As overdoses in Kentucky rise, this Louisville woman is helping others find treatment and hope

When Jennifer Twyman originally sought help for her struggles with "chaotic substance use" a dozen years ago, she heard about only two options: Sign up for inpatient treatment or join a 12-step program like Alcoholics or Narcotics Anonymous and go cold turkey.

Those initiatives help a lot of people, but they weren't right for her then. 

"What worked for somebody in my life, by going to AA meetings, didn't work for me," the 54-year-old Louisville woman told The Courier Journal.

Then, a breakthrough happened: She learned about medication-assisted treatment and tried Suboxone, which is FDA-approved and is used to treat opioid dependence. 

"I have good and bad things to say about Suboxone," she said of her past experience with it. "But it’s the reason that I'm here, and I don’t doubt that.

"Suboxone allowed me to continue to work. I was able to become that 'functioning citizen,' although the stigma and judgment that still surrounded me (as someone who uses drugs) ... I have yet to come up with the right words that can convey how heavy of a load the constant daily stigma piles on our shoulders."

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That experience led her to embrace an overall strategy called harm reduction, which aims to lessen the negative impacts associated with drug use. 

Twyman's 20 years of experience with substance use don't define her.

But it's a part of her journey she can draw from as she begins her work with a new organization, VOCAL (Voices of Community Activists and Leaders) Kentucky, to help organize a movement to change policies surrounding substance use in her hometown and throughout Kentucky — a movement led by the perspectives of people who use drugs.

"It’s so important in Louisville because people are dying every day, overdosing every day. I have, especially in the past two years … lost so many people," Twyman said. "That’s because people use in the shadows, and they don’t talk about it because they are stigmatized and judged and punished, literally, when they do try to talk about it."

VOCAL Kentucky launched this summer as an offshoot of VOCAL New York, a 23-year-old grassroots organization based in Brooklyn.

Their vision: Building "a movement of low-income people dedicated to ending the AIDS epidemic, the war on drugs, mass incarceration, and homelessness.”  

"I am more than excited," Twyman said. "There are amazing people in Louisville, on our sidewalk and in our jails, that don’t have a voice and should — and will."  

She wants harm reduction to become a more integral part of the services Louisville and communities across Kentucky provide. She describes it as offering people a menu of services — such as 12-step meetings, medication-assisted treatment and syringe-exchange opportunities — for people to choose from, which gives them more autonomy.

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Drugs aren't going anywhere, she said, "so the safer we make it for people to be able to use substances and stay alive, the better off we as a whole society will be.

“If we give people the ability to take care of themselves, they do. People don’t think that people who use drugs can take care of themselves, and that is not accurate."

Before joining VOCAL Kentucky, Twyman worked for the Louisville Metro Health Department on its harm reduction services efforts, which include a syringe exchange initiative through which people who use drugs can exchange old needles for new ones. That helps them protect themselves from pathogens like HIV.

She spoke with a lot of folks across the city as part of her work there, which included training people to use naloxone (or Narcan) to quickly treat an overdose.

Deaths from drug overdoses in Kentucky increased significantly in 2020 and 2021. Over 4,200 people died during those two years, and over 3,000 of those losses were linked to an especially deadly and increasingly prevalent synthetic opioid called fentanyl. 

"Every single one of those is a policy failure," Twyman said of Kentucky's overdoses.

Our system, she said, is "set up to stigmatize, judge and punish people" instead of to provide support, tools and education.

Through VOCAL Kentucky, she hopes to help change that — starting with giving people space to have a voice.

Twyman said she and her VOCAL Kentucky colleagues, former Louisville mayoral candidate Shameka Parrish-Wright and organizer Alfredo Carrasquillo, will be "literally hitting the streets."

"We’ll be going to talk to people in encampments, we’ll be going to talk to people in housing communities that are struggling, really all over the city. We want to go talk to the people that we are going to be building power with and see what the issues are, where we need to go first, what we need to fight for loudest right now."

To learn more about VOCAL Kentucky and Twyman's work with the organization, visit their website at vocal-ky.org or email the group at info@vocal-ky.org. 

Morgan Watkins is The Courier Journal's chief political reporter. Contact her at mwatkins@courierjournal.com. Follow her on Twitter: @morganwatkins26.