Paving the road to recovery from addiction in rural NC

This story is part of Blue Cross and Blue Shield of North Carolina’s “Changemakers” series—where we travel the state to find people making a difference in the health of their communities and share their inspiring stories.

As a child, Devin Lyall’s life revolved around dance. She carried that passion into young adulthood—working as a dance instructor and choreographer in her small town of Wilkesboro, NC, and winning awards along the way. But despite decades of rigorous training, learning how to listen to and control her body, all it took was one slip on an icy patch of snow to send her life spinning out of control.

This is a story about opioid addiction. One of millions.

The disease can start in many ways—a back injury, a fractured bone. Anything that requires a higher level of pain relief. However, a short-term prescription for painkillers like oxycodone or fentanyl can easily lead to long-term, life-altering and, at times, life-ending outcomes.

Opioids continue to be one of the top health issues facing the nation today. Even though the CDC declared an opioid epidemic in 2011 and federal funding dedicated to addressing it reached $7.4 billion in 2018, the number of drug-related deaths keeps growing. In 2021, more than 106,000 people in the U.S. died from a drug-involved overdose, including both illicit drugs and prescription opioids—a staggering 51% increase in deaths from only two years prior.

In North Carolina, the opioid crisis swarms and threatens rural areas the most. Take Lyall’s home in Wilkes County. Here, set against the spectacular backdrop of the Blue Ridge Mountains, the tragedy of substance abuse has played out for years, gaining national attention in 2007 when it was ranked as having the third highest death rate in the nation due to prescription drug overdoses.

It wasn’t always this way. In its past, Wilkes County had been a textile and manufacturing giant, the home of an original NASCAR racetrack and the birthplace of Lowe’s Hardware. When manufacturing moved overseas, Lowe’s headquarters relocated and the speedway closed, economic depression followed, and livelihoods were lost. The area’s lack of resources and a societal reluctance to openly discuss addiction created space for the disease to spread.

“It just wasn’t something you talked about. It was something that usually got swept under the rug,” says Lyall. “I remember my dad even saying he couldn’t talk to his friends about it because it just made people feel uncomfortable. It was still very stigmatized in our rural community.”

Lyall grew up in a tight-knit family, graduating at the top of her class in 2004 and securing the title of “Most Likely to Be Remembered.” She gave birth to a daughter prior to graduation and worked as a dance teacher and hairstylist after. She married, bought a home and had her second child. Life was good.

Then, in 2007, Lyall broke her ankle at a ski resort. Over the course of 18 months, she underwent six surgeries and was prescribed opioids for the pain. When the prescriptions ran out, her dependency ran high, she says.

“My body was still screaming to have more. I had this feeling of this all-powerful woman. I was being a good mother. I was teaching dance…and [the drugs are] what I felt made that possible,” Lyall says.

By age 22, Lyall was purchasing opioids off the street. A year later, she was an IV drug user, which is when, she says, “Things really started to spiral.”

She lost her home, her job at the hair salon and stopped teaching dance out of shame. Cut off by her family, she signed over custody of her children to her parents and continued using, even after being hospitalized for sepsis and endocarditis, ultimately landing in the ICU for two weeks in 2011.

“I remember waking up and actually being desperate to not go back to the environment I had been in, willing to do whatever someone told me to do,” Lyall recalls.

Wilkes County had no detox center or treatment center within a two-hour drive. The lack of beds at the local emergency department meant that people struggling with drug abuse or misuse would often be turned away. Even when hospitalized, with no treatment or detox programs available, they would find themselves back in the grips of addiction upon release.

During her hospitalization, Lyall reconnected with her family. With their support she was able to travel to a detox center, two hours south in Kings Mountain. She stayed for 10 days, followed by a 30-day stay at an inpatient treatment center. From there, Lyall moved to transitional housing in Asheville to devote more time to her recovery. She was amazed and inspired by the thriving community there, where people talked openly about their addiction with no stigma attached. A year later, Lyall returned home, this time with a mission: to bring the same services that saved her life in Asheville to Wilkes County and create a community where recovery was possible.

“If it was hard for me to get access to services, then I can only imagine other people who were in similar situations without any support, what they would do,” Lyall says. “I was fortunate to be able to go somewhere because I had a family to lean on.”