Louise Vincent, a heroin addict who overcame multiple overdoses, the amputation of her leg and her daughter’s death from opioids to help lead a movement promoting expanded access to needle exchanges, naloxone and other methods of reducing harm to drug users, died on Aug. 31 at her home in Greensboro, N.C. She was 49.
Her death was confirmed by her mother, Sarah Beale, who said Ms. Vincent had been suffering from a blood disorder and chronic health problems from injecting fentanyl laced with Xylazine, a horse tranquilizer, years earlier.
The daughter of an English professor and a teacher, Ms. Vincent received a master’s degree in public health in 2013 while battling addiction. That year she helped start the North Carolina Survivors Union, among the first organizations in the country to offer safety rails for addicts like her who were struggling to quit.
“We have one acceptable narrative about recovery that doesn’t fit everyone,” she was quoted as saying in Scalawag, an online magazine that covers marginalized communities in the South. “This idea of getting clean, staying clean, being 100 percent abstinent. You’re either all the way sick or all the way well. There’s no middle ground.”
Ms. Vincent was angered — and motivated — by the rehabilitation community’s intolerance of users who fall off the wagon.
“It’s like, ‘Hi, my name is Louise. I can’t stop using drugs, so I need your program,’” she told The Greensboro News & Record in 2021. “‘Oh, you’re going to kick me out because I can’t stop using drugs? Funny. I just told you that was my problem.’”
With nowhere to go, those users continue exposing themselves to hepatitis, H.I.V. and other diseases spread by dirty needles, along with increasingly dubious supplies of drugs laced with dangerous additives.
“As my good friend always says, ‘This ain’t your mama’s heroin!,’” Ms. Vincent wrote in 2021 in Filter, an online magazine promoting safer drug use. “So many health care providers still operate as if we are dealing with heroin, which we are not. We are dealing with fentanyl and tranquilizers and never-before-seen cutting agents.”
The North Carolina Survivors Union, run out of a small community storefront in Greensboro, provides users with tests to identify the ingredients in drugs. A sign on the wall — “We stand for loving drug users just the way they are” — represents the challenge that advocates like Ms. Vincent pose in the face of drug policies favoring abstinence, incarceration and strict rules for receiving methadone, a medication for opioid addiction.
“Louise was kind of the embodiment of the spirit of harm reduction,” Maia Szalavitz, the author of “Undoing Drugs” (2021) and a contributing opinion writer for The New York Times, said in an interview. “The idea is that we need to care about people who use drugs, whether they use drugs or not.”
In 2021, the Biden administration announced several initiatives supported by the harm reduction movement, including funding the purchase of test strips to identify fentanyl impurities. Critics argued that this approach was like buying whiskey for alcoholics; supporters said drug users deserved to maintain their dignity while battling addiction.
“So often, the problem facing all harm reduction programs is that people are so angry with those who use drugs, they want to try to punish them into abstinence,” John Oliver said in 2002 during a lengthy segment discussing harm reduction on his HBO show, “Last Week Tonight.” “But that is not how any of this works.”
He then played a clip of a television interview with Ms. Vincent.
“What we do is everything wrong to help a person,” she said. “We disconnect them from community. And then we disconnect them from their freedom. And when people finally have nothing left, then they will use until they die.”
Louise Mae Beale was born on March 15, 1976, in Greensboro. Her father, Walter Henry Beale III, was an English professor at the University of North Carolina Greensboro. Her mother taught in high schools and community colleges.
Louise was a precocious child.
At age 6, she was ordering pizzas for delivery. When she was 11, her parents made her stay home from Sunday school one day because she wasn’t ready to leave on time. She wanted to hang out with her friends, so she took a cab.
By seventh grade, she was drinking alcohol. One day, some older students offered her LSD and cocaine.
“I was a good kid,” she told The News & Record in 2013. “Thoughtful. Kind. But it was like going from Barbies to crack. I stepped off the ledge and fell face first into chaos.”
Diagnosed with bipolar disorder as a teenager, she self-medicated with hard drugs in increasing amounts. One overdose followed another. Her frequent hospital stays made her feel worthless.
“When they have security searches and room sitters, leave us in pain and withdrawal and refuse to allow any guests for us, we leave against medical advice,” she wrote in Filter. “We are treated as if we did this to ourselves and deserve our condition.”
Ms. Vincent entered Greensboro College in her mid-20s and graduated in 2005 with a bachelor’s degree in sociology. She was still using drugs off and on.
In 2007, she enrolled in the graduate program in public health at U.N.C. Greensboro and worked on a needle-exchange program. In 2013, she was struck by a car while crossing a street in a hit-and-run incident. Her ankle was crushed, and her leg had to be amputated. Later that year, she earned her master’s degree.
While attending a conference in Colorado, she met the founders of the Urban Survivors Union, an organization that promotes harm reduction strategies.
“When I first heard about harm reduction, I had an internal battle in my own heart because I grew up in the South and I was conditioned with all the same junk,” she told Scalawag. “It was a real battle. Am I doing the right thing? Is giving syringes to people … is this OK?”
In starting what became the North Carolina Survivors Union, Ms. Vincent initially worked underground. Users would call her on her cellphone and she would meet up with them to provide syringes, naloxone and sometimes CPR. She was still struggling herself.
“I didn’t start doing harm reduction because I wanted to save the world,” Ms. Vincent told NPR in 2023. “I wanted to save myself.”
In 2016, Ms. Vincent’s 19-year-old daughter, Selena Vincent, died in a rehab center from an overdose. Ms. Vincent had trained her to use naloxone, but the facility didn’t stock it.
“The maddening truth about what happened to Selena is that it was avoidable,” Ms. Vincent said.
She thought about getting high as a way of coping, but her dealer refused to sell to her.
“I’m glad that I’m OK right now,” she said. “But I know that it’s only this work. It’s only feeling like I’m a part of something that matters.”
Ms. Vincent was in a relationship for many years with Selena’s father, Carl Vincent. They were married shortly before he died from cancer in 1998.
In addition to her mother, Ms. Vincent is survived by another daughter, Summer Benton; a sister, Stella Beale; and her partner, Don Jackson, a human-rights activist who manages the North Carolina Survivors Union’s syringe program. Her father died in 2021.
Ms. Vincent was a co-author of numerous academic papers, collaborating with public health researchers like Nabarun Dasgupta of the University of North Carolina at Chapel Hill.
“She was flat-out brilliant,” Professor Dasgupta said in an interview. “She identified problems in the system and could frame injustices in truly amazing ways.”
She was also adamant that public health researchers should work with people like her.
“Given the rising rates of drug-involved morbidity and mortality, it is high time to include people who use drugs in public health efforts,” she wrote in a 2021 article in the journal Substance Abuse Treatment, Prevention, and Policy on which she collaborated with Professor Dasgupta and others. “Our lives depend on it.”
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