'Do Less Harm' full transcript

ALLISON BEHRINGER: So you probably know what people mean when they talk about “getting clean.” They mean quitting alcohol and illegal drugs completely. But in that phrase, “getting clean”, there’s this implication: that if you use drugs, you’re dirty. 

Bodies’ reporter, Hannah Harris Green, saw this attitude first hand this spring when she went to West Virginia – a state at the center of the overdose crisis.

Not only does West Virginia have more overdoses per person than anywhere else in the country, but people are reusing and sharing syringes because there aren’t enough clean ones. The needles get rough over time, damaging people’s skin and causing infections. And Hepatitis and HIV are spreading faster and faster. This is a health crisis. But the government doesn't seem to be treating it as one. Why is that?

As Hannah learned during her time in West Virginia, it has a lot to do with this idea of clean versus dirty. While Hannah was there, she met a person named Lill, who says that the sickness is in the system and that their community’s survival is on the line.

I’m Allison Behringer, and this is Bodies. 

Hannah Harris Green is gonna take it from here. And heads up - this episode contains cursing. 

HANNAH HARRIS GREEN: Lill's house isn’t on google maps. It’s in Southern West Virginia and an hour from the nearest city… to get there you have to drive higher and higher up a mountain road until there’s no more cell service. 

Ranch houses with horses poke out of the woods on this road, which winds alongside streams that connect to tributaries that once moved coal all around the state. 

These roads are pretty quiet… But in the towns down below, a lot of people are drifting around, and it’s obvious that many of them are hurting.  

That’s why I'm on my way to meet Lill. Lill has devoted their life to helping Appalachian people who use drugs.  Their goal isn’t to get people to quit drugs, it’s to help them stay as safe as possible while using drugs.  And they’ve agreed to let me into their life for 5 days. Which also means letting me into the community they love.

Their house is hard to find… My driver and I pass it and go all the way to the other end of their little town before turning back again. This time I see Lill and their friend Liira waving from their porch.  

LILL: We tried to wave at y’all while you were going away but then we couldn’t. I was like oh no….

LIIRA: There are only two ends of the road

LILL: And we were like they’ll be back.

Lill is short… shorter than I am, which is rare. They have huge thick round glasses... And they have dad-ish facial hair.. .dad beard, dad sideburns. Their small, hairy belly hangs confidently out of their shorts. 

The house is full of plants, animals, people. Everyone’s always in and out, staying at the house or on the property. There are puppies running around and a sphynx cat named Malatov. 

HANNAH: Yeah she’s like purring into the mic.

LILL:  *laughs* 

On the couch there’s a stack of baseball hats with phrases like “homosexual tendencies” on them.

While I was spending time with Lill, I heard their friends refer to them with several different pronouns. Lill usually uses they/them pronouns, but doesn’t correct people who call them “she” or “he.”

LILL: I don't think she is like wrong. It's just not quite right. He is not wrong. It's not quite right. You know? I don't know if they is even right. It's just like a little different option.

To me, I kind of believe that people around here see me as the same way that I see myself. Whereas they just don't really give a fuck if I'm a cis person or not. They don't even necessarily understand what that is. 

HANNAH: Lill is in the kitchen. They’re preparing more food than the people in the house could possibly eat. 

LILL: At this point I’ve started making more food every time I make food because every time I make three steaks for all the people that live in the house, someone’s at the door and like I haven’t had dinner, I’m hungry.

Before long, the dogs are barking, someone is indeed at the door. It’s Bruce, Lill’s neighbor.

HANNAH: Hi, I'm Hannah. I'm a journalist 

BRUCE: I'm gonna give you a hug. That's how I get to know everybody.

BRUCE: Oh, who you write for?

HANNAH: there's a station in LA called KCRW 

BRUCE: You come here from Los Angeles.

HANNAH:  I did. Yeah. 

BRUCE: Y'all must be bored out there.

HANNAH: Yeah I guess so.

LILL: Want A1 or mustard or any of that? 

BRUCE: I got some A1 down at the house, thank you. Um, am I being recorded? 

HANNAH: You are.

BRUCE:  Okay. It's fine. I don't care. Hell. I ain't got nothing to hide. 

HANNAH: I'm doing a story about Lil and their harm reduction. 

BRUCE: She's good. A good person to go, you know, put forth the effort that she does. I'll try to help her, you know, distribute from time to time, you know?

Bruce helps Lill distribute supplies like clean syringes as well as anti-overdose medication like Narcan to other people who use drugs. It's easy for him to get access to the people who need supplies the most... they're his friends. And he’s worried about how many of them are stuck sharing and reusing syringes.

BRUCE: Uh, it's just, uh, Hep C is so rampant or ringing around and running rampant up and down the river so bad. It's uh, it's kinda crazy going to be a whole generation lost.

All of a sudden the idea of a lost generation gets very real. Bruce starts to tell a story about Lill.

BRUCE: Oh, she saved my life the other day

HANNAH: Oh how?

BRUCE: I OD-ed on heroin and she'd come down and, uh, distributed Narcan and give me mouth to mouth, which I still love her

LILL: *laughs*

BRUCE: Yeah, she came down and. Yeah. and I guess I give them all a good scare. And she puts forth a lot of effort and a lot of her time to get shot down by a bunch of bureaucrats over in Charleston that don't give a shit about nothing other than theirself and padding their own pockets, you know?

HANNAH: Charleston is West Virginia’s capital. I visited Lill in May of this year. And just a month before, in April, the Charleston city council passed a new law. It turned what Lill does... giving out supplies for safer drug use...into a crime. You can catch a misdemeanor for giving out clean syringes if you don’t go through official channels. 

And there were bigger changes to come—the state of West Virginia had passed a similar law that would go into effect in July of 2021. 

By the time you’re hearing this, the law will be in effect, but during my visit it’s still something looming on the horizon. West Virginia lawmakers claim that limiting the number of available syringes will help people stop using drugs... and prevent drug users from dirtying the community with their used syringe litter.

This goes against scientific consensus. According to the CDC, clean syringe programs actually reduce syringe litter. And they help protect people from drug related health problems. 

The CDC also recommends involving drug users in distribution, because this helps ensure that people have a clean syringe every time they inject.

After the West Virginia State assembly first passed the bill, healthcare workers wrote a letter to the governor urging him not to sign it into law, saying that it’d be disastrous for the health of West Virginians. He signed it anyway. 

Which leaves Lill with two options: stop helping people, or break the law...for Lill to keep doing what they do in Charleston and soon, in the whole state, they’ll have to become sneakier. 

All this when Bruce already felt like the system has tossed him aside.

BRUCE: They think if you're a druggie that, you know, you're just garbage and you know, I've used drugs pretty much my whole life. And then it got worse after, you know, my son, I lost him in a car wreck. It just seemed like things have escalated since then, you know?

But, uh, yeah, like I said, they're, they're, they're good people. I love them to death.  Yeah. I got to get back down to the house. I'm gonna get down the stretch out.

HANNAH: Neighbors like Bruce showing up, needing pipes, food, whatever… that’s not a once in a while thing. It’s hard to get a moment alone with Lill because the phone is always ringing, people are always at their door. 

Like this one time, as I’m waiting to interview them, they’re on the phone for a long time with someone worried about what will happen to their dog if they go to jail. 

LILL: (on phone) Yeah. My, my concern is if you got arrested, they might just take her to the pound at the same time, you know? 

HANNAH: And just about every moment of the day, Lill is caring for people who use drugs. Their mood is usually light, they reflexively crack jokes. Even though this is heavy, stressful work. And this care extends way beyond handing out clean syringes. The way they think about drugs is radically different than anything I’d encountered in the past. 

In Lill’s view, even if your drug of choice is heroin or meth, you should be able to use it as safely as possible. And live with dignity, without fear of stigma or the law. But they didn’t always feel that way. Lill says that when they were growing up in rural Appalachian Kentucky, back in the 90s, “War on Drugs” propaganda was everywhere. 

I grew up seeing these PSAs, too. I remember learning that if I tried pot once, I’d be hooked, that it was a gateway drug and before long I’d be on heroin and have no control over my life. When Lill talks about the community they serve, they use the phrase “People who use drugs''. 

It’s also the phrase I’m using throughout this piece because it doesn’t judge or assume anything. The line between what qualifies as addiction and what doesn’t can be blurry. But the language of the war on drugs erases any nuance. 

Instead Lill and I grew up hearing about “drug addicts” and “abusers”... And we got the message that these “drug addicts” were generally disgusting, dirty, lazy people.

Lill can’t think of anyone from their childhood who didn’t feel ashamed of the drug users in their community ... And as they began to understand their family better, the shame started to feel personal.

LILL: Well, I think I knew my dad was in the drug trade when I was in high school. 

HANNAH: They were ashamed of their family’s connection to drugs. They were ashamed of their poverty.

LILL: What it really came down to was I was so worried about what people think of me and, and if they'll think I'm poor and unworthy.

HANNAH: Lill had a lot of coal miners in their family,  like their grandfather, their Pahpaw.

LILL: My Papa had a uh, a stub for a thumb on one side and he was really like, I'm gonna tickle you with this or whatever. And I was like, Oh, you know, when I was a little kid, but, um, it was because he fucking cut his thumb off while working in the coal mines.

He just taped it back on and worked the rest of the day. It fell the fuck off and did not, there was no saving it, you know, that is kind of like the expectation of the legacy of the coal miner, you know, you produce, produce, produce, and you work really hard and that's your whole life.

HANNAH: The community Lill serves, they are poor, but Lill doesn’t see them as unworthy. 

They spend a lot of time thinking about the various kinds of pain in their community. 

Like, a lot of people around here have decaying teeth. It reminds me of this stereotype about an Appalachian person who use drugs. A toothless hillbilly. That person is usually a punchline. 

But not to Lill.  

LILL:  I make herbal medicine for people's teeth. 

HANNAH: What is that?

LILL: This is yellow root. You can just, like, slow down tooth decay and stuff like that. 

HANNAH: There’s a room in Lill’s small house that's devoted just to people who use drugs, and to the philosophy of harm reduction. It’s called the "harm reduction room." 

LILL: It’s one of my ways to keep him out 

MALATOV: (meow)

HANNAH: Harm reduction is the practice of doing what you need to do to get by and feel good, while doing as little harm as you can. To yourself or to others. Harm reduction doesn’t require people to abstain completely from risky activities. Just to take steps to minimize the risk. 

If, during the pandemic, you wore a mask so that you could see a friend but lower the chances of giving them COVID, you were practicing harm reduction. If you’ve ever had sex with a condom, you were practicing harm reduction. And if you’re in this community, using heroin in Southern West Virginia, making sure your syringes are clean is harm reduction. 

I sit on an exercise ball in the harm reduction room and Lill shows me their supplies. There’s clean syringes and other tools to make drugs safer. Pipes for drugs like meth that minimize exposure to the toxins you might inhale smoking off of tinfoil.

They have tools to test for fentanyl—an extremely potent synthetic opioid that will increase your risk of overdose, especially if you don’t know it’s there. More and more, drugs labeled as heroin or meth contain Fentanyl. 

The supply I hear about most often, besides syringes, is Narcan. Narcan is the overdose reversal drug that they used to save Bruce's life... it's generic name is Naloxone. You administer it when someone has overdosed and passed out and is not breathing. There’s two versions, one that goes up your nose like a congestion spray, nasal Narcan, and one that you inject.  

LILL: And, uh, you pop this off, stick the needle in there. And um you want to inject someone in the muscle. So preferably like the thigh. Something funny about me that people might not realize because I have a bunch of tattoos and work in harm reduction is I used to be scared of needles. Even in the last year when I started injecting testosterone it was weird to get used to injecting myself? So the first few times I did it, I, like, didn't do it hard enough and it, like, hurt more than it needed to, you know?

HANNAH: Lill has administered naloxone many times. But still, they’re scared when they do it, scared they’ve arrived too late. 

LILL:  I know people that have been administered Naloxone 40 or 50 times this year, you know, it's not, it's just part of being a person who uses drugs with the drug supply that they have. They don't have the safe supply, so they have an unsafe supply, so, that's the option, you know.

HANNAH:  And when someone comes back, what’s that like? 

LILL: They have no idea what happened. You know, they definitely don’t know that they overdosed until you tell them. People that are really struggling you'll hear them say like, oh, we should've just let me die. You know, people have said that to me.

Um, and I'm always like, how could you say that? You know, like your life is so precious, you know, your life was just in my hands. It's so precious.

Lill says that most of the time, it's people who use drugs who administer Narcan… they’ll be with their friends who are getting high when something goes wrong. But in West Virginia this is illegal. There's a long list of rules in the state code about who can legally administer Narcan and it’s mostly limited to healthcare workers and law enforcement, with a few exceptions.

HANNAH:  If people actually followed those laws, what would happen?

LILL: It's hard for me to even think about that because like personally in my community, almost everyone I know would be dead.

HANNAH: Lill and I spend the next few days together. They drive me all around West Virginia while they distribute supplies. Like when we meet up with Tracy in Beckley.  

That’s where I’m staying at an Airbnb. It’s sprawling with a central downtown that has old fashioned brick buildings, little parks with fountains and gazebos, a tree-lined bike path. Since the statewide law hasn’t gone into effect yet, Lill is relatively safe giving out clean syringes here.

Lill’s usual routine is walking around in the open asking people if they need supplies and dropping stuff off at specific trap houses. Lill isn’t too worried about police here. But still...the new law on the horizon has people nervous. Tracy seems a bit jumpy when we meet her.

Lill opens their trunk and points to a big cardboard box.

LILL: There’s maybe about 20 doses of Narcan. Um, there's some safer snorting kits. There's some menstrual products. There's a little bit of everything in there. So, um, you could just take the whole box to the house or feel free to divide it up. 

TRACY: Is this all anonymous on them and whoever helps them and stuff? 

LILL: I have no idea who they are. I don't need to know that 

TRACY: Thank you, that's what's bothering them, you know.

HANNAH: Tracy tells Lill about going to the government, trying to get Narcan, and being told they didn't have enough funding. And she says when the health department DOES give some out, they have fewer doses than people that need them.

TRACY: Buried the love of my life because of heroin and fentanyl.  Had somebody be in there with a shot. They could have saved him. 

HANNAH: Sorry … Well this is tough to talk about. 

TRACY: Yeah, just very personal. I think if anybody has the ability or the capability or the desire, the drive to help anyone, anyway, anyhow, that they should. I believe that so strongly. I had put my life on the line to support it… 

So where's, where's our backup? if we’re the boots on the ground, where’s high command. where’s the supplies, what good is a soldier without bullets in his gun. You’re gonna lose! Have you seen the obituaries and papers and stuff? Come on. We're losing. We lose every day.

After we say goodbye to Tracy, Lill drops me off back at my Airbnb in Beckley. It's a jumping off point for tourists looking to go hiking and kayaking. My Airbnb host for the week seemed extra kind, extra hospitable. She offered to drive me to the Kroger to get groceries as soon as I arrived. She asked me if I was here to hike at the New River Gorge park.

I told her I was in town to report on some new laws around drugs in West Virginia. And she immediately started talking about the “drug problem” in Beckley… how upsetting it was to see all these toothless druggies wandering around, how she couldn’t go running on the bike path anymore. And she seemed to assume that I would just agree with her.

We sit down to talk.

CHRISTINE RESNICK: Um, um, my name is Christine Resnick. I'm a property owner here in Beckley, West Virginia. Um, I have corporate and vacation rentals, so more of the upscale clientele guests. I really enjoy meeting people and introducing them to an amazingly beautiful state for as poor as it is. It's such an amazing state.

HANNAH: She says she used to be more naive. She would hire people who used drugs to help with projects on her properties. 

CHRISTINE: Every single time I have been stolen from. And, I have a really good friend. That's a psychiatrist at one of the big company, uh, rehab places here. And he finally just said, Christine, they can't help themselves. Once they've done meth they're never off meth for the rest of their life. It's a draw that they can't resist. 

When we see toothless people walking up and down the street... all day long, all night long... It's really sad to see because I know now...when I see these people that they don't have any hope.

HANNAH: Christine tells me about one night when she heard some kind of fight at a house down the street. 

CHRISTINE: I just flew into a rage and I walked down there and I started yelling at them and I’ve said I told you like, you're you have to stop doing the drugs in our neighborhood. 

HANNAH: Chrstine says as she approached the house, she was taking a video of the woman who lived there with her phone... and the woman tried to grab the phone from her.

CHRISTINE: I mean, she was like pushing on me and I ended up hitting her with my Billy stick  and I was so angry. I don't even know really how hard I hit her. Uh, but she did let me go. 

HANNAH: I’m surprised to hear Christine openly admit to using a weapon on her neighbor. I ask her if she considered she might be invading this woman’s privacy. She says that she could see why I’d ask that, but the noise, the cars, and all the disruption that comes from that house justified the confrontation.   

CHRISTINE: I mean, wow. That I have to be in a physical confrontation with a druggie in my neighborhood. I mean, it's just. It is just infuriating. 

I don’t know what the answer is. And we're going to deal with this until it's crushed out somehow. And I don't know how that will ever happen. I really don't.

HANNAH: The thing that was so striking to me about Christine wasn’t that her views are uncommon – lots of people hold these views toward people who use drugs...and it’s part of why this new law passed. But what really stuck out me was just how different Christine is to Lill. Christine talks about crushing the problem; Lill is all about care. 

We’ll be right back, after these messages.

HANNAH: There was a time when Lill thought they would leave Appalachia and never come back. They felt like the mountains were smothering them. They wanted to get away from the poverty, the stereotypes and the drugs. 

LILL: I moved to college and just kind of, like, washed my hands of the situation and began to start my adult life. 

HANNAH: They went to the University of Kentucky in Lexington.  . Which, to them, was a world away. They felt out of place. Their accent set them apart. There was this guy in their philosophy class

LILL: And he was like, wow, I heard you talk in class the other day and I thought you were going to be like the most dumb ass, like ignorant redneck person, you know, based on what you sound like, and you are so intelligent.

And I remember being like, do you think that's a compliment? You are shitting all over every person where I'm from to lift me up. But I don't think I said that to him. I was just kind of like, thanks, you know.

And not long after that. Um, You know, my dad was arrested for some pretty serious drug trafficking charges. It was all over the news. It was on the radio. Everybody knew.

HANNAH: Lill already felt an enormous pressure to do everything perfectly at college. And then things got even harder for them. Their mom passed away.

LILL: I didn't even take any time off from school.

I was like, I have to get two bachelor's degrees. I have to make a perfect GPA. Uh, I've worked a full-time job. So I just pushed myself really hard. And I think using substances was the way to cope with it. 

You know, there was one day that I, like, had to call out of work and not go to class because my. Calf muscles were in so much pain from, like, walking to class and working like long 10 hour shifts at a restaurant on my feet. And just like never taking a break that, um, I had to like lay in bed for a couple of days. And, you know, those kinds of things really perpetuated the drug use and the binge alcohol use.

HANNAH: I asked Lill if they found it ironic, that they escaped the shame they felt about home using the very substances that had caused them to feel that shame.

LILL: It was something I thought about, but it was something that I just buried, uh, because the contradiction was too painful at the time... from desperately wanting to get away from these things that I now consider to be so deeply a part of who I am. 

HANNAH: It was only later on that Lil began to understand the many reasons why people in their community use drugs.​

JUNIOR WALK: A lot of the ways this stuff started in these areas was somebody’s working for the coal company, they get hurt on the job, they pretty much write ‘em whatever they need to write ‘em to get ‘em right back to work on the next day or the day after, you know what I mean, whether that was pain pills or what. 

Junior Walk is Lill’s neighbor and a local activist fighting against coal mining. 

JUNIOR: You know these folks that the companies helped to get hooked on these pain killers and stuff got too sick to work, lost their jobs, lost health insurance, and that’s where you see these other drugs come in to the communities, that aren’t necessarily produced by pharmaceutical companies.

HANNAH: He says that even the punchline of a hillbilly with bad teeth is not what it seems.

JUNIOR: You look back in the late 90s, you know there were all these stories running about west virginia and appalachia, they put mountain dew in their baby bottles and that’s none of them’s got teeth. What people don’t look at is that one of the contaminants that gets into the ground water from these surface mining operations is called manganese and that’ll rot your teeth right out of your head.

HANNAH: Lill talks a lot about things we get wrong about drugs. Like how policing drug dealers keeps people safer. Studies have shown that the more the drug trade is criminalized, the more people die of overdose. And Lill says it’s often the dealer who has narcan on hand. 

Not to mention the toll it takes on the incarcerated person’s family... which they experienced with their dad.

LILL: This system is treating my family like garbage. Cause I was like, why is it so hard to support him while he's locked up? I have to drive so far. There's like this short hour of window to bring him t-shirts or put money on his books or like, I was like this isn't right. You know, like.

How is selling drugs a thing that, um, can just allow the state to control so much of a whole family's life?

HANNAH: But some of the problems that come with illegal drugs… they’re definitely real. 

There is even overlap between Christine’s experience and Lill’s.. They’ve both dealt with a lot of theft. People … often the same people Lill helps... steal from their porch, so much so that they set up a security camera. 

What do you say to somebody who says people are using all these drugs? They're stealing things. They're criminals. Like there's not just the drugs, that's the crime. Like, what do you say to that?

LILL: I guess I'm more mad at the billionaires who are stealing from me, you know? So like I try to remind people that that's happening to them as well.

Um, I get it. I get frustrated when people steal from me. Like, it's not that I'm not human or I'm like, oh, it's okay. It's not okay. But, um, I understand it as a thing that might happen. And it's not a thing that might just happen because I allow people who use drugs to be in my life, but it could happen because of anyone. I probably won't like cut you out forever, but I'm gonna, like, take some time from you, you know?

HANNAH: Lill says it does sting when people steal from them, given how much effort they put into helping their community. They began working in harm reduction when they realized their friends were often using old, rough needles that were hurting their skin. So they figured out how to get clean needles. 

LILL: I had to wing it a lot... you know, how to get supplies, how to talk to people about what they actually want. I think that's the difference between like mutual aid, like weird charities, shit, you know, it's like, here's this free thing that you maybe don't need, you know?

Lill is always finding new ways to reach people, to find out who needs what. They even ask people if they need clean syringes in their dating app profiles. And that’s how they reconnected with Liira, after meeting her in the organizing community. Liira stays in a camper on Lill’s property now. 

LIIRA:  I was like, oh, I guess I'll, I'll torture myself and turned on Grindr for like that one time in three months when I turned it on and I'm like, Hey, that's Lill!

HANNAH: Liira is here recovering after spending the past year organizing a homeless encampment in Morgantown, West Virginia. At the encampment, there was infrastructure to protect people from Covid, from overdose, and from freezing to death.  But then the city shut it down. So Liira went to the went to the city council meeting to give her testimony.

LIIRA: I said, you know, like, I really need you to know this, if you do this, people will fucking die. And, uh, that's when the city manager interrupted me to tell me I needed to use appropriate language. And like, I just had to think for a minute and process that ... and finally I said something like, you know, if the only thing you take away from the sentence, people will fucking die is the word fucking ... like, I don't know how we can talk, you know.

HANNAH: And what are you going to do now? Or what are you doing now? And what are you doing about this law that's going to go into effect in July?

LIIRA: Fuck em, um, I'm fighting genocide. That's exactly what I'm doing. Something I thought about a lot in the last few days is that it's hard being a trans woman in West Virginia, which is what I am. Within living memory, the police here were rounding up people like me dragging them out of their houses and taking them off to be tortured. We're doing that to people who use drugs right now and it has to stop. 

HANNAH: Lill and Liira are so persistent in their belief that everyone deserves what might seem like a radical amount of freedom and personal choice. Lill uses drugs and is proud to be a person who uses drugs, although they’re not comfortable sharing the specifics for broadcast. 

There’s something that’s been on my mind. Lill has definitely opened up my perspective, but that doesn’t change some experiences I’ve had where it does seem like the drugs are the problem. 

Like I think about memories in my life where people close to me were using drugs and it seemed like they were using them because they couldn't stop. And it can be hard to watch — because it feels like watching people I love hurt themselves, and the people around them.

And I can’t stop thinking about earlier, how Lill told me they knew people who'd already overdosed 50 times that year. It was only May.

HANNAH:  I think meeting you, like, I have started to rethink a lot of things about drugs and stuff, but I do still have trouble. Like when you're telling me that someone is overdosing like twice a week sometimes, it's hard for me not to think this person is hurting themselves. 

Like I know it's hard, but like, it would be better if they could. You know, not depend on these, these substances, it would be better for them. Um, so yeah, I'm just, I'm just curious how you respond to that.

LILL: Um, well, I would definitely talk to that person about strategies to overdose less you know? Um, and, um, and one of those strategies might be getting administered Naloxone a lot, you know, um, and, uh, that is traumatic and is chaotic and it does take a toll. You're not wrong about that. 

Um, but I think, if you push someone away by projecting your desire for them to quit, and that's not where they are, that might be the time that they OD without the Naloxone, you know?

It's not like I don't talk to people who'd want to go to detox and support them through that. But, um, I just know that by and large, the tools are not there.

HANNAH: I looked into this. And the stats about recovery programs… they’re hard to find, they’re inconsistent, but what’s there doesn’t look great. People who go to rehab often have to come back again and again, and still they can’t stop using drugs. 

Some researchers have even suggested that this system is a scam – that rehab clinics want people to start using drugs again so that they’ll come back and spend more money.

LILL: Hey, how are you doing?

Good, how are you doing honey? 

LILL: I'm doing all right. I wondered if you needed any supplies.

I sure do. 

LILL: Yeah, same place as usual?

Yes, Ma'am.

LILL: Alrighty. Well, uh, I'll see you in a few minutes.

Okay honey. 

LILL: Alright, bye 

HANNAH: Late one evening, we drive to Charleston to distribute some more supplies. And Lill, who I've spent a couple days with at this point, is more serious, more tense than I've seen them before. It is specifically a misdemeanor to give out syringes here. 

LILL: Normally before, well, this shit in Charleston, I would hang out the car window while somebody else drove around and like talk to folks, you know, and see what they needed.

HANNAH: But tonight, Lill doesn't feel safe shouting out the window. And the streets are mostly empty anyhow. The places where homeless people used to live, under freeway overpasses, they're empty now. Lill says the cops cleared them out. 

We stop to pick up supplies in a basement where Lill goes often. Lill gathers boxes filled with syringes as well as condoms and lube from other boxes labeled in sharpie. We drive to meet one of Lill’s contacts. This contact is at a black household in a black neighborhood.  This part of Charleston is more heavily policed so we keep an extra low profile.

LILL: I probably can't bring you in there with the… I just don’t think it’d be right

HANNAH: Okay. Do you want me to leave it in the car?

LILL: I just think it's going to freak people out. 

HANNAH: Yeah, yeah, yeah. That’s good too.

HANNAH: I leave my microphone in the car and walk towards this house with Lill. It's a dark street and a few people are hanging out outside, maybe high. Inside, nobody asks why I'm there. One woman is on the couch doing a scalp conditioning treatment, the other takes the supplies and asks Lill if we can take away  some of her used syringes.  

She has them packed up in a big plastic container so that they won't stick anybody. The women try to make a bit of small talk with Lill, ask them if their septum piercing hurt at all. Lill is polite but I get the sense they want to leave pretty fast. they're afraid that the police might be around.. There's no time for me to ask questions. We go. 

We quickly get back to the car and Lill starts the engine. Their car starts beeping because we haven’t put our seatbelts on quick enough.

HANNAH: Cars are so bossy now.

LILL: They make cars scream at you about harm reduction, and yet some people still think it's bad.

What she gave back to us were you know, used syringes to dispose of, um, there's a lot, there's obviously the story is that, um, people who inject drugs, just throw their syringes on the ground and they don't care, you know, about other people or if they're littering and that's not true, that's, uh, that might happen some.

You know, a lot of people are actually really hygienic and careful with their syringes and put them in the proper containers and pass them along to, uh, harm reduction groups or, you know, just do at home disposal. 

HANNAH: Lill has used syringes they’ve collected from folks in the past week or so... all safely sealed away in plastic containers.  Charleston only has one official syringe disposal box. And so for our last stop of the night, we drive towards it.  

As we get closer, I can see the syringe disposal. It looks like a cross between a big orange biohazard container and a library return box. 

And I also see a cop car parked just a few feet away from it.

LILL: Look at that. There's literally a cop there (Your destination is on the left).

HANNAH: Wow. Yup. There really is.

LILL: I'm about to scream. I'm so mad. I've heard that that was a thing that happened.

HANNAH: Why are you so pissed? 

LILL: Because how do they expect people to bring back their syringes? When there's a police, surveilling them sitting there, nobody's going to drop their syringes off there. You have to be kidding me. 

HANNAH: We drive around the block.  

LILL: There's no reason to be sitting there other than to make people feel unsafe, to put their syringes in. (head west on Washington street, east toward lately street, in a quarter mile, turn left onto Reynold street)

HANNAH: Lill decides that they're going to throw out the needles despite the cop sitting there ... They get out of the car with the syringes in one hand and holding up their cell phone in the other.

LILL: Yeah, I'm filming you.

Well you should be ashamed of yourself for sitting in front of the only syringe disposal box in the city. You're surveilling people who are vulnerable by sitting here. You should be ashamed of that. And I'm filming you.

COP: Your opinion stinks.

HANNAH: They begin throwing the sealed up syringes into the disposal box.

LILL: I’ll be emailing the mayor about your ass, believe that.

HANNAH: What's he doing? Is he … oh he’s filming your car. 

LILL: I’m cleaning your city while you sit there and do nothing.

COP: Smile.

HANNAH: We get in the car and head home.

LILL: Jesus Christ. I hate it here. I guess we should probably leave town. 

HANNAH: Yeah, maybe.

LILL: Hahahahha.

HANNAH: Yeah, maybe.

HANNAH: The next day, we sit on their porch and talk. It’s breezy. Some kids are playing in an above ground pool at a house below us. Things feel slow and calm.

The night before, in Charleston, I’d seen Lill get really angry for the first time. Their frustration and fear had come to the surface, disturbing their normally unflappable demeanor. Seeing this side of them, it made the heartbreak that Lill’s gone through, the death they’ve seen, the precarity of their work, suddenly feel very real, very clear.  

LILL: I feel scared. I mean, I am scared of the police.  I'm not going to pretend like I'm not scared of them, but I try to push through that because, um, we have to resist that. 

HANNAH: Lill tells me about a friend of theirs named Nancy. Nancy helped distribute a salve for injection related wounds. Lill makes it from coal and local herbs. It looks kind of like lip balm in a flat, round tin. 

LILL: But, um, she overdosed and died not too long ago. And, uh, I recently got back the tin of salve. That was the last one that I gave her. And, you know, they were all the kind of like swirls of her fingerprints from, and so, I mean, it was really touching to get that back of course, but it was really hard and, um, losing people is the hardest part of this work for sure. 

(Dogs start barking)

Especially when it's like you had the Narcan, but there was nobody to give it to you. So you died alone, you know, knowing that your friend died alone.

(Dogs keep barking)

LILL: What the heck? Way to ruin my sad story, guys

HANNAH: I think they came in just afterwards.

LILL: I don’t know how to transition, now. Oh my god… (imitates dog noises) 

I don’t want any more of my friends to die alone.

HANNAH: It’s been four months since I went to visit Lill. This past summer, the ACLU sued the state of West Virginia over the law restricting clean syringes, saying it would “cost lives and deprive West Virginians of numerous constitutional rights.” However, a judge upheld the law and it went into effect in July of this year.

Since then, the CDC released a report revealing a spike in HIV cases in West Virginia. They said this spike happened in part because clean syringe programs had been shut down. To help combat this spread of HIV, Lill and other activists in West Virginia recently founded the Mountain State Harm Reduction coalition. On the phone, Lill told me that rather than driving harm reduction underground, this new law has inspired them to become more visible. 

ALLISON: To hear more about Hannah’s reporting experience, the history of harm reduction and some more info that we just couldn't fit into this episode, check out an interview with her on KCRW’s newest weekly show – Life Examined.

For a link to the Bodies podcast facebook group, as well as episode transcripts, additional resources and photos from Hannah’s trip to West Virginia, go to KCRW.com/Bodies.

You can follow Bodies on Twitter and instagram at @bodiespodcast. 

You can follow Hannah on Twitter at @write_noise – W-R-I-T-E underscore NOISE and on Instagram @feefifofannah

This episode was reported, written and produced by Hannah Harris Green. Story editing this episode by Mira Burt-Wintonick and me, Allison Behringer. Advising and editorial support from Cassius Adair, Camila Kerwin and KalaLea.

Nisha Venkat is with us as KCRW’s USC Luminary fellow and provided production support. Our team also includes associate producer Kalaisha Totty and Rebecca Mooney is our managing producer.

Original score by Dara Hirsch. Mixing by Teeny Lieberson. 

Special thanks to Caitlin Pierce and Kristen Lepore.

Episode art by Neka King. Cover art by Sarah Bachman.

Bodies is supported and distributed by KCRW. Thank you to the whole KCRW team. 

Thanks for listening. See you in two weeks.