Students score a victory in the battle against substance use disorder in Appalachia

Criminology and sociology major Amanda Ljuba had never known or, let’s face it, understood much about the mysterious legislative happenings inside the Virginia State Capitol.

But she and fellow student Saket Bikmal, then a senior studying computational and systems neuroscience, dropped everything to take a road trip to Richmond this spring on behalf of House Bill 105. “Hi, we’re from Virginia Tech,” they said as they met with delegates or their aides. “We’re with Hokies for SUD Recovery. We really want you to support this bill.”

For good reason. The bill they were advocating for was one that, as students in a fall 2021 Appalachian Community Research course, they helped write.

House Bill 105 proposed studying the feasibility of transforming Southwest Virginia's Catawba Hospital from a mental health facility into a state-of-the-art treatment center for substance use disorder (SUD). The need for the project was dire, they'd learned. With SUD running rampant in Appalachia, housing and treatment facilities were available locally for only about one in 10 people who needed them.

After interviewing local stakeholders, the course's 11 students determined to recommend the Catawba Hospital study. Co-teachers Emily Satterwhite, associate professor in the Department of Religion and Culture, and Julia Gohlke, associate professor of environmental health in the Virginia-Maryland College of Veterinary Medicine, invited Del. Sam Rasoul of Roanoke to help them write the text for the bill.

Rasoul officially introduced HB 105 in the House of Delegates in January. By then, of course, the Appalachian Community Research class had wrapped up.

But a few students found they couldn’t walk away from HB 105. Hannah O’Malley, then a senior in neuroscience, said, “I don't think there's any possibility of me not sticking with this and trying to see it through.” 

So O’Malley, Ljuba, Bikmal, and Neha Reddy, then a senior studying nanomedicine and neuroscience, signed up for an independent study with Satterwhite and gave their group of legislative warriors a name: Hokies for SUD Recovery. 

Throughout spring semester, they promoted the Catawba Hospital bill. Monday mornings, they hatched plans, and assigned tasks in a Google doc: post on social media, email legislators, call leaders at Carilion, talk to Rasoul’s legislative aide.

When they heard HB 105 was coming up for a vote in the House rules committee on a Thursday in February, Bikmal and Ljuba skipped classes to testify in Richmond. They didn’t get a chance to speak — the committee chair put it to a vote too quickly — but they relished seeing each committee member vote yes. More good news came a week later, when the full House of Delegates voted 99-0 in favor of their bill.

HB 105 then headed to the Virginia Senate. Unfortunately, that’s where it stalled out, when a motion in the Senate Rules Committee tabled it to the 2023 legislative session. To a despondent Bikmal, Ljuba, O’Malley, and Reddy, it looked like HB 105 was dead for now.

One Hail Mary pass remained. Rasoul had inserted a line-item request for funding for the Catawba Hospital feasibility study into the state budget. The students had no idea if it was likely to go through. “After the bill did not pass, I was kind of like, ‘Hannah, don't get your hopes up,’” said O’Malley.

In early June, a few weeks after Bikmal, O’Malley, and Reddy graduated from Virginia Tech, they heard news so good they didn’t know if they should believe it. The new Virginia state budget passed with $750,000 in funding exclusively for the Catawba Hospital study, part of a larger effort to assess Virginia’s mental health infrastructure. 

It wasn’t HB 105, the way the students originally envisioned the study moving forward, but the project they cared about was actually happening. “We put a lot of effort into getting this to pass, and it feels like that truly paid off,” said Bikmal.

The feasibility study will be completed by Dec. 1, and for the next six months, the Hokies for SUD Recovery students plan to remain involved. In June, a few of them attended a stakeholder meeting at Catawba Hospital, a sign of a commitment that's outlasted coursework. In politics, said Rasoul, “there’s such a high degree of apathy. And they’re continuing to stick with it. I was impressed that even in June they showed up.”

That their efforts to transform substance use disorder treatment in Appalachia have the potential to impact real lives became clear at the graduation celebration for the Virginia Tech Recovery Community, where Hokies for SUD Recovery was presented with the Recovery Ally Award. 

What made the ceremony in Hahn Horticulture Garden particularly meaningful was hearing graduates share their stories of overcoming substance use disorder. These were the people their solution was meant to help. It was a full-circle moment, a reminder of how talking to community members in recovery for their Appalachian Community Research class sparked their passion for SUD recovery. “I think we all cried,” said O’Malley. 

This fall, Hokies for SUD Recovery will continue their work on campus and off. They hope to raise awareness of SUD, encourage campus groups to participate in Narcan training, and use storytelling to decrease stigma. “The fight isn't over yet,” said Ljuba. “We've still got a lot of work to do.”