When pharmacy professor Lindsay Acree volunteers at a local needle exchange, her beliefs about addiction are challenged.

Lindsay Acree, Pharm.D., AE-C is an assistant professor at the University of Charleston School of Pharmacy. She received her pharmacy degree from the University of Charleston School of Pharmacy in 2013 and completed a PGY1 residency in academia/ambulatory care also with the University of Charleston. Dr. Acree provides patient care in several clinics throughout the Charleston area including the City of Charleston Wellness clinic and the Family Health Associates of South Charleston. Dr. Acree is a board certified asthma educator. Her involvement with the Harm Reduction Clinic located within the Kanawha Charleston Health Department includes teaching the naloxone training to patients, caregivers, and members of the community as well as assisting with Harm Reduction Clinic services. In addition to clinical services, Dr. Acree teaches several topics within the University such as substance use disorders, asthma, COPD, and tobacco cessation.

This story originally aired on August 2, 2019 in an episode titled “Saving The World.”

Story Transcript

So on a November day, November 2009, I received a call from my brother.  I was standing in my dad’s living room and he calls to tell me that a friend of mine had passed away from a drug overdose. 

He and I had not been close in many years, probably I'd say at least three or four years the time that he passed away.  He was probably the smartest kid in school.  He was absolutely the sweetest person in school.  I went to middle school and high school with him and it was kind of one of those things that if you had a question about any subject, you’d go ask him.  If you needed help with something, you'd go ask him.  And he was there for everybody. 

Because of his passing, I realized at that moment that I wanted to help people.  I wanted to help people that suffer from addiction because I thought is there something that I could have done differently?  Could I have been a better friend?  Could I have helped him at that point before then to get into recovery?  But I didn’t really know how to. 

But being in pharmacy school, I was in my first year of pharmacy school and I thought, “Well, maybe I'll learn something here that can help me help other people.”

So that was my first year of pharmacy school. Fast forward three-and-a-half years later.  I graduate.  I ended up working for the university that I went to school for.  And, because of that, it gives me some flexibility with my job. 

Well, in 2015, I heard that Charleston was getting ready to have a Harm Reduction Program, which is a syringe exchange program.  I’m not sure what they call it here.  But I thought, “Oh, my gosh.  Finally!”

Because we needed one.  It was long overdue.  West Virginia has one of the biggest drug problems.  We've been number one in overdoses for years because the state was completely flooded with pills.  So pills came in and then eventually the pills slowed down.  So when the pills slowed down, people started kind of going towards heroin, meth, anything they could get their hands on.  So it was a huge problem in our state and we really, really needed something. 

So I was so excited the program was starting and I really wanted to help, so I thought this is my way that I can maybe touch lives of people that suffer from addiction.  I went to the planning meeting not knowing what to expect.  I thought I'll probably try to volunteer at least for a couple of weeks and maybe pull my students in, help my students volunteer.  I think I’m only going to be there for a couple of weeks and just kind of getting them into the groove of everything.  Little did I know I was going to be there forever.  You fall in love with patients and you just can’t stop seeing them. 

But the planning meeting I was trying to figure out how is this logistically going to work?  How are patients going to handle being interviewed in the room?  Is this going to be a rough crowd?  I didn’t know what to expect but I wasn’t going to let that stop me.  I was determined that I was going to do it.

So first week, we were all excited.  Want to see people come.  Our health officer at the time, he stood waiting in the waiting room, like this, dressed in a suit, eager for people to walk in.  He was so excited.  The first group comes in led by this young lady. 

She comes in with her friends.  She takes one look at him and she's like, “Nope,” and she's out the door.  She took off running back to her car.  She thought, “He's a cop.  This is a trap.  I’m gone.” 

So she runs out to her car, gets in, and our health officer runs after her, knocks on her window and begs her to come back in, and she did.  And because of that day, she continued to come every single week.  She brought everybody she knew, so all of her friends, random people that she had just met that she knew used heroin or meth or whatever it may be and needed help.  She would bring them all to the health department. 

The great thing about the Harm Reduction Program was it wasn’t just us handing out syringes.  We were talking to them about being safe, so how to prevent spread of disease, how to use NARCAN to save people’s lives, and that gave them a path to actually getting to recovery.  So everybody that she brought in was able to get that same education, which was awesome. 

So the program kept growing and growing.  And the more that I talked to people, the more I realized how like this stigma surrounding addiction really affects people.  Within the first week or two of the program, I had a woman come in and she sat down in front of me.  I just started chit-chatting with her and she just started crying. 

So I gave her her moment, just let her kind of get it out, then I asked her if she was okay.  What she said to me was, “You are nice to me.  You're the first person that didn’t treat me like a dog in years.” 

But that story was not uncommon.  So the more I was at Harm Reduction, the more I heard the same kind of things.  When people were new, they would come in and they would have their hoods up.  Their heads would be down. They wouldn’t make eye contact.  But the more they started coming back, the more they would kind of open up to us. 

They knew us by name.  We really didn’t know their names because it was an anonymous program.  Sometimes they told us that.  But more importantly, their heads would be held higher.  They would have a little bit more self-respect.  They’d have their hoods down and they would greet us.  That allowed us that connection to actually help them, which is what we were there for. 

Like I said, it kept growing and growing and growing.  I really didn’t understand everybody’s path to addiction.  We have this idea that everybody starts a certain way, but that’s not necessarily true.  Some people’s path was with pills, some people they start with heroin or meth or whatever it may be. 

But one thing I didn’t realize was that oftentimes people are forced at a young age.  I think the most shocking age that I heard was six.  So someone started using at six.  Again, that has to do with a lot of issues in the family and being forced.  It’s shocking.  It’s the only word I can think to describe it. 

I'd like to tell you about one patient.  I went out to get this patient, to take her into the room and I had no idea how she was going to affect me.  I had no idea what I was in for.  But she comes in and she’s just hard.  She's cold. 

She sits down, she crosses her arms.  She won’t look at me and she leans back in the chair just trying to act as tough as she could.  I just talk to her just like I did everybody else, try to get her to open up and, eventually, she did.  Then she started to cry.

She told me that she never really opened up to anybody because she didn’t trust anybody.  So she had no one to trust, no one to talk to.  This was really the first time that she opened up.  So I sat there and watched her cry and it took everything in me to keep also from crying.  I tried to talk to her.  We tried to get her help. 

Eventually, she left the room and I left the room.  As soon as I left the room, tears.  I just couldn’t hold them back anymore.  So I went to the nurse’s station and I stood there and I just cried because I couldn’t figure out how I was going to go to the next patient.  Like how do you move on from that?  It’s not my life but it’s still someone else’s.  Like how do you just go to the next person like nothing happened? 

So I stood there and just thought about that.  But then I realized that the next person probably has a very, very similar story, so does the next person.  Then I never saw her again. 

Like I said, everybody’s path is different.  Then there's this idea I always hear people say that addiction is a choice.  I disagree, obviously, but some of the stories that I've heard are the reasons that I disagree. 

I've had people come in and tell me that they used to find syringes on the side of the road, clean them out in puddle water and use them.  One guy had one clean syringe left and he sharpened it on the sidewalk because he didn’t want to use a shared syringe.  Mothers don’t have custody of their kids, families losing their homes. 

So all kinds of things that make me think that there's no way that this is a choice, because if it was a choice they would just stop using, right?  So how could it be a choice?  It has to be a disease.

Harm Reduction or Needle Exchange Programs, they're very controversial in my state.  There are a lot of issues surrounding the program, a lot of people that didn’t really understand everything that we did, who thought we were enabling because we heard that quite a lot.  There's a lot of things in the news, a lot of bad press and, eventually, the program was shut down. 

But when it shut down, the first thing I thought is what’s going to happen to those people?  Where are they going to go now?  How are they going to get help?  Never once did I think am I on the right side of the fence here, because there's a lot of things in the news that sounded pretty bad?  But not once did I think that.  Not once did I wonder if we were saving lives.  Not once did I wonder if we were making a difference, because I knew the answers to those questions. 

But am I going to hear about that same guy going back and cleaning that syringe out in a puddle of water?  Am I going to see their faces or their names, which I usually, for the most part, didn’t know, but am I going to see them in the obituaries?  Is it going to be this week?  Is it going to be next week?  I don't know.  Thank you, all, for listening.