Drug addicts orphaned in Virginia

ABOUT THIS ARTICLE: This Sunday centerpiece is both a business and human-interest story. It's a snapshot of the lives of people struggling to get over their drug addiction while lamenting the closing of the place that turned them onto the path towards recovery -- a closing that represents a business trend in the treatment of addicts. Of my own articles, this is my favorite; I got to observe and talk to these people for a while, and their candor is not something I've ever been able to find to quite the same extent.

THE ROANOKE TIMES
January 21, 2007
Last chance at life
Roanoke's longtime "home of last resort" for hard-core drug addicts will close its doors in May.
By Ana Ribeiro

As Roxanne Sargent lay down on a massage table, completely relaxed, the whole world stayed outside the therapy room.

Suddenly, it came rushing in.

"He was going to kill me and rape me," she groaned, reliving a night in the woods more than a decade ago, when she barely escaped an attacker.

Therapist Diane Elliot moved her hands under Sargent's back and gently prodded her to describe memories the touch brought forth. Sargent, 40, screamed and writhed as she remembered sexual abuse she experienced as a little girl, from her stepfather.

Meanwhile, downstairs in Hegira House's living room, several people sat and talked openly about their turbulent pasts. Like Sargent, they're facing painful issues stemming from drug addiction. They must dig deep inside to find what led them to drug abuse in the first place, and rebuild their self-image.

They're all residents of the long-term drug treatment center, which opened in Roanoke in 1973. Blue Ridge Behavioral Healthcare, the organization that runs Hegira, will close the facility in May. Hegira's 12-person staff and its annual $295,000 federal grant will go into outpatient treatment.

'House of miracles'

By the time the program ends, Hegira's 20 current residents will have graduated, but their attachment to the three-story white house on Patterson Avenue and the people in it will last a long time.

They are long-term addicts who've failed to kick their habits in other treatment programs, and have been in jail or prison. Some are finishing sentences at the house. Many feel Hegira is their last chance in life.

The residents have taken news of the closing pretty hard. They see other patients and staff as family, and the house as a safe place they can return to in times of temptation.

"[With Hegira,] I know I'm not alone in this big city, in this big world," said Sargent, a recovering cocaine addict who is expected to graduate in February.

"I've been in and out of jail since I was 18 years old," said recent Hegira graduate Michelle Hess, 26. "In my heart, I honestly believe that if I hadn't come through here, I would be dead now. ... I call this 'the house of miracles.' "

She entered Hegira in November 2005 upon her release from state prison. A recovering crack and OxyContin addict, Hess said she started using drugs at age 9, after being raped by a teenage boy.

She recounted important lessons she learned at Hegira. Those ranged from simple arithmetic to how to live with other people, love herself and deal with the grief of being raped. She now wants to work on mending her relationship with her mother and getting custody of her four children.

"This place is magic. ... It changed everything about my life," said Angela Smith, 38, who had used various drugs and been in a state prison before entering and graduating from Hegira in 2003. Now she supervises 14 people at Goodwill Industries of the Valleys.

"I became employable. It helped me realize I was worth so much more than what I had been giving myself. I learned to get what I needed without stealing it. ... My family now trusts me."

One of the toughest

Hegira, a word with both Arabic and Latin roots, means "journey from a dangerous place." It refers to the forced departure from Mecca of the Prophet Muhammad and his followers in 622.

Above the house's fireplace hangs a drawing that depicts dark, somber alleys leading to an illuminated Hegira House in the back.

It has earned a reputation as one of the toughest drug treatment facilities in the state. Botetourt County Commonwealth's Attorney Joel Branscom said some convicts have told him they'd rather go back to jail than live at Hegira.

Hegira's philosophy is based on the "therapeutic community" model first adopted in the 1960s in New York and California. Adult residents live in a structured, self-contained society for four to six months while they develop responsibility and social skills. They perform tasks such as cooking, cleaning and working the reception desk, being promoted by merit.

They are also able to secure jobs in the private sector or in Hegira Works, an in-house janitorial services company. And they're eligible for various forms of healing, such as the touch therapy Sargent received on the massage table.

Hegira was the first program among eight or nine in Virginia to adopt that model, said Ken Batten, a director with the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services.

Several other programs remain, but Hegira is the last therapeutic community in Virginia to receive federal funding, according to Gail Burruss, Blue Ridge Behavioral's director of adult clinical services.

Over the years, Hegira has shown a high success rate. A 2003 study noted that 74 percent of graduates remained drug-free for three years after they left the program, said Kevin Lynch, a counselor at the house.

Although 70-percent-plus success rates are not unheard-of in residential programs, "most short-term programs don't have that success rate," Batten said. "You don't make those sorts of life changes in short-term residential care."

A question of resources

Money, resources and demand for drug treatment in the Roanoke Valley are at the root of the decision to close Hegira.

The house costs a little less than $600,000 annually to operate, said Eddie Blair, its program coordinator. About half of that comes from a Department of Corrections contract that funds 14 beds for prison inmates from all over the state.

Ending the contract will still leave the federal grant of about $300,000. That will be used to expand outpatient services and treat an additional 126 Roanoke Valley substance abusers each year, Burruss said.

"We have to serve our community by using our resources in the most effective and efficient way," she said.

Hegira's closing highlights a trend in drug treatment in Virginia, Batten said. High expenses leave long-term residential programs increasingly unable to sustain themselves.

The trend is further reflected in actual patients. From 2005 to 2006, the number of people served by residential drug treatment in Virginia dropped by more than half, from 10,490 to 5,238, according to the Department of Mental Health, Mental Retardation and Substance Abuse Services. Meanwhile, the number of people in outpatient drug treatment increased from 64,845 to 66,031.

Those numbers are little comfort to Hegira residents, or its staff. They argue that less intensive, shorter-term treatments don't always work for many addicts.

Branscom, the Botetourt prosecutor, would agree.

"We have a plethora of 90-day programs that ... don't seem to get the job done," said Branscom, whose sister is a counselor at Hegira. "Hegira can actually help them, and I haven't seen that in other programs."

Burruss argued that the success of substance abuse treatment has more to do with the time patients spend in programs than with whether they actually live in a treatment facility. Blue Ridge Behavioral will use the federal funds no longer needed by Hegira to send addicts into outpatient substance abuse programs immediately after they leave jail. Currently, they need to wait at least a month to enter an outpatient program, Burruss said.

Hegira staff who are redirected into outpatient treatment will be bringing the experience they gained at Hegira and adjusting the intensity of the outpatient treatment as needed, Burruss noted.

"Transitions are very, very difficult for people who are in need of services, people who finish up a detoxification," Burruss said. "This way, they'll have their own customized treatment."

Getting humbler

Like others who have fought drug dependency, Vinnie Dabney, a former heroin addict who graduated Hegira in 1999, strongly favors long-term inpatient treatment.

"There's a scarcity of those, not only in the state, but in this country," said Dabney, 54, a counselor at Family Service of Roanoke Valley. He also sits on Blue Ridge Behavioral's board of directors.

Dabney was cocky and arrogant and had a long history of arrests when he entered Hegira House. His six-month stay taught him to be humbler and more in touch with reality, he said.

He remembers Hegira's living room fireplace as a kind of altar used to help redefine residents' poor self-images. Whoever committed an infraction -- be it a sexual comment, fight or act of negligence -- stood in front of the fireplace as patients and staff confronted the violator.

The confrontation continued until the behavior was corrected. But hard work never ended while Dabney was there. He recalled replanting grass, painting inside and out, installing a new electrical system, changing carpets and sanding furniture during renovations for the Patterson Avenue house.

"It [Hegira] gave me things to do in terms of the structure; it allowed me to put things together and not be concerned with keeping up an image," Dabney said. "It takes you away from the stresses of daily life and allows you to focus on yourself. ... It's sad to think other people [after Hegira's closing] won't have the same opportunities that I had."

After the massage

Roxanne Sargent, who moved into Hegira in August, has found that self-confidence. She's also found an outside job. She said she keeps "praying a miracle will happen and this [Hegira] won't close, because a lot of men and women need this."

As she stood up from the massage table after her intense therapy session, her face was smeared with tears. She sniffled and felt her sinuses clear.

She'd begun to let go of the stress and pain she'd held in for years, both in her mind and body. She hugged her therapist, Elliot, for a long while and thanked her.

Elliot insisted that Sargent should thank herself above all, "for the courage and willingness to do this work."

"I feel young and I feel free," Sargent said. "The child that was taken from me, I have it back."