UNC Health Care
Rachel and her daughter, Marleigh

A Young Mother’s Journey to Recovery

Rachel Lankford, 24, started abusing drugs when she was 13. By the time she was 22, she had experienced a lifetime’s worth of trauma: She had a gun held to her head as her house was robbed by an ex-boyfriend, she watched loved ones overdose, she went to rehab twice and also spent time in jail.

But when Lankford lost custody of her 9-month-old daughter, Marleigh, she was willing to do anything to get her back. North Carolina Child Protective Services recommended she get into a drug treatment court as a first step, which provides treatment services to convicted individuals who are addicted to drugs.

“What they failed to mention was how hard drug treatment court was and that you actually had to do what they tell you or they will put you in jail,” Lankford says. “I didn’t know how to live without Marleigh, and the only way I knew to cope was to get high.”

After failing five drug tests because she continued to use opioids while in drug treatment court, she was sent to jail for a month and then to a rehab facility in Asheville for 90 days as she waited for a spot to open in a residential program at the UNC Horizons Program, a substance use disorder treatment program for pregnant women or women with children.

A Lifeline for Mothers

The UNC Horizons Program is a comprehensive recovery and relapse prevention program that includes a range of residential and outpatient services. Women in the program receive prenatal and OB-GYN care, psychiatric services, individual and group counseling, and medication-assisted treatment for opioid use disorder.

The program helps women with practical tasks such as finding a job, creating a budget and managing finances, as well as emotional skills needed to create healthy relationships and heal from abuse and violence. Treatment goals are individualized to address the needs of each woman and her family.

For women and their children in the residential program, each family lives in a rent-free apartment at one of two local apartment complexes, which are staffed 24 hours per day, seven days per week.

Mothers attend full-time treatment programming, and children up to age 5 attend UNC Horizons’ 5-star Early Head Start Child Development Center. Older children attend schools in Chapel Hill.

Each mother-child pair is visited at home by a maternal-child therapist who works with them on how to read each other’s cues and establish bedtime, meal time and discipline routines. This helps bring consistency and predictability to the home while building parenting skills, all in the service of reducing the chances of child abuse.

A Rough Road to Horizons

Lankford relapsed the day before she was to start at Horizons.

“All I had to do was stay clean,” she says. “But I didn’t. I got drunk on the Fourth of July and went to see an old boyfriend who was still using. I thought I could hide it.”

On her third day at Horizons, a drug test revealed she had relapsed, which meant she had to go back to jail.

“I had just gotten Marleigh back. I had her for a weekend, and then she went back to foster care for the 72 hours I went back to jail,” Lankford says. “Then someone from Horizons picked me up from the Orange County Jailhouse and took me back to the program. I got Marleigh back that same day, and I haven’t let go of her since.”

Families and Addiction

John M. Thorp Jr., MD, a longtime faculty member in the UNC Department of Obstetrics and Gynecology, started Horizons in 1993 in response to the drug and alcohol use epidemic in the late 1980s.

“I believe that addiction is a family disease. Whether it’s genetics or environment — it’s probably a complex mixture of both — we can break that intergenerational cycle of addiction and violence.”

“There was a great need in North Carolina for a treatment and recovery program for pregnant and mothering women that helped to resolve the issues of drug use that are specific to women and their families and kept those families together,” Dr. Thorp says. “I believe that addiction is a family disease. Whether it’s genetics or environment — it’s probably a complex mixture of both — we can break that intergenerational cycle of addiction and violence.”

“I believe that addiction is a family disease. Whether it’s genetics or environment — it’s probably a complex mixture of both — we can break that intergenerational cycle of addiction and violence.”

What began with a handful of patients in his clinic is now a robust program with more than 200 clients from across North Carolina each year. About 50 percent are pregnant when they enter the program and about 90 percent have at least one child.

More than 5,200 women and children have been through the Horizons program since its inception.

Executive Director Hendrée Jones, PhD, says what makes Horizons different from other treatment and recovery programs is its focus on breaking the cycle of both addiction and trauma.

“The vast majority of our women have had sexual, physical and emotional abuse since childhood that has continued into adulthood,” Dr. Jones says. “So we focus on being able to heal that and help women see their self-worth.”

A Chance at a New Life

Rachel and her daughter MarleighLankford says Horizons helped rehabilitate her physically and emotionally to get to the core of her problems.

“I was tired, beaten down and broken. I had been abused. I didn’t love myself, and when I got to Horizons, it wasn’t all on me anymore. I had a therapist who saved my life,” she says. “They were all there for me. My case manager from Horizons went to every court date with me, and I had a lot of court dates. They saw me as a human being, not just another case.”

After nine months at Horizons, Lankford graduated from the recovery program. And three months after Marleigh turned 2, Lankford received full custody.

“This program can transform lives and families,” says Elisabeth Johnson, PhD, family nurse practitioner and director of health services at Horizons. “What I love most about my job is being able to see the difference we can make, not just in a person but in an entire family. The women we take care of are the strongest, most resilient, amazing people you’ll ever meet.”

Today, Lankford has been drug-free for more than two years. She enjoys watching Marleigh perform in her dance classes and run around on the farm Lankford’s family manages. Lankford now works as a residential adviser at Horizons, providing residents with peer support, encouragement and transportation.

“I am there to provide moral support, but not counseling. I love my clients because I see myself in them,” Lankford says. “I am humbled to be their inspiration just like others were for me when I was undergoing treatment. I love telling them my story. I wouldn’t have the relationships I have in my life now if it weren’t for Horizons. They’re family.”


Learn more about the UNC Horizons Program and meet another mother in the program.