It was Whac-A-Mole on steroids: When police took one source out, there would be a short lag until the next source presented itself. Meantime, the overdoses kept stacking up. And that was before the worst spike in fentanyl hit.
*
Perkins had long championed community policing in Roanoke, wherein officers engage with teenagers in high-crime areas (often patrolling on bicycle) while always refining where they need to be, using real-time data. Violent crime in the city, much of it previously crack-related, had dropped 64.5 percent and property crime 39.9 percent since 2006. A 2011 program Perkins pioneered called the Drug Market Initiative offered nonviolent offenders the opportunity to bypass jail and receive job training if they agreed to leave the drug trade.
But the cellphone had put an end to open-air drug markets, enabling the coordination of drug buys in gas-station and shopping-mall parking lots. Hotels situated along the perimeter of Roanoke on I-81 and near Interstate 581, which cuts through the city center, were also prime drug-deal spots because higher-level distributors could sell there and quickly get back on the road.
Experienced dealers were hiring addicted middlemen like Tess to conduct street-level business for them, lowering the dealers’ risk. And shoplifting fueled by users like Tess had nearly doubled in the past five years. Violent crime was edging upward, too: A thirty-four-year-old woman was murdered at a rent-by-the-week airport motel known to be a hangout for the heroin-addicted. A woman Jamie Waldrop had been coaxing toward treatment for months was found dead of overdose at a Howard Johnson’s next to I-81.
“She’s next on the list” to be admitted, a rehab intake counselor texted Jamie the next day.
But it was too late. “She died in a motel last night,” Jamie wrote back.
It was time to get nimble again.
*
On the eve of his retirement, Chief Perkins vowed to do something about Roanoke’s surging heroin problem. A data geek as well as an incessant worrier—nights and weekends, Perkins had crime reports emailed to his phone every hour, one of the reasons he retired early, after twenty-four years on the force—he was eyeing a program he hoped to implement, if he could just get buy-in from the disparate health care and criminal justice agencies. “This is what I’m going out on!” he told me, almost manically, in late 2015.
He hoped to follow the path of Gloucester, Massachusetts, police chief Joseph Campanello, who’d recently told the growing number of heroin users in his town: Turn in your drugs, and I’ll hook you up with treatment instead of handcuffs. By early 2017, the Gloucester model, called Police Assisted Addiction and Recovery Initiative, had been adopted by two hundred police agencies in twenty-eight states.
The Hope Initiative, as the PAARI program in Roanoke would be called, was the impatient police chief’s swan song. “We want the carrot to be: We’ll treat it like a disease, and if you stay clean, we’ll go away,” Perkins said.
The idea was to create a public-private partnership where “angels,” or trained volunteers, helped funnel addicts into treatment, mentoring them during the cumbersome and usually relapse-ridden march toward sobriety—kind of like an on-call NA sponsor, only with the skills of a social worker able to take advantage of the city’s housing, mental health, and job resources. The program would be located at the Bradley Free Clinic, a long-running program for the working poor staffed by physician volunteers and located in Old Southwest, a burgeoning heroin hot spot.
The clinic’s executive director, Janine Underwood, wasn’t a doctor. In the fall of 2015 she attended the first Hope Initiative meeting not because she ran a nonprofit medical clinic but because her twenty-eight-year-old son, Bobby Baylis, was among the four who died of fentanyl-laced heroin that June, while Tess was in jail.
Janine had spent the previous seven years floundering as she watched Bobby seesaw between rehab and jail after initially becoming addicted to OxyContin prescribed in the wake of ACL surgery following a snowboarding accident. He’d gotten clean—finally, she thought—during a three-year prison sentence, during which he’d participated in drug treatment and become a certified journeyman in heating and air-conditioning. On probation back in Roanoke, Bobby was excelling at his new job, living in her basement, and doing well after his release. “You could see the sparkle again in his eyes, for the first time in years,” she said. Three months after leaving prison, a visit with some old Hidden Valley friends led to a single dose of fentanyl-laced heroin. Janine discovered Bobby’s body, cold and blue, laid out on the basement floor, the evidence cleaned up and his user-dealer friends long gone from the scene.
Still raw in her grief—Bobby had been dead only six months—Janine could draw a detailed mental map of the flaws in the treatment landscape, from health care privacy hurdles and other treatment barriers to the lack of guidance about what to do the moment you realize your twenty-one-year-old is injecting heroin: Janine had found a box of hypodermic needles hidden in a box in the back of Bobby’s closet. He’d wrapped them up in his baby blanket, sandwiched between soccer trophies and Boy Scout patches.
What Janine did was sob. “It was the worst moment in my life. I didn’t understand yet the connection between pills and heroin. I kept thinking, ‘He’s gonna get better; it’s just pills.’
“I’m in health care, and there were just so many things I didn’t know,” she said. “It’s almost impossible the way the systems are set up, for a parent to get good treatment for their child.”
Janine was the first Hope Initiative angel to tell the chief, “I’m in.”
*
The second was Jamie Waldrop, Christopher’s mom—the one who’d personally accompanied her addicted son to the Montana rehab. By now, so many in the Hidden Valley circle of heroin users had become intertwined: Jamie’s boys had known Bobby, Janine’s son, who’d been in the same court-ordered halfway house as Spencer Mumpower. And Jamie’s older son had at one point dated Tess.
“It was like we had a Dementor from Harry Potter who was swirling around the households of Hidden Valley, going, ‘I want you and you and you and you,’” Jamie told me.
The third volunteer was Terrence Engles, a former pro baseball player who’d progressed from taking injury-prescribed OxyContin to scamming pain-management doctors on Manhattan’s Upper East Side to overdosing on a Staten Island ferry in 2011. He’d just landed in Roanoke as a treatment consultant for American Addiction Centers, with three years of sobriety. He spent most of his time in Roanoke trying to persuade addicted twentysomethings to go to treatment, whether it was to one of his company’s dozen centers across the United States (for those with insurance) or to the scant few regional or charity options, most of them faith-based and abstinence-only. “I get about twenty calls a week from people in crisis,” he said.
In Chief Perkins’s ideal world, Carilion Clinic, the region’s largest employer with nonprofit hospitals and a new research center already known for its work on addiction research, would provide much-needed inpatient treatment. No comparable treatment was available locally, only short-term detox programs and one privately owned facility that accepted only insurance and cash (a twenty-eight-day stay ran around $20,000), and it didn’t allow patients to take maintenance medications.