One woman’s controversial fight to get America to accept drug users for who they are

Introducing Louise Vincent at a drug policy conference in Phoenix last month. The crowd burst into applause.

She was a small woman, skinny. At 47, her face is weathered by what she describes as a hard life.

The situation has become more difficult in recent years as drug cartels have begun pushing deadlier drugs, including fentanyl and the veterinary drug xylazine, into American communities.

“We’ve seen a sea change in the supply of drugs,” Vincent told the crowd. “poisonous.”

Vincent said in an interview with NPR that she began using drugs at the age of 13 and was never able to live soberly for long. “What they told me was that if I couldn’t get off drugs, I wasn’t doing the right thing, but that’s not true,” she said.

Vincent points to research showing that abstinence-focused recovery approaches don’t work for many addicted people.

His own ideas are controversial and face strong opposition from many American politicians. Many Democrats and Republicans want tougher laws and longer sentences to combat fentanyl.

But Vincent has become one of the nation’s leading voices pushing to humanize and fight for help for addicts like her, even if they are not yet willing or able to live sober.

“We have made it possible to abandon drug addicts. We tell everyone that it doesn’t matter even if they die,” she said.

With more than 112,000 drug-related deaths in the United States each year, she believes the country’s focus on law enforcement and drug treatment isn’t working, and it’s time to try something new.

“How many years have we been really pushing abstinence?” Vincent said. “Then where were we?”

A “Harm Reduction” Philosophy Born on the Streets

Vincent’s own drug addiction began early in North Carolina. From the beginning, she told people that she was worthless, a drug addict, a criminal, and a zombie.

“I felt like I didn’t belong anywhere,” she said. “It’s devastating.”

Vincent believes this shame, rejection and isolation deepens the cycle of addiction and self-destructive behavior, leaving people like them vulnerable.

The illegal drug supply has become even more dangerous since Vincent started taking drugs. Several years ago, before public health warnings were issued about the dangers of After mixing xylazine with fentanyl, Vincent administered a dose of the chemical cocktail.

This left her with wounds that have yet to heal. “It ate the skin off my whole arm,” she said. “I can’t even talk about it without crying.”

This part is hard for many Americans to understand. If drug use is so harmful, why don’t thoughtful people like Louise Vincent just stop?

Research shows that addiction doesn’t work that way.

It’s complex and hard to beat, entangled with everything from mental illness and trauma to poverty and homelessness.

Federal investigators say approximately 27.2 million Americans suffer from some form of drug addiction. Approximately 5 million to 6 million people in the United States abuse opioids each year.

Opioids like fentanyl and heroin are especially difficult to escape. Relapse is common.

Most experts agree that the United States has failed to create the health care system needed to help more people recover.

Vincent’s argument, made in conferences and public appearances, is that America needs to reinvent addiction care by treating addicts with dignity and helping them avoid the worst outcomes.

Addiction strategies Vincent supports include:

• Provide drug users with basic health care and access to clean needles and other supplies proven to reduce diseases such as HIV/AIDS and hepatitis C
• Making treatment for opioid addiction like methadone and buprenorphine more accessible and affordable
• When street drug use threatens to disrupt communities, it should be responded to with affordable housing, counseling and other supports, not more arrests.

“I just want to say that I didn’t start harm reduction because I wanted to save the world,” she said. “I wanted to save myself. I needed a family. I didn’t want to feel rejected anymore.”

Let drug addicts come out of the shadows

Vincent was one of the first activists in the United States to put many of these ideas into practice, publicly providing services and care for active drug users.

She founded the Urban Survivors Alliance, a space in downtown Greensboro, North Carolina. Drug addicts who come here don’t have to hide their addiction. They can have a meal or a cup of coffee.

“It was a mess, and we worked very hard to make it a comfortable, warm place,” she said during an NPR tour of the facility.

Staff can direct people to social service programs or treatment. There is equipment that can detect high-risk chemicals like fentanyl and xylazine in street drugs.

“We are creating a wound room for people coming in with xylazine wounds,” Vincent said.

She compared this grassroots effort — to humanize and make drug users public — to the fight for LGBTQ acceptance in the 1990s. She said the stigma and deaths surrounding addiction during the fentanyl crisis mirrored those of the early HIV/AIDS epidemic.

“Our entire community was swept away. I can’t even imagine all the people I knew who died,” she said.

“I mean, a lot of people died. My daughter died. Our mentor died. Sometimes I can barely stand standing here because of all the trauma and people we’ve lost.”

Many drug policy experts in government, academia and addiction treatment — including the American Medical Association and the American Society of Addiction Medicine — agree with Vincent that the current U.S. approach to the drug crisis has failed.

The AMA and ASAM have endorsed the idea of ​​providing safe places to use drugs as a strategy to reduce fatal drug overdoses, as Canada, Portugal and other countries have done, But so far, only two such sites are publicly operating in the United States, both located in New York City.

“It’s so dangerous right now that there are some answers and some effective measures that we simply refuse to implement,” Vincent said.

‘Harm reduction’ faces backlash as public anger over drug use grows

Many politicians are moving in the opposite direction. In response to homeless encampments and open-air drug markets, some Democrats and Republicans support stricter drug laws against fentanyl, like those passed during the crack cocaine epidemic.

Vincent fears the backlash will drive more people like her underground, making them more vulnerable to overdoses.

“They’re now saying arrest, arrest, arrest, arrest,” she said. “No one is going to talk about a drug they’re not already using.”

Vincent said she will continue to fight for the idea that drug users across America should be accepted and have places like her Drug User Union where they can feel welcome and safe.

“I think that’s what it’s all about. We built this and we did it underground when it was illegal,” she said. “I would break the law again. I believe drug users should be treated with dignity and respect.”

But with fentanyl deaths still rising and many politicians promising a tougher response, Vincent acknowledged that his vision of drug users being accepted and cared for in the United States remains out of reach.

April Laissle, host and reporter, NPR member station WFDD in North Carolina contributed reporting to this story

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