RADFORD — When Misti Carper moved to the city three years ago, she said she was scared.

After 18 years of active drug addiction, the 39-year-old mother of four had lost custody of her children and was in recovery. While Radford offered a new opportunity, Carper said she was facing rebuilding her life without the Narcotics Anonymous meetings that had been her support.

“When I lived in Pulaski I could literally walk to a meeting three to four nights a week,” Carper said. “And there were plenty of people there that were in recovery who I could get a ride with.”

Until last year, the closest NA meetings to Radford were in Christiansburg and Dublin, Carper said. She worried about how that would affect her recovery and her chances of getting her kids back.

Then, on July 7 of last year, New River Valley Community Services (NRVCS) opened the 401 Peer Center beside its offices on West Main Street.

“I was like, thank God, there is going to be some recovery for addiction in Radford,” Carper said. “I was really concerned for the longest time. I can even walk there because it’s not that far.”

Within days of its opening, she stopped by.

“It was just so peaceful. It was just immediate; I was completely grateful,” Carper said. “Since then I go to meetings there at least once a week.”

The only drop-in support facility of its kind west of Roanoke, the Peer Center is open six days a week, including holidays and offers a range of recovery group meetings, as well as computer access, a shower, job application help, tutoring and a variety of supports and activities.

With an annual budget of about $140,000, the center serves up to 250 people a month, according to NRVCS figures.

Many come for 12-step meetings, but many also come to have a safe place to talk with people who understand the struggles of life with a substance use disorder. All three Peer Center staff members are themselves recovering from addiction.

“That’s the beauty of it is that people come in, and we automatically connect just because of our background and our history,” center Supervisor Chris Alderman said.

Suffering in silence

Inspired by a similar program in Rhode Island, the Peer Center was developed through a two-year grant from the Virginia Department of Behavioral Health and Developmental Services, said Angela Scott of NRVCS.

As supervisor of the Office of Peer Supports and Recovery, Scott oversees a dozen peer recovery specialists who support agency clients in a number of programs, including the Peer Center.

“It’s hard to grow these programs west of Roanoke because it just takes a while for funds and programs to reach far southwest,” Scott said. “We are taking on some responsibility at NRVCS to help grow and develop more peer recovery specialist staff and develop programming, so that we can support Medicaid offering this great resource.”

Last year NRVCS served 12,129 people in Radford and the counties of Floyd, Giles, Pulaski and Montgomery with a range of mental health, substance abuse and developmental needs. Of those, 1,146 received help for substance use disorder — the medical term for addiction. But that number can be misleading.

The area’s addiction problem is “much, much bigger than that,” said Glenn Mathews, NRVCS Substance Abuse Services program manager. “There’s thousands of people out there that could be diagnosed with substance use disorder who are suffering in silence.”

In 2016 — the most recent year available — about 20 million people aged 12 or older had a substance use disorder in the United States, according to the National Survey on Drug Use and Health. About 15 million of them had an alcohol use disorder and 7 million had an illicit drug use disorder.

Substance use disorder, according to current thinking, is a chronic brain-related illness with a strong genetic component. Environment, particularly childhood trauma, can play a large role as well, Mathews said. Researchers estimate that one in six people may be predisposed to develop an addiction.

Prescription opioid abuse and heroin use have in recent years brought widespread attention to substance use disorder. The lacing of street drugs with illicit fentanyl — a synthetic pain killer many times stronger than morphine — has accelerated drug overdose deaths and caused a nationwide response, including strict regulation of legal prescriptions and new funding to address addiction.

Overall in Virginia last year there were 8,624 emergency room visits for opioid and heroin overdoses, according to the state Department of Health. The year before that 1,426 people died of opioid- and heroin or fentanyl-related overdoses — 31 of those deaths were reported in the NRV.

But labeling the issue “The Opioid Epidemic” may overshadow the scope of the problem.

“Alcohol is still number one,” Glenn Mathews said. “[Methamphetamine] is still alive and well and stronger than ever. Cocaine is back. It’s not just about opioids. There are so many substances out there that people are using.”

Your brain on drugs

It was never just one substance for Chris Alderman. He said he started smoking pot at 13 and had overdosed on caffeine pills by 15. Through high school, a period on the streets and an attempt at a military career, his drug addiction followed.

“I was on a meth binge for a couple of years,” he said. “I smoked crack for a couple of years. Every day it was something — pain pills, alcohol, whatever I could get my hands on,” Alderman said. “I overdosed four times, total, in 13 years. So by the time I went into treatment I had used for half my life.”

Since then, the 40-year-old peer recovery specialist said he’s had four relapses, but even his worst days in recovery are better than life before treatment. For several years, he’s worked at NRVCS, doing peer support for a number of programs.

Creating a safe place for others needing recovery has been Alderman’s dream, he said. All are welcome, whether or not they’re in treatment and no matter what kind of treatment they are in — abstinence-only or medication assisted.

The center is designed to provide a low-key place to socialize, watch a movie, play video or board games or check email. Trained peer support specialists are always on duty to listen and provide resources for those who are struggling, Alderman said.

It’s not just about recovery meetings. Alderman said he wants the wider community to see what the recovery community can contribute. The center has collected donations for the homeless, offered its shower to a family that had been without power and collected for a Christmas toy drive.

“Everybody knows there’s an addiction issue — there’s no question about that. But not a lot of people know what people in recovery are about,” Alderman said. “It’s amazing, the things that we can do when we’re clean. So that’s what we’re doing here, and we want the community to see that.”

Misconceptions abound about what causes addiction, but some things are certain.

Substance use disorder is not a moral failing, Glenn Mathews said. It’s not a sign of laziness. It is not a lack of willpower or a character flaw, he added. And social isolation, shame and guilt won’t fix it.

People who suffer with addiction “have a substance use disorder; it’s not a choice,” he added. “OK, yeah, on the first day someone tries a substance, there’s a choice. After that, once the drug hijacks the brain, choice goes out the window.”

While some people can binge drink or take drugs for a period of their lives but not develop an addiction, others get hooked quickly. There’s no way to tell for sure who is in danger, and there is no cure for addiction once it takes hold. But it can be managed.

“It requires ongoing medical care,” Mathews said. “And it’s not just about treatment, but it’s about support.”

But sufferers can and do correct the course of their lives.

It can take four or five stints in treatment and several years in recovery to reach the point when the chances of a relapse decrease significantly. As people work their way through the process, peer support can keep them motivated.

“The Peer Center is huge,” Mathews said. “It’s a must-have if you’re going to help folks with addiction.”

It even helps the staff.

“It reminds me why I’m doing it, and it keeps me connected with the recovery community,” said Rachel Jarvis, who has worked at the center since it opened. “I believe there’s a reason that I had figured out how to get out of the active lifestyle of addiction, and if anything I went through can benefit someone else, then that’s my purpose.”

A song for sobriety

A lack of sober places for people to go during or after treatment leaves a wide gap in the recovery system.

“I remember when I first got clean, it was my birthday,” Misti Carper said. “And I was like, “Wow, what do clean people do on their birthday? I don’t know.’ ”

Her first sober Halloween, she ended up at a party where people were drinking. While she didn’t partake, “I didn’t make the best choices,” Carper said.

But this past October, she took her kids to the Peer Center’s Trunk or Treat event.

“On New Year’s Eve, they are open,” Carper said. “I was actually asleep in bed this year, but to know that there is actually a place to go is phenomenal.”

NRVCS would like to expand the peer center program, Glenn Mathews said. “I would open up peer centers in other areas, like for instance, Floyd and out in Elliston and Shawsville.”

But there are obstacles. Funding could probably be found, Matthews said. But most grants cover only staff and programming, not brick and mortar space. And finding centralized locations with public transportation to serve people without a car can be difficult, he added.

Aside from events and a sober environment, the heart of the center — peer support — has a long pedigree of success.

“It all started with the old 12-step programs going back to [Alcoholics Anonymous] in 1935,” said Angela Weight, state opioid response recovery services coordinator for the Virginia Department of Behavioral Health and Developmental Services.

Peer-to-peer support programs “have through the years been a very reliable source of helping people to stay in recovery,” Weight said. “There’s so, so much evidence out there that shows that it works.”

Weight knows its value because she has experienced it for herself.

“When I first got into recovery years and years ago, the people in my group used to always tell me: ‘We’re going to love you until you can love yourself,’” she said. “You feel so unlovable and that you’ve screwed up everything in your life.

“And you have a group of people ... willing to be there for you and put their arms around you,” Weight said. “They feel closer than your family in so many ways.”

Unlike the old days, though, it’s no longer just a volunteer job. Peer support is seen as so important that in 2017 the General Assembly approved peer recovery specialist as a registered health profession in Virginia.

Peers, as they are called, must have two years of sobriety, complete an approved training program, pass a certification exam and complete 500 hours of practice before registering with the state Board of Counseling.

Peers don’t provide addiction treatment. That’s done by inpatient and outpatient practioners, Chris Alderman said. But peers support people as they begin and maintain their recovery.

People come to 401 Peer Center to watch TV, drink a cup of coffee or eat a handful of Goldfish crackers. The long couches, over-sized bean bag chairs, soft lighting and inspirational quotes hanging on the walls invite conversation. And sometimes there are special reasons to show up.

Misti Carper said she’d been attending meetings and movie nights for a while when something unexpected happened. In September, the center sponsored a free recovery concert with headliners Joe Nester and Marshall Alexander, both musicians in recovery who perform in sober venues.

Years of seeing drug and alcohol use at country music and rock shows made her skeptical that she could enjoy live music without risking her sobriety.

“That was the first clean concert I had been to,” Carper said. “To be able to go to a concert and not even worry about temptation being there was awesome.”

Today Carper works full time, is engaged to be married and lives with two of her children. She said she plans to train to become a peer support specialist.

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