Steve Loyd and Robert Pack’s partnership

Steve Loyd and Robert Pack’s partnership brought research, regional coalition-building, and personal knowledge of opioid addiction together in an effort to make treatment available in rural Tennessee. Its clearest expression was Overmountain Recovery, a clinic planned to offer medication alongside counseling, alternative therapies, and job-training support. The partnership mattered not only because it helped create a treatment site, but because it showed how a locally rooted coalition could negotiate opposition and institutional barriers without reducing recovery to medication alone.

A partnership within a regional coalition

Robert Pack was a public-health professor at East Tennessee State University whose addiction research began after a close friend died by suicide related to opioid use in 2006. He helped lead a regional working group that brought together mental-health and substance-use administrators. Steve Loyd, a physician with local roots and a history of opioid addiction, co-led the group with Pack. Their collaboration thus connected academic and institutional work with a leader who could speak from his own experience of dependence and recovery.

The working group had developed beyond a single clinic proposal. With backing from East Tennessee State University, a regional nonprofit hospital corporation, and the state mental-health agency, it had obtained $2.5 million in grants, funded eight projects, generated twenty-five research proposals, and opened a Center for Prescription Drug Abuse focused on research. Overmountain Recovery became its latest project. Pack’s role in the coalition also extended to other local initiatives: a community coalition he spearheaded helped change the approach of Bristol Recovery Center director Bob Garrett, who had initially planned to exclude patients receiving medication-assisted treatment. The partnership therefore formed part of a broader effort to establish evidence-based treatment across the region, not simply a joint venture around one facility.

Designing treatment for a rural region

The planned clinic was in Gray, Tennessee, between Johnson City and Kingsport. Its name joined a local historical reference to a statement of purpose: Overmountain recalled the farmers and frontiersmen known as the Overmountain Men, while Recovery signaled an approach intended to reach beyond medication. The clinic’s proposed services included group and individual counseling, yoga and other alternative therapies, and job-training support.

Although the outpatient facility would eventually offer Suboxone, its primary medication was to be methadone. The organizers’ stated practical reasons were cost and the ability to limit diversion: patients would drink the liquid medication daily in front of a nurse. That choice addressed a major geographic gap. The nearest existing methadone facility was about sixty miles away, over a mountain. The clinic was conceived, then, as both a treatment program and a response to distance—the absence of nearby care made a local service consequential in its own right.

Loyd’s recovery and public credibility

Loyd brought to the collaboration more than professional status. He had been in recovery for over a decade when the clinic was being developed and could describe the ways his own addiction had affected his conduct as a doctor. Before seeking treatment, he had sought prescriptions from colleagues, taken medication from relatives’ medicine cabinets, and feigned an ankle injury to obtain surgery and leave with painkillers. His father confronted him in 2004 and compelled him to enter treatment.

That treatment included ninety days of inpatient rehabilitation, followed by five years of random drug testing, support services, and intensive monitoring. A condition of his recovery was the possibility that he could lose his medical license if he relapsed or made a serious medical error while treating a patient. Even after becoming Tennessee’s assistant commissioner for Substance Abuse Services, he continued checking daily through a cellphone app for the possibility of a random drug test. This ongoing structure gave his advocacy a concrete dimension: recovery was not presented as a single decision or a completed episode, but as a continuing practice supported by accountability and care.

Opposition and the clinic’s opening

The proposed clinic encountered organized resistance in Gray, a middle-class community of farmers and suburban residents, with a high school nearby. Citizens to Maintain Gray worried that patients receiving methadone would be unsafe drivers. Some opponents were not opposed to treatment in principle but did not want the center in their own community. The account also records that some privately acknowledged to Loyd and Pack that addiction had affected their own families.

Pack and Loyd responded by listening to residents and bringing in police chiefs and methadone providers from elsewhere. Those outside participants supplied examples and studies from other communities to address safety concerns before local decision-makers. The organizers endured more than a year of public opposition; in a town of 1,222 people, over 300 spoke against the project, and some characterized Pack and Loyd as drug lords. Their process culminated in near-unanimous approval from the city zoning board and approval from the state. Overmountain Recovery opened in September 2017.

Significance of their collaboration

The partnership’s achievement lay in joining capacities that the treatment system often kept separate. Pack helped organize research, funding, and interagency cooperation; Loyd connected that work to local experience and to the demanding routines of long-term recovery. Together, they helped move a clinic from a regional plan through public scrutiny and into operation, with a design that paired medication with broader supports.

The opening did not erase the region’s treatment shortage or the stigma that shaped local debate. It did establish a practical alternative to leaving patients to travel roughly sixty miles for methadone, and it demonstrated how a coalition could answer opposition through sustained engagement and evidence. In the book’s account, Loyd and Pack’s partnership is therefore both an institutional collaboration and a model of community-level response: research and lived experience worked together to build a service that neither could have provided on its own.