Nancy Hans

Nancy Hans was a drug-prevention coordinator in Roanoke County whose experience illustrates how the emerging heroin crisis could remain obscured even to people working in prevention. Early efforts focused on unused medications and synthetic bath salts, while the connection between prescription opioids and heroin went largely unrecognized. By the time that connection became clear, Hans was hearing from mothers of addicted young people and speaking to students at the schools their children had attended.

Prevention Before Recognition

In 2010, the Prevention Council of Roanoke County, where Hans worked, began holding drug take-back events so residents could safely dispose of unused medications. Looking back, she wished the events had drawn particular attention to opioids. At the time, however, the risks of prescription painkillers were not yet central to the council’s approach.

In 2012, at the urging of local police, Hans launched a campaign warning parents about synthetic bath salts. The products had attracted attention because of reports of erratic behavior and two overdose deaths among local young women. After the president signed a law banning their sale, Vice magazine came to Roanoke to report on the issue. The bath-salts problem was real, but Hans later understood it as a short-lived distraction from the quieter and deadlier spread of opioid addiction.

The Prescription-Drug Blind Spot

Hans acknowledged that local prevention workers had not understood the connection between heroin and pills until at least 2014. The gap was not confined to prevention campaigns: doctors, too, did not always recognize their role in the developing problem. A prescription of thirty Percocet pills for a teenager after wisdom-tooth extraction seemed ordinary enough that parents did not know to question it. Hans described the period as one of shared denial, in which the danger was present but difficult for families and professionals to see.

The contrast between the public alarm over bath salts and the slower recognition of opioids marked a failure of attention as much as a failure of information. A visible, sensational problem drew a campaign and outside media interest; opioid exposure through routine medical prescribing did not prompt the same immediate response. Hans’s later reflection connected those choices to the time lost before communities recognized how prescription pills could lead users toward heroin.

From Hindsight to Community Contact

Within five years, Hans had mothers of addicted young people saved in her cellphone. Her work brought her from funerals for young adults who had died of heroin overdoses to prevention talks in the high-school auditoriums they had once attended. The movement between mourning and prevention gave the crisis a local and continuing shape: the people lost were not abstractions, but former students whose deaths became part of the warning delivered to those still in school.

Hans’s experience also records a change in what prevention required. Early take-back events and a campaign against bath salts had addressed drug risks without identifying the opioid pathway at the center of the unfolding crisis. Later, her contact with families and the funerals she attended made that crisis harder to treat as distant or exceptional. Her retrospective account places the missed connection, the consequences of delay, and the work of warning young people within the same community history.