Paving the road to recovery from addiction in rural NC

This story is part of the Blue Cross and Blue Shield of North Carolina Changemakers series — where we travel the state to find people making a difference in the health of their communities. Read more on our Point of Blue blog.


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.”

Ericka Minton, a harm reductionist at WRR, provides assistance to peers in recovery, including syringe exchange, wound care and free Naloxone kits, which reverse opioid overdoses.
Ericka Minton, a Harm Reductionist at WRR, provides assistance to peers in recovery, including syringe exchange, wound care and free naloxone kits, which reverse opioid overdoses.

In 2015, she opened Wilkes Recovery Revolution (WRR), a peer-run organization with a staff that shares the lived experience of addiction. WRR began with one transitional housing unit, donated by a local family. Over the past seven years, the nonprofit has expanded its facilities, services, and programs, creating a recovery ecosystem. One aspect of the ecosystem is the R3 Recovery Center, which Lyall refers to as “The Hub.”

“We realized really quickly that we needed a center where people could walk in and say, ‘I need help’ or ‘My son needs detox’,” Lyall says. The Hub is open weekdays from 9:00am–5:00pm, with plans to soon become a 24-hour operation. It serves as a safe space for anyone who needs acceptance, assistance or physical separation from a negative environment.

At the hub, WRR “navigators” (Lyall’s term for peer support specialists), connect those in need to a variety of resources that WRR provides. There are now three peer-driven transitional housing facilities: one for women and two for men. An employment assistance program helps residents find jobs. There are wellness education workshops and work-study opportunities, including the Fresh Mobile Market, a collaborative with local farmers to provide underserved communities with access to healthy food.

In addition to support services, WRR’s harm reduction program offers wound care and syringe exchange in order to reduce infection and disease among users. The program also provides free Naloxone kits, a life-saving medicine that reverses opioid overdoses.

“We really have to meet individuals where they’re at in their journey with love and compassion, and be ready to provide services,” Lyall says.

WRR has found that those seeking recovery services are more apt to take action when met with open arms and open minds. The results speak for themselves: In 2021, WRR conducted 907 recovery coaching sessions, distributed 571 Naloxone kits, collected 87,617 syringes, donated $30K in dental care, helped facilitate 17 enrollments at Wilkes Community College and watched as 82 certification programs were successfully completed.

And, most important of all, 70 lives were saved through overdose reversals that year. In total there have been more than 500 overdose reversals since the organization first opened its doors.

A community that once averted its gaze from the crisis hiding in plain sight is joining Lyall’s mission. WRR is working in tandem with Wilkes EMS and the local hospital to start a post overdose response program. Through a partnership with the North Wilkesboro and Wilkesboro Police Departments, WRR created a new Crisis Intervention Team. WRR staff are connected with law enforcement to help support when mental health and substance use/misuse are dispatched and respond to hospital calls and mobile crisis referrals.

In early 2025, Lyall hopes to open the doors to Evolution Treatment Center, the first inpatient facility for substance abuse in the area. Situated in the mountains, the campus—a former charter school—will house a 44-bed center for those taking their first steps on the road to recovery.

Heather Casey, a Wilkes County resident and employee of Blue Cross and Blue Shield of North Carolina (Blue Cross NC), met Lyall in 2021 and has become a regular volunteer at WRR events. She’s also served as the connector between WRR and Blue Cross NC, finding ways for the organizations to work together to improve the health of their shared community.

In 2022, WRR participated in Blue Cross NC’s Extra Miles Tour (EMT). This statewide listening tour enables company leaders to meet with local organizations and hear firsthand about the challenges they face in order to find meaningful ways to support. During the EMT stop in Wilkes, Lyall was able to shed more light on the addiction issues plaguing Wilkes County, and the impact her organization is making.

“The work being done by people like Devin is changing and saving lives of people here in Wilkes County and beyond, and giving them hope for their future,” Casey says. “Blue Cross NC is proud to support Wilkes Recovery Revolution as they work towards making North Carolinians healthier by meeting people where they are on their journey and providing them with the essentials for good health.”

Lyall says that in the past two years, there has been a positive shift in the way community members are talking about substance misuse. The “meet them where they are” mentality is growing. So are compassion and connection.

“In rural communities, there’s this unique way of weaving people together to help them find their place in the work. I learned that if you want to go fast, go alone and if you want to go far, go together.” Lyall chose the latter.

Her days are beyond busy, running a growing organization and being a mom, but Lyall has still found time to reconnect to dance by leading a local children’s theater camp. Though the choreography of her life may not have been what she originally planned, it’s moving an entire community in the right direction.