Two new residential addiction treatment facilities for pregnant and parenting women are coming to Southwest Virginia, addressing a critical gap in care in a region hard-hit by the opioid crisis.
Strong Futures, which will be located in Norton, and Four Truths, in Roanoke, received funding from the Virginia Opioid Abatement Authority to launch and expand residential treatment options that allow women to keep their children with them in the facility while they go through treatment for substance use disorder.
Residential treatment programs for this population are limited across the state, and nearly nonexistent in far Southwest Virginia. Most resources are concentrated in the Richmond area, leaving a significant access gap in communities hardest hit by the opioid crisis. Yet demand is high. These types of programs treat substance use disorder while also providing the wraparound services needed to break intergenerational cycles of addiction and instability, said Tammy Albright, vice president and chief executive officer of Ballad Health’s behavioral health services.
The authority is an independent body tasked with distributing funds from opioid settlements paid to Virginia as a result of litigation against manufacturers, distributors and pharmacies that allegedly contributed to the opioid crisis. The money must be used to support programs that address illegal substance use across the state.
Strong Futures and Four Truths were developed through partnerships with city and county governments as well as other community partners. Both programs aim to address not only addiction but broader social determinants of health that drive it, especially among families.
Ballad Health will support Strong Futures in Norton with operational assistance and matching funds. The abatement funds, totaling about $597,000, will help pay for the renovation of the fourth floor of the former Mountain View Regional Medical Center to house the new program.
The medical center, which was acquired by Ballad in 2018 as part of the merger that brought together two health systems, closed its doors in April 2023 and has remained vacant since then.
“When these hospitals close, they become dilapidated very quickly,” said Anthony Keck, Ballad’s executive vice president for system innovation and chief population health officer. “We’re able to take that facility and repurpose it for another use.”
Ballad plans to transform the old hospital into a space that feels like a home. That process can be challenging, especially in a building that has stood vacant for so long, Albright said. But she’s seen it done before.
Strong Futures is modeled after a similar program in Greenville, Tennessee, where another hospital setting was renovated to resemble a personal living space. There, pregnant and parenting women can receive long-term addiction treatment without being separated from their children. 
Ballad’s leaders said they were motivated to bring this program to Virginia after analyzing results from their most recent community health needs assessment. For the first time, the health system included a survey of adverse childhood experiences, or ACEs, in Southwest Virginia, said Todd Norris, vice president of community health and system advancement.
These are potentially traumatic events that occur during childhood, such as exposure to violence, substance use in the household, mental illness or incarceration of a family member, according to the Centers for Disease Control and Prevention.
People who have had four or more adverse childhood experiences are more likely to develop substance use disorders, face unemployment and experience early death because of chronic disease, Norris said.
In Southwest Virginia, Ballad found that 68% of people had experienced at least one of these childhood experiences and 28% had experienced four or more, Norris said.
“It’s not an accident that when you have about a quarter of the people with adverse childhood experiences, you also see that about a quarter of the people, a quarter of the children live in poverty, about a quarter of the children are experiencing food insecurity,” Norris said. “This area has been the heart of the opioid crisis in America and is exacerbated by all of these social determinant factors in these early childhood experiences. That was the rationale for saying we really need to look at a program that can really turn the tide.”
The Strong Futures program aims to create a supportive ecosystem for recovery. Women who enroll will live on site with their children in a safe, homelike environment. They’ll continue caring for their kids while participating in parenting classes, life skills training and financial management training. Children will have access to Ballad’s early childhood services, medical care and help enrolling in local public schools.
The length of stay will vary based on individual treatment plans, ranging from two to six months. At the Greenville, Tennessee, Strong Futures site, the average stay is about four months, Albright said.
Currently, no residential treatment centers in far Southwest Virginia are specifically designed for pregnant or parenting women where children can live on site with their mothers. This lack of access can mean the difference between a mother keeping custody or permanently losing her parental rights.
Early intervention during pregnancy is critical in a region with some of the highest rates of neonatal abstinence syndrome in the state, a condition in which newborns experience withdrawal symptoms due to prenatal drug exposure.
In Norton, 38 out of every 1,000 newborn hospitalizations are linked to substance exposure, more than eight times the state average of 4.6, according to state data. In Wise County, the number climbs to 56 per 1,000 — over 12 times the state rate.
The Strong Futures program in Tennessee has shown promising results, according to Ballad’s grant application. More than 550 women have completed the program, and 95% of those who were pregnant delivered babies free of substances. Every mother who lived onsite completed the full program, exceeding the national average completion rate of 45% for long-term residential addiction treatment, according to grant materials.
A Roanoke program plans to expand
A Roanoke-based program is expanding sober living options for pregnant and parenting women and their children with the help of opioid abatement funds.
Four Truths, a nonprofit recovery residence, opened in 2024 with space for eight women and their children. Now, with the support of new funding, the organization plans to grow, adding room for four more women and increasing its total capacity to 12 families, according to the grant application.
Representatives with the organization declined to provide details beyond what was included in the grant application, saying that the final award notification is still pending.
The program is slated to receive a $154,800 grant from the opioid abatement authority to support operating expenses for one year. According to the grant application, future funding renewals will go toward capital costs to purchase additional recovery homes.
The Four Truths program serves as a step-down program from services provided at The Grove on Patterson, a residential treatment center in Roanoke for pregnant and postpartum women in early recovery. The Grove opened earlier this year through a partnership between Restoration Housing, Carilion Clinic, Anderson Treatment and The Twelve Foundation. It was created to replace the services once provided by Bethany Hall, which closed in 2022 after 50 years in operation.
Participants in the Four Truths program pay a one-time $350 admission fee and $140 per week for a minimum six-month stay. To remain in the program, women must be employed, adhere to a curfew and attend weekly recovery meetings, such as group therapy.
Support is provided by peer recovery specialists, individuals with lived experience of addiction who provide trauma-informed, maternal-centered care, according to the grant application. The program is designed to promote long-term recovery in a stable, supportive environment that allows participants to parent their children while rebuilding their lives.
