Women who use drugs: Challenges demand self-led harm reduction

Tessie Castillo


Women who use drugs: Challenges demand self-led harm reduction

3 June 2019

By Tessie Castillo

Bree Cassell first injected heroin when she was 15 years old. Despite wanting to do so, she was so scared of the needle that it took two men to hold her thrashing body down, and a third to inject the drug into her vein.

Now 26, Cassell frequents a syringe exchange program in Wilmington, North Carolina, for sterile injection equipment, overdose prevention supplies, and friendly faces.

The small exchange—just a whitewashed room in an aging strip mall—doesn’t boast much. But the two women who run the exchange, Becca Lilly and Bernadette Calicchio, have done their best to make it welcoming and comfortable to people who seek refuge there.

Bright Christmas lights deck the walls and old tables are draped in cheerfully-patterned cloths. The exchange offers free clothing, food and toiletries. On one desk a collection of greeting cards is marked, “Write a card to someone you love. We’ll provide the stamp and mail it.”

In late April I visited the exchange for its inaugural Women’s Day, a Friday afternoon where only women could visit the program. The ladies had decked a long table with snacks and party favors, wrapped in pink crepe paper, to welcome their guests.

While we waited for people to show up, I sat down with Cassell and Lilly to learn about their experiences with drug use. Both were introduced to IV heroin, at 15 and 16 years old respectively, by male friends. Both have engaged in sex work to buy drugs at the request of male partners. Both have experienced the difficulty of finding affordable drug treatment programs for women.