Tracey’s health and weight fluctuate wildly during the two years in which the film was shot. After serving another six-month stint in jail, and proudly telling the camera that she refused to use drugs while inside, an accomplice offers to buy heroin for her. She relapses within eight hours of her release. “It wasn’t all that great,” she says, lying in bed the following morning, staring at the ceiling. Toward the end of the film, Tracey injects herself and says, “Sometimes it makes me happy.”

Her habit was such that she was injecting heroin into the soles of her feet as she no longer had any usable veins. She got arrested again, and served time while detoxing in the San Francisco County Jail. But this time she found a path to recovery. She chose to enter a long-term rehabilitation program, followed by four years in a sober living environment. The last time she used heroin was on February 27, 1998.

Now 45, Tracey has earned two degrees from San Francisco State University and established a career managing public health programs, often including services around substance abuse. She is raising three children under seven with her husband of eight years, and she landed a book deal after her blog — subtitled ‘Stories of parenting, insanity and addiction’ — attracted an agent. Her online presence covers an array of social media outlets, all linked by the username ‘traceyh415’, the digits referring to her San Francisco area code.

Credit: Tracey Helton

Since Black Tar Heroin was uploaded in full to YouTube, in November 2012, she has left dozens of comments responding to queries about the film and her life since recovering. “Keep asking me questions,” she wrote early in 2015. “I will try to answer as many as I can. Hard to believe this was me.”

Tracey first became involved with distributing naloxone through her public health work in 2003, when there were only five such programs in the United States; now there are over 700. Later, she began to offer free counseling and basic intervention with drug users on the internet. She noted the number of users across the country who complained of having no access to the life-saving clear fluid, whose sole purpose is to reverse opioid overdoses. The seed of an idea was planted.

Her involvement with Reddit began two years ago, when an online friend encouraged her to share her harm reduction strategies and knowledge. Tracey introduced herself to the OpiatesRecovery subreddit in July 2013; the welcoming response there led to her becoming a moderator in the Opiates subreddit, which has over 15,000 subscribers.

“There’s an anonymity involved with Reddit that I appreciate, because I know it’s really hard for people to come out if they’re involved with drugs,” she says. She has been open about her own past and identity because she wants her online companions to see her as living proof that recovery is possible. “I used my name so people could Google me and see I’m the same person,” she says. “I thought that, by being a semi-public figure willing to share my own experience, it would help people open up in a different way around their using.”

As her profile grew in this community of social outsiders and outcasts — many of whom feel stigmatized by the poor public perception of intravenous drug use — Tracey realized that her experience in running public health programs in San Francisco could offer another avenue of assistance on Reddit. “People were contacting me saying they had no access to naloxone, and I thought, ‘Well, that’s something I guess I could do.’” She mailed her first care package in August 2013. “I assumed a long time ago that somebody else would take over. I didn’t expect to be doing it for this long.”

Now she averages 10 packs of clean syringes and two packs of naloxone per week. Though she won’t disclose how she obtains the drug, Tracey says she has sent over 280 vials, 20 of which were multi-use receptacles containing ten doses apiece. Most of the program funding has come directly from Redditors: a slow trickle of piecemeal PayPal donations allows her to keep the idea afloat without opening her own wallet too often. “I have a few donors who don’t use drugs themselves, but they choose to donate to the program, so I like to keep them in the loop,” she says. “It all goes to the program; it’s not like I’m paying myself a salary.”

She keeps a spreadsheet of her care package recipients and monitors Reddit and social media responses, so she can track how her national distribution program is working. On March 4, she began a thread titled 100 Saves. “You beautiful Redditors have done it!” she wrote. “You have saved 100 lives with naloxone since I joined Reddit 18 months ago. Just got a message this morning about the 100th save. People say junkies don’t care but that is a lie! We do care! Give us the tools we need! Naloxone needs to be in every first aid kit.”

When we speak via Google Hangouts in May, the number of confirmed saves has surpassed 110; two months later, the number is 115. The campaign has gone on longer than she had anticipated, but she continues sending packages in spite of its questionable legality. Although the drug can be bought legally in pharmacies in her home state of California, she explains to her recipients that they risk a potential misdemeanor charge if police catch them holding a vial without a prescription. “I just think that this is something that should be available over-the-counter,” she says. “I’m correcting an injustice.”

As far as Tracey is concerned, it’s a risk worth taking. “Some of these people live in areas where the paramedics won’t get there for 45 minutes,” she notes. For over 15 years, her efforts in harm reduction — both online and off — have been motivated by an intensely felt and unshakeable urge to right a perceived wrong: that all drug users and addicts deserve compassion and support, rather than demonization and criminalization.

“What I do is somewhat illegal, to a certain extent, but I feel compelled to do it because I was a heroin user. I’ve been administered naloxone. I’ve seen it work in the lives of so many people,” she says. “There’s a belief that somehow you’re punishing people or helping them get clean by not giving them access to the things that they need. That doesn’t actually work. A person can’t get clean if they’re dead.”

In the thriving community of r/opiates, in which posts featuring new drug experiments or glamour shots of freshly acquired illicit goods are not uncommon, Tracey’s outreach efforts have helped to foster a rare haven. Intravenous drug users are often tarred in the public eye as reckless misfits, but as with any subculture, the ways in which individuals approach their habit vary widely. On the more responsible end of the spectrum are those users who ensure they always have naloxone on hand, just in case, as well as clean needles. The mother of r/opiates helps spread these safer behaviors.

Credit: Tracey Helton

“Her care packages are a lot greater than the sum of their contents,” says a 28-year-old user living in Cleveland, Ohio, who asks to be identified by the pseudonym John Bryson. Bryson overdosed in December after stepping away from his habit for two weeks — he was saved by an experienced friend who was carrying a vial of Tracey’s naloxone in her purse after he had given it to her. He returned to the forum to share his experience, with advice of his own for future naloxone administrators. “People should also note that it took three shots before I came back, and not to get discouraged if the first shot or two doesn’t seem to be working,” he wrote on Reddit, before privately making another donation of $50 into Tracey’s PayPal account.

The vial had only been in Jef Croll’s possession for a week before he used it on an overdosing friend in late April. The 30-year-old resident of Sandusky, Ohio, says there is no needle exchange program in his town, and local supermarkets and drugstores frown upon users purchasing clean needles. Croll himself has now taken up the harm reduction cause. “I’m basically the Tracey of our area,” he says, outlining his efforts to encourage friends to visit his home and trade their busted rigs for fresh needles, free of charge.

So has Brad, the user whose older brother, Bill, rescued him from an overdose. “I strive to be more like her,” he says of Tracey. “I actually went on the internet and ordered a hundred-pack of needles. I sent out a mass text message to all my friends that use: ‘Hey, bring all your dirty needles to my house, I’ll throw them away and give you clean ones for free.’” His ordeal inspired him “to try to kick everybody’s ass into gear around here.”

Tracey’s influence on r/opiates is not limited to her trips to the post office. Nick, a 23-year-old living in Michigan, says, “To a lot of the younger people like me who have been using for a long time, she represents change: that you can do this, come out the other side and be clean, have a family, get a job, get a college degree. She’s proven that. And she’s still connected to the community in a positive way. Twelve-step programs demonize you, and tell you you’re powerless; Tracey has empowered people.”

On her Instagram profile, amid photographs of her smiling children, of kittens and screenshots of grateful messages from Redditors whose lives have been touched by her naloxone program, are occasional images from less pleasant moments: screen captures from Black Tar Heroin, for instance, or the mugshot from her arrest in October 1996, which Tracey posted in early June. “You can change,” she wrote alongside the mugshot. “I promise you can. I know this for a fact. Look at this person; look at who I am now.”

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