Skip to main content
You are the owner of this article.
You have permission to edit this article.
Persons in recovery from substance use disorder can provide powerful help to others in need, but not all are allowed to help

Persons in recovery from substance use disorder can provide powerful help to others in need, but not all are allowed to help

  • 0

A handful of professionals will soon hit Richmond-area streets helping to steer drug users toward recovery at a critical time — immediately following an overdose.

Working with police and emergency medical services personnel in Richmond and Henrico and Chesterfield counties, four certified peer recovery specialists will have an edge when assisting those suffering from addictions: They are recovering drug users themselves.

Victor McKenzie Jr., executive director of the Substance Abuse and Addiction Recovery Alliance of Virginia, which helped organize Project RECOVER, explained that “sometimes the only way to break through is to have somebody who can talk that talk.” Other peer recovery specialists are being trained and certified to help in Richmond, the Virginia Department of Corrections and elsewhere in the state.

In Virginia, however, it’s not always possible for an experienced, qualified former problem substance user to help others in need. Rudolph Carey III, 51, of Stafford County, straightened his life out and became a drug recovery counselor. And he, like many who’ve been addicted, has a criminal record.

In 2018, he lost his counseling job because of a Virginia law banning people with convictions for any of 176 “barrier” crimes from “direct care” treatment positions for substance use disorder in facilities licensed by the Virginia Department of Behavioral Health and Developmental Services.

Earlier this month, Carey, represented by lawyers with the Institute for Justice in Arlington, filed suit in U.S. District Court in Richmond against the DBHDS, challenging the Virginia law as unconstitutional.

Constitutional or not, some experts inside and outside state government see the law as an impediment to hiring qualified help as the number of overdose deaths continues to climb.

In July, the Virginia Office of the Chief Medical Examiner reported that preliminary numbers for the first quarter of this year show the largest number of fatal drug overdoses ever seen.

Since the beginning of the COVID-19 pandemic in March 2020, fatal overdoses increased significantly and continue to remain record-breaking through this year, said the medical examiner’s office, which is predicting a toll of 2,576 this year compared with 2,308 last year and 1,627 in 2019.

SAARA is not involved in Carey’s suit. But McKenzie said, “Virginia’s behavioral health care system’s workforce is incredibly strained right now ... we need to have more peers in the work force for both substance use disorder and mental health. One of the challenges is barrier crimes.”

According to the DBHDS, certification is not mandatory for employment in Virginia as a peer recovery specialist. But certification is required to register with the Department of Health Professions’ Board of Counseling for billing Medicaid.

McKenzie said another challenge is the low Medicaid reimbursement rate paid to agencies employing certified peer recovery specialists.

He said that even with a recent increase, the rate paid to agencies billing Medicaid for peer recovery is less than $30 an hour, which must also cover administrative and other associated expenses in addition to the peer’s salary.

Because litigation is pending, officials with the DBHDS would not comment on Carey’s suit. But in a presentation to Virginia lawmakers in June, the department acknowledged that the barrier crime law impedes the hiring of otherwise qualified people.

“Many of these applicants have lived experience, or first-hand experience with mental health or substance use challenges,” which can help with providing services and is essential to the growth of peer services, added the department’s presentation.


Project RECOVER is a pilot project using people in recovery from substance use disorders that is being funded its first year by a $301,780 federal grant announced earlier this month by the U.S. Attorney’s Office for the Eastern District of Virginia.

The project’s partners include SAARA, Chesterfield Fire & EMS, the Henrico Division of Fire, the Richmond Ambulance Authority and the Richmond Police Department. The certified peer recovery specialists will be “embedded” with those emergency organizations.

The U.S. Attorney’s Office said that often, a drug overdose victim is left soon after encounters with EMS or police who must press on to other emergencies, and the drug abuser is alone without sustainable treatment and recovery options during one of the most critical periods on any path to recovery.

The goal is to fill that gap by providing people in need with immediate support from a peer who has overcome similar challenges and has gained real-world knowledge of treatment and recovery, said federal officials.

The project will have four certified peer recovery specialists and a supervisor providing support for overdose victims as they go through treatment and recovery. The recovery specialists will also educate and train others, including law enforcement, on how to provide support for those with substance use disorders.

The supervisor for Project RECOVER has already been hired, and McKenzie said he hopes to have the four peer recovery specialists hired and out and running by the second or third week of November.

He said, “Each one of the recovery specialists is going to work with a different locality. ... Ultimately they can co-respond with emergency services or on a delayed response.”

SAARA is also in talks with Hanover County to provide peer services there, he said.

“When EMS or [Richmond police] happen on an incident involving an opioid overdose or substance use-related incident, they have the ability to assess the situation quickly and then bring in this peer recovery specialist to connect with this person,” McKenzie said.

“This peer can offer them the resources that they need to navigate that path to recovery, whether it could be inpatient ... whatever it is and also some additional case management,” he said.


Carey, now a truck driver, said he would jump at the chance to get back into recovery counseling work.

Even though it could mean a cut in income, he said he believes his background helps him help others.

“People who are in recovery and have turned their life around ... we have a better understanding when the clients come to us when they’re ‘dopesick,’ or maybe they have family issues,” he said.

Dopesick is a common term among addicts — and the title of the nonfiction book by former Roanoke Times reporter Beth Macy — that describes the withdrawal symptoms chronic drug users can experience in the throes of active addiction.

“We can understand the pain that they go through. We can understand some of their thought processes and the low self-esteem,” he said. It is also harder for someone in recovery to fool someone else in recovery about how they are doing or what they are feeling and thinking, Carey said.

According to his suit, Carey used drugs and alcohol and would steal to pay for drugs. One day in 2004, he was on his way to buy drugs when he was pulled over by police for a broken taillight. He was high and driving on a suspended license. Carey signed his ticket with a fake name and, when the officer tried to arrest him for forging a public record, he tried to run away and struck the officer who was trying to handcuff him. He was released from prison in 2007.

Assaulting a police officer is one of Virginia’s barrier crimes.

After Carey was released from prison, he stopped using drugs and alcohol. He began working as a case manager at a homeless shelter and, after completing requisite study, he became a substance abuse counselor helping others with addictions.

In 2018, after five years working as a counselor, the facility where he was employed was sold. The new owners reviewed their legal obligations under the barrier law and contacted the DBHDS, which confirmed that Carey was forever barred from direct care positions at a state-licensed facility based on his then-14-year-old assault conviction.

Barrier crimes can be misdemeanors as well as felonies and include such offenses as robbery, recklessly driving a boat, prostitution, hazing and pointing a laser at a law enforcement officer, according to the suit.

“Most of these crimes have nothing to do with substance abuse counseling,” the suit argues. Nevertheless, since 2018 the ban has blocked roughly 1,100 people from positions supervised by the DBHDS, said Carey’s lawyers.

The suit contends that “there is no rational basis for this blanket, lifetime prohibition. It bars qualified counselors from working because of old and irrelevant offenses with no regard for present-day circumstances. ... This irrational scheme does not pass even basic constitutional scrutiny.”

Be it by a court decision or a change in the law, Carey said he wants to return to helping people and hearing them say, “When I talk to you, you understand and you can relate.”

“A lot of my clients used to say that,” he said.


Related to this story

Get up-to-the-minute news sent straight to your device.


Breaking News