The dictionary definition of “force of nature” should consist of two words: Louise Vincent. With an extraordinary, almost uncontrollable energy, spirit and power, she fought for the rights and health of people who use drugs in profoundly impactful ways—often by defying societal norms, breaking laws, and achieving goals through sheer willpower and charisma.
On August 31, this force of nature died. Louise was 49. It is a staggering loss for her family, friends and the harm reduction and drug-user communities.
With harm reduction as her North Star and a master’s degree in public health under her belt, Louise got shit done. She helped build the North Carolina Users Union (NCSU) to advocate for drug-user rights, and served as its executive director while also playing a leadership role in national groups. She and her colleagues opened the Greensboro Health Hub, which offers drug checking, sterile syringes and wound care. She was one of the authors of the groundbreaking Methadone Manifesto, co-authored academic articles and wrote for Filter.
There’s more! Louise was the interim chair of the International Network of People who Use Drugs, which has paid tribute to her, and a representative of the North American Network of People who Use Drugs. A proud feminist, she was also involved in developing the Narcofeminism storyshare model.
“It’s harm reduction and this work that keeps me alive and going forward every day.”
Little wonder, then, that she was presented with the inaugural Any Positive Change award, established in memory of fellow harm reduction legend Dan Bigg, at the National Harm Reduction Coalition’s 2018 conference.
“It’s been harm reduction and this work that sustained me when my daughter died,” she told that conference. “It’s been harm reduction and this work that sustained me when my leg was gone. And it’s harm reduction and this work that keeps me alive and going forward every day.”
Louise was a sought-after speaker, in person and in the mainstream media, because of this passion, because of her lived experience of the harms of the drug war and her extensive knowledge of drug treatment and policy. Her speeches could make you laugh and cry.
Louise’s story was one of how she fought heart-and-soul against the racist drug war, the carceral methadone clinic system that humiliated her, and the unethical ways the health care system discriminated against her because she used drugs. Through all the chaos and pain, she became an indefatigable activist, educator and leader.
Louise wasn’t perfect, and I don’t believe she’d want her life and work, which had many complications, to be sanitized or deified. She acknowledged making mistakes at times. She was human—and which of us could chart a perfect course through the kind of persecution she endured?
The drug war had spent years trying to kill Louise. From the time she started to use cocaine and heroin in her teens, the drug war in all its iterations harassed and policed her. She was arrested, jailed and thrown out of methadone clinics. She experienced severe health problems as a result of a toxic drug supply under prohibition, combined with a lack of access to consistent, compassionate medical care, eventually leading to chronic disabilities.
She wrote in a gut-wrenching 2021 Filter article:
“My injection wounds were just one of many side effects as my body was slowly poisoned … I could not stand the hospital, the treatment. I could not face the hateful people I would be forced to deal with. I could not deal with the withdrawal I would most certainly face if I went. I said I would rather die, and I meant it. But Don, my partner, took me to the hospital.”
I first met Louise in 2020 in Greensboro, North Carolina. My co-filmmaker Marilena Marchetti and I traveled there to interview her for Swallow THIS, a documentary about methadone and COVID-19, in which she played a starring role. We spent three days recording interviews, shooting B-roll in the drop-in center, drinking espresso and talking about all things methadone.
Louise had the ability to distill complicated ideas into sound bites that landed like bombs. She said of methadone clinics, “Shut them all down until it makes fucking sense!”
The harm reduction movement has lost one of its bravest, most authentic voices.
The methadone clinic system traumatized Louise. In an episode of the podcast Naturally Noncompliant, she shared the recording of a phone conversation she had with her counselor. Louise insisted that a positive urine screen and missing a few doses didn’t mean that she wasn’t doing well in the program. She was the executive director of the NCSU and was traveling around the country to speak and do trainings! The counselor kept insisting if Louise wasn’t complying with all the clinic rules and regulations, she was failing treatment.
The infuriating back-and-forth argument sums up everything that is wrong with the clinic system. I’ll always wonder how Louise’s life would have been different if she was just able to get a monthly supply of methadone delivered to her home from a local pharmacy.
The harm reduction movement has lost one of its bravest, most authentic voices. We all stand on Louise’s shoulders, and the work that she so passionately pursued will go on.
Below, Filter has collected tributes to Louise Vincent from some of those who knew and worked with her.
Louise Vincent, 1976-2025
“There are people who light up rooms, but Louise set them on fire.”
“The National Survivors Union and our allies stand heartbroken, holding a gaping void in each of our hearts. Those of us who stood with Louise through thick and thin are doing our best to keep heavy limbs in motion. There is so much work left, and her life and passing serve as a constant reminder. She broke the mold in more ways than we can count.
After working with Shilo Jama, Isaac Jackson, Robert Suarez and Don Jackson to found North America’s first national users union, Louise took the helm and never looked back. It is as if everything in life had led her to that moment, and nothing could prepare the world for what was to come.
There are people who light up rooms, but Louise set them on fire. Many are still burning right now. Her goal at every turn was to challenge the norm and she was always trying to make things better. No one came out of a conversation with her without a deep desire to dismantle and build better systems.
If there is anything that Louise would want, it would be for her life to serve as a catalyst for change.”
—Aaron Ferguson, National Survivors Union leadership team
“My first opportunity to work with Louise directly was when she came to present at a conference in Baltimore County and we traveled around the state speaking to different groups: government employees, service providers, grassroots organizers. I got to be her chauffeur, valet and warm-up act.
The impact she had, and the grace that she operated with—all while managing crises by phone back home, as the DEA threatened to raid their program—was something to behold.
That trip began more than seven years of collaborations too numerous to mention. It’s unlikely that any one person has had more impact on my life over that time. We came to share trust, respect, vulnerability and deep friendship. Her passing leaves my life smaller.”
—Andrew Bell, Community First Support Solutions
“During the summer of 2012, Louise entered my life, with six simple words, ‘You and I are stronger together.’ She would often tell me that she ‘courted me,’ until I finally gave in. I could write about our organizing origin story, or list the many projects we brought to life, born from intensely animated conversations that would end with the sun rising, only to start again once we each got some sleep. Reframe the Blame was one project we worked on together. Louise was the great innovator of ideas, a myriad of ways to break down the barriers that we, as women who use drugs, continuously faced. What she struggled with was finishing them alone. I had the opposite problem. Together, we were a whole. She started. I finished.
As I sat down to write this, I inevitably thought to myself, Damn you, Louise. Why aren’t you here to start this with me? Louise and I had the ability to see the brilliance in one another that we often couldn’t see in ourselves. We schooled one another on perseverance, survival and self love. Sometimes, we had to convince one another that we were going to win, because the drug war made us believe we were broken, unwanted and had no purpose. Our relationship could be tumultuous at times, but we always shared a vision where people who use drugs are met with radical love and respect. Louise, I love you. You started. And I will finish.”
—Jess Tilley, executive director, New England Users Union
“An internationally recognized advocate for people who use drugs, Louise was feisty and brilliant. She was the friend you always wanted in your corner. But when you invited her in, you best be ready to hear the hard truths that nobody else would utter.
She started her formal work in harm reduction under the wing of Thelma Wright, another North Carolina legend. Sterile syringes prevent HIV infection, and Louise’s organization has stopped untold thousands of transmission events through distribution of sterile injecting and smoking equipment. She created services to help people who use drugs or are engaged in sex work to get free hepatitis testing and treatment. But most of all, she gave them a place where they were treated as equals, without judgement, no matter what.”
—Nabarun Dasgupta, senior scientist, University of North Carolina, Chapel Hill (writing in his own blog tribute)
“Since her passing, some of us have observed that the work we did alongside her was our best work. She relentlessly called us to think bigger.”
“Louise Vincent was the executive director of the NC Survivors Union and a core member of the National Survivors Union. Louise was also a public health expert, a parent who has lost a child to overdose, an advisor to federal agencies, a genuine innovator of novel strategies for keeping people safer with fentanyl and xylazine in the drug supply. She was also a beloved friend and teacher to many.
Since her passing, some of us have observed that the work we did alongside her, often at her behest, was our best work. She relentlessly called us to do our best work. To think bigger. To dream harder. To expect more. She always expected us to be the greatest versions of ourselves, and she did so while dancing on one foot, chuckling deviously, acting a little bit giddy about the glorious trouble we were planning to cause. She left the world much better than she found it. I feel so much richer for the time we had and devastated she is gone so soon.”
—Jennifer J. Carroll, associate professor, North Carolina State University
“Our introduction to Louise was a sea change for me and my group, Prescription Addiction Intervention Now (PAIN.) She showed us how to stand against the War on Drugs by supporting people who use drugs on their own terms. We had so much to learn and she was an ideal teacher. It was an honor to share the stage with her at the North Carolina Survivors Union’s Overdose Awareness Day in 2021. Working with Louise to acquire a Mass Spectrometer for NCSU’s center, and learning how to test drugs was a profound experience for us. Under Louise’s leadership, this machine would go on to save lives, including hers, spread awareness and educate those in her community, while also assisting research at the University of North Carolina to develop data trends monitoring the local drug supply.
Louise was a real power—funny and embracing. A truly generous and empathetic person who was deeply concerned with others’ well being and kept many people alive.”
—Nan Goldin, PAIN
Photographs by Marilena Marchetti and Helen Redmond