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'I ain't found it yet.' No line this mother won't cross to save her addicted daughter
View Date:2024-12-24 00:14:59
Renae moves hedge clippers, gloves and used coffee mugs off a table in her backyard and wipes it down. She scans the lawn behind her modest home in the rural South for folding chairs and pulls up three. There are paper plates for pizza. Renae is about to host a gathering with a singular goal: saving lives.
"Hey baby, you sit right here," Renae says to Christina, the first guest to arrive. "Just get your stuff ready."
Christina opens a Mountain Dew and arranges her supplies: a new syringe, a lighter, a tiny metal cup and a baggie with brownish powder clumped in one corner. A test strip will confirm it includes fentanyl, the opioid that's driving overdose deaths in the United States to record highs — an estimated 112,000 lives lost in the latest 12-month period.
Christina will use the powder anyway to appease her addiction and numb the pain of abuse, lost children and despair. On fentanyl, Christina gets temporary relief from three mental health diagnoses she struggles to manage: depression, anxiety and bipolar disorder.
Renae occasionally monitors illegal drug use at her home for Christina and a few dozen other people she's grown close to over the years. It's an informal, rarely discussed version of the controversial overdose prevention centers, also known as supervised consumption sites, where trained staff supervise people using drugs. Those clinics are endorsed by the American Medical Association and other leading medical groups but condemned by critics who say they sanction, even endorse, drug use.
Renae bustles around, looking for her glasses, pulling back her hair and chatting with a few other guests who have now arrived. But Christina's in a hurry. It's been nine hours since her last shot of an opioid. She's anxious and has that feeling she's going to be sick — the early signs of withdrawal.
Still, Christina has taken the time to come to Renae's backyard because she trusts Renae to keep her alive.
Much of what happens next may be illegal, so this story will not include full names, locations or detailed timelines.
Renae, who has medical training, pulls up a stool next to Christina. She watches as Christina pours the powder into the aluminum cup, melts the contents with her lighter and draws the liquid into a syringe. The injection is over in seconds.
After the shot, Renae chats with Christina about whether she's drinking enough water on this warm day. She turns a fan on Christina to help cool her down. Renae has Narcan handy, a brand of naloxone, the drug that can reverse an overdose. But this time, she doesn't need it. About five minutes later, Christina stands up.
"I'm OK," Christina says, and Renae agrees. Christina did not take a fatal dose of fentanyl today. Christina says thanks, the two women hug, and Christina walks away.
"This is seriously all it takes to keep somebody alive," Renae says, hands spread toward her home-based supervised consumption site. "People die of overdoses because they're by themselves."
Nationwide, more than half of people found dead after an overdose were alone. Renae is determined to make a dent in those numbers by intervening when people stop breathing and helping them start treatment for their addiction if they are ready. In the meantime, she makes people comfortable if they nod off, checks vital signs and provides rescue breathing or Narcan when needed.
Renae is cautious about who she lets into her home, and there are rules. Call or text before you come. Only one person uses at a time. No drugs left behind. By Renae's tally, she's reversed at least 30 overdoses in the past few years. She's never had to call 911. She's never lost anyone.
What Renae sees as a life-saving mission is likely a violation of a federal law passed in 1986, during a surge in crack cocaine use. It says allowing illegal drug use in any designated space is against the law. At least one U.S. city and a few states are testing this law and have opened or plan to open supervised consumption clinics. It's unclear whether federal agents will move to shut them down.
Opponents argue that Renae and others should focus on sending people with an addiction to treatment, not enabling their use.
"Yes, I enable, I absolutely do." she says. "I enable them to leave of their own volition and not on an ambulance gurney or in a body bag."
Many Americans condemn what Renae does. She understands why. Some years ago, when Renae's daughter began using drugs, Renae would have condemned her own behavior too.
Keeping Brooke alive
Renae's transformation from anxious mom to intrepid overdose prevention advocate started in her daughter's early teens with lots of mother-daughter fights. Brooke would break a rule. Renae would respond like many parents do. She would ground Brooke and take away her cell phone. As she puts it, "I was wanting to force her to do what I wanted her to do."
Renae says her approach "bombed." She pushed and punished, and lost Brooke's trust. Brooke says her mom's demands — go to school, get a job, do the "right" things — were reasonable. But Brooke didn't want to or didn't feel like she could.
"I got tired," Brooke says. "I didn't want to let her down, so I just left."
Brooke moved out at age 16. By 18, she was using opioids regularly. Renae often didn't know where she was or whether she was alive or dead. Her despair is familiar to many parents of children with an addiction.
Renae imagined spotting Brooke somewhere, swooping her into a big bag and racing home, like scenes from a Bugs Bunny cartoon.
Then one day, after a month of unanswered texts and calls, Renae saw her daughter walking down a street, and something inside Renae flipped. All the fights, fury and disappointment melted into "pure joy." Brooke was alive.
"That's all that counts," Renae remembers saying to herself. Her baby was still breathing.
Brooke didn't want to talk and wouldn't come home. Renae watched her go. But for Renae, everything had changed. She would give up on trying to control Brooke's life. She would figure out how to keep Brooke alive instead.
A gut-wrenching dilemma
Renae's new mission started with a simple step: She stocked up on Narcan for Brooke. It was a way back into her daughter's life.
During each delivery, Renae did a quick scan. Brooke seemed reasonably healthy, and not too thin, but open wounds on her arms were getting worse. Renae could imagine why: Needles get dull with repeated use. Searching for a vein with a blunt needle creates bruising and wounds. And Renae assumed Brooke was sharing needles with friends who could have hepatitis C, HIV and other viruses. Transmissions are common among people without access to clean needles.
Renae knew clean needles could improve her daughter's health. She also knew a needle she dropped off might deliver her daughter's final shot of opioids, the one that would slow her breathing to a stop, turn her lips blue and end her life.
What was the lesser of two evils? Would Renae be encouraging, even sanctioning, Brooke's drug use by giving her needles, or helping prevent injury and disease? Was she using needles as a way to see her daughter more often?
"The swirl of emotions was just insane," Renae says. "The guilt, the anxiety, the fear."
Renae ruminated for weeks. "It f
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