View Lauren’s poster presentation about her project here.

Lauren Kestner Headshot (Circle Format)

Title: Associate Director of Harm Reduction Services  
Organization: Center for Prevention Services
City: Charlotte, North Carolina
Project: Harm Reduction Housing First for People Who Use Drugs

Lauren Kestner is an artist and activist whose work centers on improving the lives and health of people who use drugs (PWUD). In her role overseeing Queen City Harm Reduction, a program that provides PWUD and their families with a range of services and support, Lauren combines her unique experience as a former injection drug user with research and best practices.

An artist all her life, Lauren initially started a nonprofit organization called “Artists’ Recovery Movement,” which brought creative expression workshops to shelters and treatment centers. Later, while working at the Center for Prevention Services, she secured a grant to support syringe access and peer distribution and helped grow Queen City Harm Reduction — a grassroots organization that provides people with critical health care services, syringe services, clothing, or a cup of soup and a hot coffee.

During her 18 months as an Addiction Policy Scholar, Lauren secured $1.8 million in funding to implement a “Harm Reduction Housing First” initiative.

“I was a justice-involved heroin user. My peers were the ones who taught me how to bleach my drug use equipment, where to access free and sterile syringes, and how to heal my scars. I wanted to take everything I had learned as a person, as a professional artist, and in treatment and bring it to my peers. At Queen City Harm Reduction, we bring helpful remedies to people who are using substances and need access to safer drug use and safer sex supplies, are seeking peer support, and/or social and healthcare support services. Societies at large want to see the good over the bad. And that’s valid. It can be very difficult and uncomfortable to embrace the raw and more vulnerable sides of humanity, to look at what most of us are complicit in creating. However, the ‘unhealthy,’ the ‘different,’ and the ‘difficult’ people and cultures are very much a part of our reality. If we continue to treat people based on ideals, if we remain unwilling to experience discomfort, we will continue to see people orbit a revolving door of sickness and institutions. We will lose more people we love to preventable death.”

Lauren also works with the North Carolina Harm Reduction Advocacy Group and Expand Good Samaritan NC to stop regressive bills that would hinder efforts to create more inclusive access to evidence-based harm reduction, as well as on policy reform initiatives to improve health outcomes for people who use drugs and people with substance use disorder. She lives in Charlotte, North Carolina, with her 7-year-old daughter.

“Harm Reduction Housing First” creates low-barrier access to housing support services for people who use drugs. The initiative — the first of its kind in the United States — couples the Critical Time Intervention for Rapid Rehousing (CTI-RRH) model with contingency management to provide wrap-around support, case management, and incentives to support safe and stable housing for PWUD. This approach removes expectations that people and providers often place on recovery and enables individuals to move at a pace that works for them. It can be the difference between life and death.

Elements of CTI-RRH and this program include: (1) case management that provides linkage to services, such as getting identification, signing up for SNAP, WIC, and Medicaid benefits, utility assistance, employment support, and eviction prevention and (2) fiscal support, such as rental deposits, security deposits, transportation needs, and rent for six to nine months. The program also helps program participants sustain their current livelihood and addresses barriers that prevent them from accessing shelter.

The project is supported by a $1.8 million investment from opioid settlement funds. Since the inception of the program in June 2023, there have been zero overdose events, and program participants have had a decrease in drug use and an increase in employment.

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