Chris Perkins

Chris Perkins was the Roanoke police chief who recognized that fentanyl was changing the city’s heroin crisis and made his retirement a final effort to bring police and health services into closer cooperation. His career joined two approaches that the book presents in tension: drug enforcement and community policing on one side, and treatment-oriented responses on the other. The Hope Initiative, his proposed swan song, sought to turn that tension into a practical route from contact with police to treatment.

Identity and Career

Perkins was forty-six in 2015 and had spent twenty-four years on the force. His earlier experience included undercover drug work in the mid-1990s, when he used the name Woody Call. By then, heroin was present in Roanoke, but the market and its perceived reach differed sharply from the one he would confront as chief. In the 1980s and 1990s, assistant U.S. attorney Don Wolthuis recalled, only a few dozen people in the area used heroin. It was commonly understood as an inner-city drug, associated in local assumptions with Black residents, and its users were often described as isolated and largely invisible. The later spread of heroin beyond those boundaries would make the older picture increasingly inadequate.

Perkins’s attention to changing patterns was rooted in a policing practice that used real-time information to refine where officers worked. He had long championed community policing, including officers’ engagement with teenagers in high-crime areas, sometimes on bicycle patrol. The book places that work against city crime figures: since 2006, violent crime had fallen 64.5 percent and property crime 39.9 percent. Those figures describe a broader change during Perkins’s tenure; they do not resolve the emerging drug crisis, which was changing form even as other measures of crime declined.

A Market Transformed

Perkins saw fentanyl as a turning point. In 2015, he anticipated that potent blends would draw more teenagers, including people who could snort drugs rather than inject them. That change could lower the initial barrier associated with injection and leave fewer visible signs, while counterfeit pills sold as Xanax or oxycodone could expose buyers to fentanyl without their knowing what they had taken. The danger, in his account, lay not only in the drug’s potency but in the ways it could reach people who might not identify themselves as heroin users.

The material sold in Roanoke had also changed. In Perkins’s earlier undercover years, dealers cut heroin with baby powder; by 2015, fentanyl had become the dangerous adulterant. He described a market saturated with heroin, supplied both by former crack dealers diversifying their business and by subordinate sellers. Roanoke police seized 560 grams in 2015, an amount the book equates to 18,666 doses. These seizures did not end the supply: after police removed one source, another could appear following a short delay, while overdoses continued. The contrast between the scale of enforcement and the market’s ability to replenish itself sharpened the limits of a response based on removing individual suppliers.

The structure of dealing had shifted as well. Cellphones had helped displace open-air markets, allowing transactions to be arranged in gas-station and shopping-mall parking lots. Hotels around Roanoke, near I-81 and Interstate 581, offered convenient places for distributors to sell and resume travel. Experienced dealers could use addicted middlemen for street-level transactions, reducing their own exposure. In this setting, the visible street corner was no longer a sufficient map of the trade, and one arrest could leave the broader distribution system intact.

Policing Beyond Arrest

Perkins had already pursued alternatives for some nonviolent offenders. In 2011, he pioneered the Drug Market Initiative, which offered participants the chance to avoid jail and receive job training if they agreed to leave the drug trade. The program did not amount to abandoning enforcement; rather, it recognized that a response to drug markets could include an exit from them as well as prosecution. The book sets this approach beside the intensified conditions of the mid-2010s, when users were increasingly drawn into street dealing and shoplifting to sustain their drug use, while deaths and other harms mounted.

As retirement approached, Perkins remained preoccupied with the crisis. He received crime reports on his phone every hour, including at night and on weekends, a practice the book identifies as one reason he retired early. In late 2015, he was trying to secure agreement among health-care and criminal-justice agencies for a new program. The model he admired came from Gloucester, Massachusetts, where police chief Joseph Campanello had offered people a route to treatment instead of arrest if they turned in their drugs. By early 2017, the Police Assisted Addiction and Recovery Initiative had been adopted by two hundred police agencies in twenty-eight states.

In Roanoke, the proposed local program was called the Hope Initiative. Perkins framed its incentive around treating addiction as a disease and making continued recovery a condition for police stepping back. Its design depended on cooperation beyond the police department: trained volunteers, called angels, would help people enter treatment and support them through a difficult process in which relapse was a recurring risk. The volunteers were intended to connect participants with the city’s housing, mental-health, and employment resources, taking a role comparable to an on-call recovery sponsor while also drawing on social-work skills. The program was to be based at the Bradley Free Clinic in Old Southwest, an area described as an emerging heroin hot spot.

A Proposed Handoff, and Its Limits

The Hope Initiative’s ambitions confronted a care system that could not reliably move people from an overdose or detox stay into continuing treatment. In Roanoke, psychologist Cheri Hartman and Kuehl worked on a hospital-to-treatment transfer modeled on Ontario protocols, where overdose patients were automatically referred from emergency departments to outpatient medication-assisted treatment and counseling. They faced bureaucratic, financial, and legal obstacles, including too few medication-assisted-treatment providers and insufficient detox and treatment beds. Hospital social workers were referring some revived patients to Hope, but a referral did not guarantee that a place in care would be available.

The shortfall became stark in the Hope Initiative’s first month: twenty-two people came through its doors, but none entered residential treatment, and only a handful obtained outpatient medication-assisted treatment. The volunteers’ careful spreadsheet could record contacts and interest, but it could not create beds or providers. This outcome makes the program’s central problem visible: connection and persistence mattered, yet the practical handoff depended on a larger service system with limited capacity. The account does not establish that Perkins personally solved those barriers or that his proposed program overcame them.

Perkins’s significance lies in the turn he tried to make at the end of his police career. He had worked within a department that pursued drug markets and pioneered a diversion program, then pressed for a local partnership that would treat addiction as a health problem and enlist volunteers to help people reach care. The Hope Initiative did not erase the divide between criminal justice and health care; it was conceived because that divide left people without a dependable path forward. His final effort therefore stands both as a practical proposal and as a measure of how much depended on cooperation—and on treatment capacity that the police chief alone could not supply.