I was a 20-year IV drug user and my best friend died from an overdose. I just had to do something different so that’s when I went back to school and became a certified addictions counselor and then got a master’s in social work. I had been studying and writing papers on syringe exchanges and safe injection sites so working for SWAN was a perfect fit.
In school, they really push that self-disclosure isn’t the best thing unless it’s helpful for the client, which I agree with. But I’ve found that because people know me from the streets and know that I have lived experience, that connection is huge. It helps build relationships and trust in situations where that might not necessarily happen.
The way I try to approach stigma is just by being authentic and making sure that the people working with us are as open and real as possible. We can slowly affect the social stigma by continuing to do public education, but on the individual level just by showing up every day, being consistent, and being real with people, it starts to change them. They start to see that these types of interactions are possible and they don’t have to be ashamed of themselves for whatever situation they’re in.
Everybody is pretty aware of Narcan and they know to keep it on them, especially in this neighborhood. You’ll hear somebody yelling down the street, “Narcan! Narcan!” and somebody will come help. Or they know if they see our van they can flag us down. We have folks who come back and say, ‘I used my kit’ and they’ll report what happened.
The public health department has been doing an incredible job collecting overdose data. Every week they send out a list of all the overdoses that have happened in the city. It doesn’t give any personally identifiable information, but it’ll say the street corners so then we know an area is kind of hot and can make sure that we go there and give Narcan out.
We do a needle buyback program to motivate people to bring back used needles—we give like $10 for 50 used syringes. On Saturday mornings, there’s a line of people all bringing their syringes back so we get thousands every week. It gets the needles off the street and it helps the folks out by giving them a few bucks. We have a limit of 100 syringes per person but if we had more funding we’d be able to collect way more.
Tracy Pugh Senior Program Manager Overdose Prevention Program, Vital Strategies
The Ruth Ellis Center started 21 years ago and focused on mostly Black and brown homeless youth. It’s named after a Black lesbian woman who came out in the late 1800s and had her own business—she ran a printing press. She and her partner opened up their house so that Black and brown young people who were coming out or not coming out could be there and dance and have fun. So she’s our namesake and that’s what we do.
We’ve grown from the drop-in center into a health and wellness center that offers medically affirming trans and other services. We have behavioral health and HIV services, we help people get jobs, and we do lots of wraparound services, working with agency partners on things like domestic violence and sexual assault. We’re building our own permanent supportive housing, which is a 43-unit long-term shelter. It’s really a radical idea because with most organizations there’s a time limit when you have to go. But if you’re a trans woman of color who transitioned at 13 and has been doing sex work for 10 or 15 years, even three to five years is just not going to radically change everything in your life. We work with people on their time and believe in creating spaces where they can grow.
We believe someone can come in here homeless and then one day become executive director, and we’ve really seen it. I am a brown trans woman that transitioned at 17. I was a youth at Ruth Ellis. I’ve done sex work, I’ve done drugs, I was in the ballroom scene. I came to Ruth Ellis to get condoms and to be with my people and now I’m a director here. I’m also the first trans woman of color to lead a public organization in Michigan.
Racism exists, and the only way to move on from it is to address it. We built things and changed the idea of Ruth Ellis into a place that’s giving more people of color power. My department is 100 percent black and brown folks. No one else, even in Detroit, hires more black and brown trans people. Our folks lead federal program grants and local grants and do research and are doing really great things. Some of the folks that I have were homeless and doing sex work before they got this job, and it’s literally changed their lives. The beautiful thing is if you can empower the community, they’ll change their own community. So that’s what we’ve done.
We believe in the approach of risk reduction or harm reduction, whether it’s HIV or sex or drugs. So harm reduction means that we don’t negate or put people in a bad place because they have to make decisions. You’re a sex worker—fine. Is that what you want? If so, our goal is to figure out how to get you to a place where there’s less harm. So maybe instead of doing random dates or clients, you are more thoughtful about what you do. Maybe you think about taking someone with you that can identify the license plate number and the person. There’s lots of ways to do harm reduction.
If you go into it saying, ‘I’m going to stop people from doing sex work,’ that’s not harm reduction. Harm reduction is figuring out how people want to live their life. Some people want to do sex work in safer ways, so we talk to them about that and we talk to them about condoms. If you tell someone, ‘Don’t have sex,’ that doesn’t work. But you can talk to them about ways that they can reduce their risks and what makes sense to them and then you help them create a plan. So it’s very client centered. Most organizations, especially with drugs, come into it with, ‘You can’t do this,’ which is why many of their clients are kicked out of their system. We just want you to get help so all we do is harm reduction work here.”
Chauncy – Red Project Clean Works Assistant
My first interaction with Prevention Point was as a participant. They saved my life multiple times in multiple ways. They fed me when I hadn’t eaten in days, they gave me water when I hadn’t drank all day. They gave me a place to sit down when nobody else would even let me sit down. And then of course the Narcan that they provided saved me multiple times. I would definitely not be sitting here if it wasn’t for this organization. I like to say that I’m one of Prevention Point’s success stories.
When I was ready to try another attempt at treatment for opioid use disorder, I knew that this place would support me. I knew that they would help me find the peer support specialist that I could call when I was struggling. I knew that they would help me with transportation to get to my appointments, to get to the methadone clinic. I knew that they would connect me with services when I was ready to go into inpatient treatment. All of that kind of builds up over time. It wasn’t like the first time I came here I went straight to that—they built a relationship with me. I spent a year and a half on the streets out here, and when you’re out on the streets homeless, heavily using chaotically, it’s very lonely. I knew when I came here I could not feel so scared for just a little while. The people that work here made me feel that way.
Initially I started volunteering at Prevention Point. When I was here I didn’t think about using and I felt good about myself so I wanted more of that. Now I work with the syringe services program, getting our shipment of needles and packaging them up with supplies to get them ready for the exchange and for distribution. On Fridays we do an education table. Every week we pick a new topic—something that they can learn about how to be safer in their use or their health. At the same time, I’m also letting them know about the other services we offer. One that I try to stress is HIV and hep C testing. We also do treatment here. It’s not just handing you the medicine or the prescription, it’s all the support surrounding it, so letting people know about that.
I feel like that’s the function of an exchange to meet people where they are and also bring them up and help them better themselves. Help them learn that so much is possible for them. Because I know what it’s like to be on the other side of it and feel hopeless, and feel like so much is out of reach and it’s not. That’s such a crucial juncture. When an exchange is running well, we’re helping people get into treatment, helping people getting into housing, helping people get fed, helping people get clothed, all of these things. The exchange is the point of contact but there’s so much more we can do while we have them.
Public announcement board detailing important information to Prevention Point community.
For the people I know that use drugs in Grand Rapids and Muskegon, it’s a huge priority to make sure that everybody knows about Red Project. People know where the truck is going to be and they know what the hours are and they make sure to get supplies for everybody who can’t make it there. They take it very seriously and really appreciate it.
The first friend that I ever used with, that was the first thing he did when I decided to get high. He was like, ‘We’ve got to go to Red Project tomorrow.’ He made me read pamphlets and everything. I think that was his way of contributing as much positivity as he could to something he maybe had mixed feelings about, like letting his friend use with him. But he believed that I had the freedom to make my own choice so he was there with me and tried to keep me and everybody around him safe for as long as he could.
Red Project Naloxone rescue kit use report.
You can have all the book smarts you want, but if you’re not connected with the community, or if you don’t have any experience working with the community then you’re not going to get the end result that you want. You’re not going to build that same rapport or get people to feel they can trust you because they don’t know you or know where you came from.
Media coverage often conflates Neonatal Abstinence Syndrome with addiction, using inaccurate terminology that paints a negative picture of persons with SUD in general.
I met Beatrice four years ago when she was walking around trying to find people to help. I’m a current sex worker, I’m still an active drug user, and I was homeless for four years—like literally on the street homeless, not couch bouncing.
About a year and a half ago SWAN started having me give out harm reduction supplies so my backpack is like a part of me—I always have it on me. It’s filled with harm reduction supplies, like needles, cooker kits, wound care stuff, Narcan, and fentanyl test strips, which are so important. I try to get people to use them—I tell them it’s like a pregnancy test. If I get a bag of dope and I haven’t done it before I’ll test it. Now I help out on the van but I still carry the backpack every day. I feel naked without it.
I’ve spoken on panels for medical students about how people like me feel when we’re being treated in emergency rooms. I found that to be scary at first but it ended up being very cathartic for me.
When I’m telling my story, I really try to stress that I came from a wonderful family. My dad was a cop, my mom was a secretary … I became a drug addict. I’ll point at people in the audience, I’ll look them in the eye, and I’ll say, ‘I could be your mother, I could be your sister, I could be your daughter.’ People need to understand that just because it’s not happening to them that it can’t happen someday—like you might not have had cancer, but one day you might.
I’ve been told many times that I’m brutally honest so I have no problem saying what it’s like to be out there at 2:30 in the morning and being scared and beat up and robbed by somebody that you just had to service. And they just wanted to take the money back and brag to friends about it afterwards and leave you in the middle of nowhere. Or what it’s like to have a gun held to your head. It’s so important for people to know that nobody chooses to be in this position. That is what I really try to drive home.
I’ve been working with the SWAN van since they got it. I show up for work, I make sure I go to sleep at night, I don’t go home unless I have stuff for the morning so I’m not sick—I take it very seriously. I’m just a little person but I know I make a difference. Like last year I got hit by a car and broke my leg. I was in the hospital for 9 days. I came out—I’m on crutches, I’ve got my backpack, and this woman comes up to me and asks what happened. She got really emotional.
She was looking under the dumpsters for a dirty needle to shoot up with and after asking if I was OK she said, ‘Can I have supplies?’ Just by doing something that small, all of us little people are making a difference. It’s the big people that need to do a little better—I’m talking about way, way up there. There just really needs to be more money, more resources, more housing, more community action—and more tolerance.
This is not bragging but I am proud of it—I have nine Narcan saves myself, and most of them were people on the street that I know and love. I would like to say the majority of them are carrying Narcan all the time but they’re not. I know when I was homeless you’re constantly losing things so the Narcan is always getting lost. I’ve been in situations where I’ve been dealing with an overdose and did not have Narcan on me and I had to do mouth to mouth until the ambulance came. I tell people that all the time.
A lot of people don’t like to use the injectable naloxone but now we’ve got the nasal one they come in two-packs. I have a friend whose hustle is he rents his bedroom out to all the girls. A lot of guys pick up girls and they don’t want to do it in the car, they want a spot, so for $10 or $20 you can go to his house and rent his room. So because he’s always got girls there, I gave him a Narcan kit. I kept one Narcan, I gave him the other one, and a week later he saved my life with it. I overdosed in his house and he saved my life with that Narcan that SWAN gave me.
Sex Workers and Allies Network leadership development participants.
I became a volunteer because when they were giving out food and free stuff, they gave me information about harm reduction and I thought I could do that. It helps people because even though they’re using, at least they’re using the right way—with sterilization and everything is clean. By doing this everybody is trying to prevent diseases and deaths.
If you have a person from the community helping the community it can change a lot. They know I’m not going to give them anything to hurt them. And also by the community seeing how Narcan works—it actually brings the person back. They’re like yeah, I want that because that can happen to me.
“I’ve saved three lives. I Narcan’d a dude last night because he fell out on the avenue in front of the liquor store. Everybody was just looking at him so I was like, ‘Get a Narcan!’ I happened to have one in my pack and I just went over and stuck him with it, called 911 from the payphone and they came. I felt good because that’s one less death.
New Jersey Harm Reduction Coalition members conducting distribution of essential supplies.
When I was homeless, I lived in the heart of the city, I suffered in the heart of the city. I had my own addiction issues and yes, I sold drugs too. I’ve also stopped people from using drugs. But now I’ve purposely said instead of me giving you something to kill you, let me give you something to keep you alive, let me show you how to use Narcan. Now I have a track record and we have about 30 to 50 documented overdose reversals, but that’s just documented. There’s way more because nobody is going to be there at 3:00 in the morning in an abandoned house to be like, ‘Hey I just stopped an overdose.’
So harm reduction is a beautiful thing. I will highlight that because it’s something I believe in and because I’ve lost a lot of friends and I’ve seen what it’s done to people’s lives—I’ve seen what it’s done to my life. But harm reduction is just a small piece of extending the life expectancy of poor folks and really helping them. The most important thing is addressing the national shortage of housing and health care.
I’m a human rights activist above all else, I’m a human service provider so I can’t just send a person that I know back to the streets. I can hand out harm reduction stuff until the end of days, but unless I can get that person to the next step, which is an acute care site, a drop-in center, with health care and human services, there is no getting out of homelessness. That’s what we’re asking for: a year-round space, a safe space not just for homeless people but also for the working-class poor. The homeless are dealing with chronic health conditions all the time, so combine that with an overdose epidemic and a pandemic—that’s a problem. New Brunswick brags about being a healthcare city. So how is it that we don’t have a drop-in space for people to go to? How is it that people don’t have a place to shower and do their laundry? That’s what I’m fighting for.
Kara Sepulveda - Quinnipiack Valley Health District, Public Health Program Assistant
I got involved with Detroit Action when I was going through a family crisis. I met Miss T, my mentor, and when she did the intake, the form asked what three things I needed help with or that I wanted to be different. I put, ‘Education for my children, a better living situation, and a job.’ The next week I got a call to do an interview. For the first time in my life, I felt like I found a job that I actually loved. This is my family outside of my real family because when I go through stuff my job always helps me get back on the right track.
I’m a canvasser for Detroit Action. We believe in housing and economic justice and peace and equality for all. There’s so many people who need help and don’t want to say what they’re going through, especially if they’ve been strong in past situations—they feel like they’re going to get over that hump.
So when the pandemic first kicked in, it was hard for a lot of people. They were advertising all this money, back rent assistance and this and that, but they’ve got restrictions on everything. You’ve got to go through certain criteria to get any type of help. With our mutual aid program, we’re trying to help where the government isn’t and we’re not doing all the extra requirements. People are scared to ask for help but I think if more people knew where they could go for help without going through all the hassle, I think they would.
When I approach people, I look at it as everybody goes through something and at that moment, it might not be you who made them feel some type of way but it’s you who they decide to lash out at. I know when I’m having a rough time how I would like to be approached so I’ll sit there and I’ll allow people to snap. But by the end of the conversation, they’re in a better mood and I might get an apology or they might be willing to sign up. I would say patience and communication is important but a lot of people get it messed up.
JaVay - Detroit Action Canvasser
After I came out of prison, I got my commercial driver’s license and I was working for a soda company but I always felt like I needed to give back. Sometimes in recovery people are like, I’m going to get clean and I’m going to be a counselor. But what’s that saying—it takes a village—not everybody needs to be the counselor. So I just happened to be looking on Craigslist for a different job and I saw an opening for a bus driver for Prevention Point, the overdose surge bus. I was like, that’s exactly what I’m looking for because I don’t have any degree but I have a commercial driver’s license so I can drive the bus.
My sister died from an overdose in Kensington, so between that and all the friends I’ve lost to drug overdoses, I just felt like I need to be doing something to help people stay alive until they find the strength to seek recovery. I’ve lived in the neighborhood and I go to church a few blocks away so I know Kensington pretty well. I knew from my experience that I wasn’t going to try to just jump in and get in people’s business because people on the streets can be kind of standoffish. It’s almost like they have to see you around a little bit in order to trust you so that’s kind of what I’m doing here—just showing up and being available if someone needs to talk.
Prevention Point Philly members, Shawn, Jason, and Bekka in front of the Prevention Point Mobile Health Center bus.
We had an eviction out in West Haven and after roaming around a few other counties we ended up getting on a bus. The driver gave us a free ride to New Haven and after we got here we spoke to many other homeless people and they told us to go to DESK. The atmosphere was very welcoming and there was no judgment, which was something we weren’t used to at the time.
DESK acted as a central hub for information and survival. They gave us a tent, a tarp, sleeping bags, clothes, hygiene supplies, lamps, and a lot of things that are often overlooked, like socks. Things that really make it more endurable in a situation when you’re homeless. If it weren’t for DESK, we wouldn’t be alive. They saved our lives in every sense of the word.
A lot of programs use their positions of authority to inconvenience people who they disagree with or who they don’t like—either personality-wise or because a lot of the homeless are coming from a really rough place in their life. They’re not exactly where they want to be. Not many people want to be homeless and people who are suffering definitely don’t want to have to be all lovey-dovey and begging. They don’t want to grovel in order to get services that would normally be just a human right. What’s amazing about DESK is they don’t ask for any of that.
To anyone seeking any services, I would say to just accept the fact that it’s OK to ask for help. It doesn’t make you a bad person. It doesn’t change who you are to need anything. We’re all human beings—we all have needs and wants. Everybody can struggle, everybody has those moments in life where they’re like, ‘Oh my god, I’m going to lose my apartment’ or ‘I’m going to lose my job or my car.’ You have to realize anybody can be in that boat. It’s not just people who ‘did it to themselves.’
Kate Boulton, Legal Technical Advisor, Vital Strategies