Andreas Guerrero ’20, Provides Preventative Services and Support for People at Risk of and Living with HIV/AIDS at Blue Mountain Heart to Heart in Walla Walla, WA.

Opiate Use and the Importance of Being Heard:

 An Update on My Fellowship at Blue Mountain Heart to Heart

By Andreas Guerrero

“For some of our clients this is the only human interaction they will have all week”. I had been working at Blue Mountain Heart to Heart in Walla Walla for about a month when I heard this reminder as part of an admonishment of my interaction with a client. It felt like a punch in the gut, and the reality of the importance of the services Heart to Heart provides really sank in for me then.

Heart to Heart is an organization that provides preventative services and support for people at risk of and living with HIV/AIDS and Hepatitis C. A significant part of this work is its syringe exchange program, which it operates out of 1520 Kelly Place suite 20 in Walla Walla. Syringe exchange programs are important for reducing the transmission of disease, because when people have access to clean needles, they are less likely to share syringes, which can spread blood-borne illnesses. As part of my work at Heart to Heart, I help manage the syringe exchange.


In a typical interaction with a client (someone who uses injected drugs) I will welcome them at the door and invite them into the back room where we do the exchange. Clients present their dirty syringes and I give them the same number of clean syringes back. At the exchange, we also provide condoms, lubricant, sterile water, cottons, cookers, triple-antibiotic, wound-care supplies and many other materials that all improve the safety of injected drug use.


We also distribute Naloxone at the exchange, a drug that wrenches people experiencing opiates back into sobriety. It is a crucial intervention for reversing drug overdoses, and is responsible for saving many lives. We distribute it to as many clients as we can, because injected drug users are the people most likely to be at the scene of an opiate overdose. Since we participate in a study with the University of Washington to collect data about Naloxone use and overdoses in Washington State, I fill out a form every time I distribute Naloxone to a client, asking them about their drug usage, their housing situation, and other information germane to the study. It was when I collected this data that I made the error that earned me the reprimand mentioned above.

A client wanted Naloxone, and I wanted to fill out the form as I had been instructed, so I asked them the questions on the list, box by box, barely looking up from my clipboard. When I was finished, I gave the Naloxone, and looked to the next task. My supervisor pulled me aside after and criticized me for my conduct. The point of the interaction, she told me, is not to answer the questions on the sheet. We don’t care about those so much as the person in front of us. Our clients face stigma on the streets from community members who see them as less-than human because they use drugs. They often are exposed to violence at home if they are lucky enough to have one, or on the street if that is where they live. When they come to us, they deserve, above all else, to be listened to, heard, and seen as human beings.

I felt terrible for my mistake, and it’s been on my mind in each subsequent interaction. If our clients don’t feel heard, they won’t feel safe coming to our exchange, and the whole goal of the project will be jeoprodized. As a provider, the best thing I can do is listen. I’m glad to have learned this lesson now, because as someone who is considering a career in medicine, I think that remembering my true priority, the well-being of the client, will be a vital skill going on. This is just one example of the many opportunities I have had working at Heart to Heart to reflect on my actions and to improve the way I interact with people in need of my support.

The author is a senior at Whitman College, working towards a degree in Biochemistry, Biophysics, and Molecular Biology, and Philosophy. He is active in his fraternity, Sigma Chi, as well as various clubs around campus, including the Mycology Club, of which he is co-president.

Experiences like Andreas’ are made possible by the Whitman Internship Grant, which provides funding for students to participate in unpaid internships at both for-profit and non-profit organizations. To learn how you could secure a Whitman Internship Grant or host a Whitman intern at your organization, click here or contact Assistant Director for Internship Programs Mitzy Rodriguez


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