On a Mission to Show Up for Drug Users in West Virginia

    In the driveway next to an old brick church in Winston-Salem, North Carolina, the type of building that punctuates neighborhoods throughout the Bible Belt, a few of us load a van full of supplies⁠—3,000 doses of naloxone, 10,000 syringes of various gauges, condoms, lube, and all kinds of other goodies. The cool evening air makes my flesh pimple.

    My nerves are tight, stomach twisted. I’m still “on paper” until February; my probationary license only allows me to drive between 7am and 6pm for work purposes. I’m a drug user. What if my medicine gets confiscated? What if I get locked up and they won’t let me have my buprenorphine? I know that what I’m about to do is illegal, and my mind whirls with anxieties.

    My phone buzzes. “Weezie!” I squeal. It’s my long-time friend and partner in crime, Louise Vincent. She’s the executive director of the Urban Survivors Union (and a Filter contributor). As we discuss our mission to West Virginia, my fear is refocused into angry resolve. I must do what is right, regardless.

    Cranking up the outreach van, I start the drive through Appalachia.


    About a month prior, Louise had told me about her experience at the International Network on Hepatitis and Substance Users (INHSU) advisory meeting in Montreal. One speaker there was Dr. Judith Fienberg, a professor of Behavioral Medicine and Psychiatry at WVU, who presented about the dire situations drug users in West Virginia face daily.

    “It was embarrassing how far we are behind other countries.”

    West Virginia had easily the highest rate of opioid-involved deaths in the nation in 2017, at 49.6 per 100,000 people. Yet harm reduction programs have been underfunded and politically unwelcome. A syringe service program in Charleston, for example, was shut down in spring 2018. Counties have experienced recent HIV outbreaks.

    “It was embarrassing how far we are behind other countries,” Louise told me, exasperated. “You could see the shock on the faces of all these people from Europe and shit that have government funding and robust harm reduction programs.”

    A day or two later, Louise got a call from Shannon Hicks, who runs the West Virginia Exchange Union, the state’s drug user union. They discussed a new HIV cluster, preventable overdose deaths, and closures of syringe service programs. Shannon asked, “There’s too many of us to just let us all die, right?”

    The call ended with Shannon and Louise clear that something had to be done. So in late September, we put out the call to our networks of friends, allies and accomplices: Let’s help our people in West Virginia.

    The planning process that followedin all of its messy, inconvenient glorybrought me to this cool October night, driving through mountains blanketed with milky fog. 

    “Dan Bigg would not have just sat back and watched this, he would have done something.”

    Most people who have done harm reduction work for any length of time in the US have a Dan Bigg story. Dan, who died last year, ran the Chicago Recovery Alliance. But from Maine to Indiana to North Carolina to all over the damn place, Dan responded to the unmet needs of drug users, sex workers and other marginalized people with love, support and supplies. He never waited for permission to do this.

    “When I think about all the lives that have been saved with just the naloxone he supplied, it blows my mind,” Louise says as we reminisce in the van about our friend. “It’s Dan’s love and kindness that I think of whenever people are denied access to lifesaving supplies. He made sure that people got their hands on these supplies no matter what, because it is the right thing to do. He would not have just sat back and watched this, he would have done something.”

    So #BiggLoveWV had become our rallying cry as we planned actions, gathered supplies, and examined policy to support drug users in West Virginia, guided by Dan’s spirit. Those of us in the van and others arriving from around the country—many from states that have also suffered severe lack of harm reduction access, making it all the more personal—have two goals: showing (Bigg)love and bringing supplies.

    After arriving in Charleston that night of October 13, I find myself in conversation with Tanya, a friend who works with the North Carolina Survivors Union, as we ready supplies for distribution.

    She speaks of the time before syringe access was legal in North Carolina. “Oh my God, life was horrible back then,” she says, shaking her head. “Not only did we have to reuse rigs, we had to sharpen points over and over again, between lubing plungers and bleaching to try to prevent disease the only way we knew how.  It was almost impossible to take care of your health.”

    Tanya tells me, as her voice shudders and her eyes well up, that this hellish memory makes participating in today’s action so important to her.

    I look around the room and take in what we have accomplished: row upon row of brown lunch bagsall stuffed with supplies. Cramming our backpacks as full as we can the next morning, my friend Jes and I head to grab coffee to fuel what will be two days of continual outreach.  

     As we move through downtown Charleston meeting people who use drugs, many of them sleeping out or living in poverty, we hear the stories and concerns that many of us know all too well. Constant police harassment. Having to reuse syringes until all the lines and numbers are worn off. Sharing syringes out of necessity. Being abused in a litany of ways.

    One darkly humorous story comes from a man who says he and his friends are followed and harrassed regularly by police. One night, he tells us, the police ambushed them down by the railroad tracks where he and other unhoused friends sometimes hide supplies for later access. The officers jumped out of hiding, threw the men on the ground, and shouted at them to tell them where they had hidden their drugs. When they searched the bushes to find the supposed contraband, they discovered the friends’ stash of…assorted stale muffins. This story makes us laugh, but it also illustrates the repressive treatment of people who use drugs here in Charleston.

    So we do what we can. We empathize with folks, provide some education, and try our best to equip people to mitigate the harms from both substance use and oppressive systems. But we all realize that we are only scraping the surface of the need that is evident all around us.

    “When you have a death list so long you can’t even remember all the names off the top of your head, it’s time to start fighting.”

    Getting back to the outreach van after emptying my backpack, I drive to a vigil on the steps of the State Capitol led by some of my favorite people. I hate vigils, and ponder skipping out and holing up in a bar somewhere, but I don’t. About 40-50 people are gathered in the cold night air, bathed in the purple light of dusk. A few minutes in, people begin to call out names of those who have died.

    Faces float in and out of my mindfriends, acquaintances, loversbut the sheer volume renders me practically speechless, able to muster only a few of the many names I could add.

    Leaving the vigil, I recall something my friend Knina said the previous day: “When you have a death list so long you can’t even remember all the names off the top of your head, it’s time to start fighting. Fighting for your own friends, your own people and yourself, because by this point it’s obvious no one else is.” In the cool night breeze ghosts walk us to our cars, and I know they are with us in the fight.

    I’m still seeing Victoria, Nathan, Dan, Michael and all who have left us too soon as we assemble in the downtown Davis Square Park the next morning, steam rising from our clutched coffee cups.  

    “We can no longer sit idly by and wait for the slow tick-tock of politics.”

    Sharing embraces and small talk with a few folks sleeping out that I met doing outreach the previous day, my attention is soon grabbed by a familiar booming baritone. “Drug users are amongst the most talented, gifted and blessed individuals on the planet and we can no longer sit idly by and wait for the slow tick-tock of politics!” 

    It’s Robert Suarez, a veteran harm reduction organizer from New York, VOCAL-NY member and friend of us all, urging us to take back the power that has been stripped from us.

    Together, we express our pain and anger with chants of “Not one more!”; “Drug user rights are human rights!”; and “Shame on you Governor [Jim] Justice!” until our throats are raw. And then, one by one, we drug users, supporters and allies, holding cardboard gravestones representing those we have lost, lie down in the cool dewy grass and “die.” 

    Robert Suarez (right) with other activists in Draper Square Park.


    For 10 minutes we lie silently, as passers-by stare and camera crews film. I ruminate on all of the needless deaths inflicted by this war on people, haunted by the fact that there are many more to come. 

    I also recall being asked why we needed to bring supplies to an area that does have a needle exchangeand why the answer that is clear to me is less so to others. It’s complicated, but there are some things we know. For instance, when drug users are not included in the creation and delivery of services, they are usually not services that make a real difference in our lives.

    Drug users like us are trying to pick up the slack left by ineffective, insensitive, restrictive and judgemental programs. Even with our criminal histories, drug habits and so on, we showed up when we saw a need. 

    So here we are, on this lovely fall morning, staring into the sky or closing our eyes, communing with those we have lost, who live on through the work we all carry forward. 

    Louise Vincent being interviewed in Charleston.


    As we load up our cars and vans after the peaceful demonstration, we excitedly show each other pictures on social media with the #BiggLoveWV hashtag: Our allies around the country have been dropping banners to show love for West Virginia drug users, which we all agree is amazing.

    Driving home, I think about what could have been done better, about missed opportunities, and fret about how the media might frame the outreach, the vigil, the demonstration. Us drug users, like a lot of people, can be our own harshest critics.

    New funding for harm reduction in West Virginia, including through HepConnect, a major grants program administered by the Harm Reduction Coalition, should improve and save lives. But there will always be a need for direct action.

    I think of Dan. And Gator, who was my mentor in harm reduction work in North Carolina. And Gary, who was a father figure to me when I had noneof all those who taught me to ask for forgiveness rather than permission, to break unjust laws, and to stand alongside all people who are oppressed. 

    The creation of this article involved a collaboration between Tanya Knoon, Robert Suarez, Knina Strichartz, Dinah Ortiz and Louise Vincent.  

    All photographs courtesy of Louise Vincent.

    • Colin has been involved in harm reduction since 2003 as both a recipient and provider of services. He was introduced to harm reduction via Access Works/Women with a Point in his hometown of Minneapolis. He has since worked primarily with people living with HIV and HCV, drug users, sex workers and people experiencing homelessness. He works as an organizer and educator with the Twin City Harm Reduction Collective, a drug user-led syringe service program that he co-founded in Winston-Salem, North Carolina. 

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