He liked to tease me about my hat, asking me to buy him a matching one. He would make a game out of trying to guess our volunteers’ names when he saw a new one. And he would help keep me out of trouble, telling me when it was unsafe to be around the camp. He was that kind of man – someone who always looked out for others.
In the weeks prior to his overdose, we spoke many times about treatment for his substance use. He was mentally preparing, but never quite ready. Each week I would make my case and each week he would have some other reason why he couldn’t. But I could feel him inching closer, truly pondering a life without drugs. And then, one week, he was gone. The news was heartbreaking. This was a charismatic and kind person who deserved better. We truly mourned his loss.
There is a saying in the harm reduction community – dead people don’t recover. That means that when caring for people who use drugs, our first goal is to keep them alive. There are few people more vulnerable to the complications of substance use than people who use drugs and are homeless. They are often ostracized, pushed to the fringes of our society and forced to use substances in hidden ways, meaning they are at great risk for being alone if they overdose.
This year alone, our street medicine team has responded to multiple overdose episodes. Many more lives have been saved by our unhoused neighbors, who have responded to overdose events with the lifesaving medicine, naloxone. While I dream of the day where our patients don’t need illicit substances in their lives, the reality is that prohibition has never worked. So rather than criticize or force our values on our patients, our mission is to treat them with love and kindness; to help them be the safest they can be when they use.
The statistics around overdose, while abysmal, take the humanity out of the crisis we are facing. This patient story is just one of many. Each fatal overdose robs society of a human life – a person that has value in the world. Who knows what would have happened if I had a few more weeks with my friend. I like to daydream about a time we would have met in a different setting, when he was housed and living his best life. But that opportunity is gone – because, as they say, dead people don’t recover.
At Street Medicine St. Louis we value the lives of all of our patients – attempting to meet people where they are, with genuine compassion and no expectations. Loving support is the first step towards any meaningful dialogue around recovery. Using a harm reduction focus, our goal is to keep people alive and connect them to the resources they need. And if recovery is not on the table, my sincerest hope is that each patient feels loved and supported, even if our goals do not always align.
