue and that law enforcement could play a role in connecting people with treatment rather than simply arresting them.
Still, enough people believed something different was possible. Community leaders, healthcare providers and social service organizations came together to build what became the Hope Initiative.
Ten years later, Perkins is proud of what the program has accomplished, but funding the program continues to be challenging.
The initiative is funded by federal grants, corporate sponsorships and community donations. This year, the Virginia Opioid Abatement Authority awarded $207,800 to the clinic to support the Hope Initiative.
Underwood said she is constantly looking for additional grants.
“The state should be giving them money hand over fist,” Perkins said. “The numbers [of people] that they help could improve and could have such an impact on our overall well-being as a city, as a region, as a country.”
