In a church basement on the southern edge of the Twin Cities area, a teary-eyed mother held her smartphone in the air and played a recording of her daughter Serena's final heartbeats before a drug overdose killed her at age 23.

One by one, about 20 parents listening to Serena's beating heart rose from their chairs and gathered at the center of the room, where they enveloped the grieving mother in a large embrace and spoke words of support. All had children who were in the throes of addiction or recovery, or who had loved ones who had died from substance abuse.

"It felt like I had come home to a safe place, like landing on a soft cloud," said the grieving mother, Deirdre Johnson, of Savage. "I could breathe again."

At the center of the circle was Pamela Lanhart, a family recovery coach who lost her 24-year-old son Jacob to a drug overdose in the fall of 2021. Lanhart has turned her grief into activism, and now stands at the forefront of a movement that challenges long-held views about how family members should respond to the opioid epidemic. They have abandoned the idea that people addicted to drugs need tough love and harsh consequences, and instead have embraced a strategy of empathy, love and unconditional support.

More than 3,000 people have joined workshops and family support groups led by Lanhart's nonprofit, Thrive Family Recovery Services, which has gained a passionate following among parents seeking ways to maintain contact with children in recovery or still using. They point to grim statistics— including a near-tripling of overdose deaths in Minnesota over the four-year period ending in 2021 — as evidence that the old approach is failing to save lives.

"It has become abundantly clear that shaming and punishing people doesn't work," Lanhart said. "This is a disease, and we would never shame a child of ours who was dying from cancer, would we?"

On a warm spring evening, the mood was upbeat as a dozen parents filed into the Hometown Church, in a wooded subdivision of Lakeville. They sat in a tight circle, each holding a thick lesson book with tips on how to communicate with loved ones struggling with substance abuse. The circle kept widening to make room for newcomers, as Lanhart placed a box of tissues and chocolates at the center.

Lanhart broke the silence with a plea for everyone to describe their "personal wins" for the week. There was applause when a mother announced that her son had reached the three-year mark of his recovery from opioid addiction. Another recounted how friends at her dancing class surprised her with hugs after learning that her son was struggling with substance abuse. "It was like a prayer had been answered," said the mother, Lynda Cannova, of the embrace.

Yet the specter of heartache looms over each of the group's Thursday night meetings.

Even in their happiest moments, parents acknowledged living with the awareness that, on any given day, their children could die from the increasingly potent pills being sold online and on the streets. Several of the parents had children who were using fentanyl — a synthetic opioid that is cheap to make and up to 100 times more potent than morphine. Fentanyl poisoning has become the leading cause of death for Americans aged 18 to 49, according to a Washington Post analysis of national death data.

"These days, it's irresponsible to say, 'Let that person hit rock bottom before getting them help,'" Lanhart said. "With fentanyl, 'rock bottom' usually means death."

When she began attending Thrive's support meetings, Johnson had already accepted the possibility that her daughter Serena might not live to her 24th birthday. Early this year, her daughter overdosed seven times in 10 days as she drifted from sober homes to the streets. At times, Serena would vanish for weeks at a time. Johnson would sometimes use a location-tracking app on her phone to rescue her from a dangerous home or hotel room, she said.

"There were times when Serena would call me at 2 or 3 in the morning and say, 'Mom, come get me,' and I would drop everything and come — no questions asked," Johnson said. "Other nights I would just pray to the Lord to take care of her, wherever she was."

Then, on the night of March 11, Serena collapsed on the bathroom floor of a treatment center in Minneapolis after taking fentanyl. She was resuscitated with Narcan, a drug used to reverse opioid overdoses, but was pronounced dead two days later. As a final act of kindness, Serena donated her organs for transplant, saving at least four lives, her family said.

Within 48 hours of her daughter's death, Johnson was back at the support circle in Lakeville, where she felt comfortable sharing her anguish. "I keep asking myself, 'Why am I still going?'" Johnson said. "What the others said really hit me, which was, 'We need you here to teach us what it's like on the other side of our worst fears.'"

All the parents in the group speak of nonstop stress, of living through anguished days and nights when they struggle to maintain relationships. A few expressed exasperation that their adult children's mental and emotional well-being had seemed to halt at the ages when they began using, making basic tasks difficult for them: making meals, scheduling doctor appointments, filling out job applications.

Much of Thrive's weekly sessions focuses on practical ways that family members can communicate with loved ones snared in addiction and too ashamed to talk about it. They do frequent role-playing exercises in which they practice asking open-ended questions about their children's lives, and avoid scolding or shaming language. They share tips on ways to control their anger, such as taking long pauses before reacting to chaotic situations.

"The opposite of addiction is connection," Lanhart said. "When we say things like, 'Don't talk to me until you're sober,' it has the effect of disconnecting us from our loved ones, and that chases them right back to the drugs that are killing them."

Cannova has lost track of how many times her 42-year-old son has overdosed.

For much of the past six years, she has lived in near constant dread and uncertainty, with her days dictated by whether her son was abusing drugs. Like many members of families torn apart by addiction, Cannova feared that she was too permissive, and she reacted to her son's substance use by kicking him out of her home. But that approach backfired: Her son ended up sleeping on the streets and in emergency shelters for months, where he sought out stronger opiates to ease his crippling anxiety and other psychiatric disorders, she said.

"There was a time when my attitude was, 'It's my way or the highway, and you have to face the natural consequences of your actions,'" Cannova said. "But then who do they turn to? You have to maintain a loving connection even if that connection is boundaried."

Holly Marshall, one of the members of the Lakeville support group, described checking on her 30-year-old son in his bedroom every hour when he was abusing drugs, to make sure he was still breathing. "There were stretches when I let his [substance] use consume me, when I couldn't eat and I couldn't sleep because I was so terrified," she said. "Now I've learned to communicate with him exactly where he's at, which means he knows he's loved."

For members of the support group, the weekly meetings can be both exhilarating and draining — particularly for those who are working to rebuild broken relationships.

On a night in April, a few of the parents looked exhausted as the conversation wound to an end and they clasped hands at the center of the room. With heads bowed and eyes closed, they took turns chanting words meant to guide them in the difficult days ahead.

"Patience," declared a mother.

"Kindness," said another.

Then, after a moment of silence, a few of the parents uttered the same word: "hope."