A mother is working to impede overdose deaths by supervising drug use at home : NPR

ARI SHAPIRO, HOST:

There’s a vigorous public debate about illegal drug use and whether to allow supervised consumption or overdose prevention sites. Those are clinics where people using drugs are monitored to make sure they don’t overdose and die. In private, some family members take it upon themselves.

RENAE: I want people to stay alive.

SHAPIRO: That’s Renae, whose story we began this morning. WBUR reporter Martha Bebinger begins part two with Renae in her kitchen.

MARTHA BEBINGER, BYLINE: Renae was making supper late one afternoon when her daughter Brooke arrived unexpectedly, clearly in withdrawal. Renae and Brooke had been through a lot. Renae’s sole mission became keeping Brooke alive. In the kitchen, Renae watched Brooke pull a needle and drugs out of her bag.

RENAE: She kind of gathered up all of her stuff and started walking off towards the hallway bathroom. And immediately in my brain, I said, no.

BEBINGER: Because the bathroom Brooke headed for is small.

RENAE: If she got in that bathroom and shut the door and fell out overdosed, there’s no way I’d be able to get that door open with her leaning against it.

BEBINGER: So Renae did something she’d never done before. She asked Brooke to stay.

RENAE: She was so sick. She was going to use carelessly. It took no time at all for my mind to process that whole situation and say, Brooke, you got to do this here, babe.

BEBINGER: Renae remembers turning to face the kitchen sink and give Brooke some privacy. She looked back when she heard soft sobs.

RENAE: She had stuck herself unsuccessfully so many times that she had blood running down the back of her hand and dripping off of her fingertips onto the floor.

BEBINGER: Renae, who has medical training, helped her daughter clean up and calm down. After the shot, Renae sat with Brooke until the danger of a fatal fentanyl overdose had passed. What has stayed with Brooke years later, when she’s no longer injecting drugs, is the certainty in that moment that she was loved.

BROOKE: And she didn’t, you know, evaluate me for what I was doing. She just wanted me to be all right. It was weird, though. I ain’t going to lie. It was weird.

BEBINGER: Some parents would go way beyond weird and call what Renae did that day irresponsible or even criminal. Others are quietly doing something similar – an ear pressed against a bedroom or bathroom door, hoping they can intervene if needed before it’s too late. Renae knows that what worked for her to keep Brooke alive won’t be right for every family.

RENAE: I hope I give them permission to love their loved one the way they see fit. There’s no blueprint for this.

BEBINGER: But for Renae, a blueprint did emerge that day in the kitchen, what might be called home-based overdose prevention. Renae stood watch with Brooke again and then with some of Brooke’s friends. These days, Renae monitors drug use occasionally for a dozen or so people she’s met while passing out clean needles and Narcan, a brand of the overdose reversal drug which she keeps handy, too.

RENAE: Got our Narcan here. You know, so if anything were to happen, we’re ready.

BEBINGER: Today, Renae’s backyard is a temporary overdose prevention or supervised consumption site. Her first guest is Christina, a mother of four.

RENAE: Where did that baggie go? I had a little bit in it.

CHRISTINA: (Inaudible).

RENAE: And that’s all I got left.

BEBINGER: We’re not using full names and have altered some voices because some of what the participants talk about could be illegal.

RENAE: I have trouble with this [expletive], and I’m a nurse.

BEBINGER: Christina is anxious, shaky and can’t find a vein. Renae presses several spots on Christina’s arm and locates one. The shot is done in seconds.

RENAE: But now I want her to sit here with me for a few minutes just to make sure she’s…

CHRISTINA: I’m starting to sweat.

RENAE: We can cut that fan on. Let me get you some water.

BEBINGER: If Christina took a lethal dose of fentanyl, it will knock her out fast. At Renae’s, Christina will not have to worry about being raped or robbed if she nods off. After five minutes or so, the two women stand, hug, and Renae walks Christina to her ride.

RENAE: This is seriously all it takes to keep somebody alive. People die of overdoses using by themselves.

BEBINGER: Renae says she’s reversed about 30 overdoses in the past few years, doing her part to tackle a grim fact. Most people found dead after an overdose were alone. In Renae’s home, there are some rules. Do not show up unannounced. Never leave drugs behind. And people have to take turns.

RENAE: I mean. I can’t revive that one person at a time. I’m good, but I ain’t that good.

BEBINGER: The American Medical Association and other leading health care groups have endorsed overdose prevention sites, but supporters in almost every state are afraid to open them under current drug laws. Some lawmakers, police and prosecutors pushed to ban these sites, saying they boost violence and property crimes, although studies show this has not occurred at the two sites in the U.S. Opponents also argue that people with an addiction should be sent to treatment, not a place that enables drug use. Renae says people will use, safe space or not.

RENAE: I enable them to leave of their own volition and not on an ambulance, gurney or in a body bag. That’s what I enable.

BEBINGER: Renae doesn’t just enable people to survive their addiction. She also offers treatment. Sometimes that starts here, too, in her backyard.

RENAE: You can get your car and drive it behind the shed and pull it right back here.

BEBINGER: A, a working mom who Renae’s known for years, arrives just to pick up clean needles and naloxone. A tells Renae she’s trying to wean herself off fentanyl, only injecting once or twice a day, just enough to impede full withdrawal.

A: I used to not be sick.

BEBINGER: A wants to get on Suboxone, a drug that combines an opioid and naloxone to curb cravings and impede an overdose. But her local treatment program told her she’d have to foresee 72 hours between her last shot of fentanyl and starting Suboxone. A says she tried and decided she’d rather die.

A: You just think, well, just get sick and get it over with. I don’t know why. I don’t know why it’s so hard.

BEBINGER: Renae listens as A starts to cry. Then Renae describes another way to start Suboxone. It’s called microdosing and is used at many medical centers. As soon as A can no longer tolerate the fentanyl withdrawal, she’ll take a small dose of Suboxone and slowly transition to the new drug. Renae says she’s done this for half a dozen people, even though she can’t prescribe Suboxone.

RENAE: So people appreciate me have to break the law. We have to risk everything still to help people appreciate her.

BEBINGER: Sometime soon, Renae will find a way to get Suboxone. She wants to have it in hand when A calls or comes by because the window of opportunity between a last shot, the decision to start treatment and gut-punching withdrawal might be just a few hours.

RENAE: All she’s got to do now is look at me and say, I’m ready. That’s the end of the conversation.

BEBINGER: A wipes her face as she weighs Renae’s offer. She says she isn’t ready yet but is close. What matters to A in this moment is knowing that Renae will do whatever she can to help whether A starts treatment or not.

A: It does give me hope. You know, it gives me hope that she hasn’t given up on me. I think if there was more of that, it’s – I can’t visualize how different things could be.

BEBINGER: Renae’s work is helping make a difference for her daughter. Brooke says she’s no longer addicted to opioids. If there’s a line Renae is not willing to cross to continue keeping Brooke, Christina and A alive, Renae says she hasn’t found it yet. For NPR News, I’m Martha Bebinger.

(SOUNDBITE OF MARSHA AMBROSIUS SONG, “FAR AWAY”)

Copyright © 2023 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for advance information.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.