Dan Bigg didn’t worry about social norms or even the law when lives were at stake.
In the early 1990s, when he was a Chicago activist trying to stem the spread of HIV by distributing clean hypodermic needles, that activity was in a legal gray zone. He did it anyway.
A decade later, as heroin-related deaths began to surge, he pioneered the idea of putting the overdose-reversing medication naloxone into the hands of drug users and their loved ones. At the time, it was available only with a prescription, and some said making it readily accessible would encourage risky behavior. He did it anyway.
As a result of Bigg’s efforts, friends and colleagues said, thousands of people who would have died from infections or overdoses are still alive — a flesh and blood legacy of the “harm reduction” philosophy Bigg helped to popularize.
Bigg, a co-founder of the Chicago Recovery Alliance, died at his home Tuesday. He was 59. The Cook County medical examiner’s office said the cause of death remains undetermined pending further tests.
“I think he was really a creative revolutionary who was always looking out for people who were disenfranchised,” said his wife, Karen Stanczykiewicz-Bigg. “He was very passionate about the health — not just physical health but emotional health — of people who were often overlooked and stigmatized, like active drug users.”
News of Bigg’s death brought a flood of tributes from across the world, with many activists recalling how he helped them start their own naloxone programs. Daniel Raymond of the Harm Reduction Coalition said Bigg changed the way people who use drugs are treated.
“He was a real force of nature,” Raymond said. “The degree of acceptance we have now, that naloxone would be in the hands of people who need it to survive — it would have been unthinkable without him taking that initial risk.”
Bigg grew up in Winnetka but lived in Chicago for most of his adult life. In the mid-1980s, he was a substance abuse treatment worker who took note of the high rate of HIV infection among people who shared syringes to inject drugs.
He co-founded the Chicago Recovery Alliance to address that problem. Though having a syringe without a prescription was against the law in Illinois, the alliance found a loophole by teaming with public health researchers. Even so, the group didn’t wait for the official green light to begin its work.
“He was frustrated because the response by so many people was just hysterical, the same (stuff) over and over again — ‘Just say no’ and amping up the drug war,” said Mark Parts, who helped found the alliance with Bigg.
In the early days, Parts said, volunteers hauled syringes, condoms, and sterile disposal buckets to the South Side in the trunks of their cars, then set out the material on card tables.
Later, a silver van carried supplies to various spots around the city and near suburbs, allowing drug users to get clean gear, health services and — if they were willing — referrals to treatment.
The idea behind harm reduction is to use drugs as safely as possible, minimizing the threat to a user’s health and that of the public. Bigg described it as a more realistic approach than an all-or-nothing philosophy.
“Most opiate-addicted people don’t want to be,” he said in a 2003 Tribune interview. “They wish it was different. But it isn’t. The best we can do is help them take care of themselves and minimize the harm to themselves and others until they are ready to stop on their own.”
Stephan Kamenicky, 61, a former drug user who works with the alliance, said its patience and understanding helped him finally defeat a heroin addiction that lasted for decades.
“That’s the best you can do,” he said. “I’m a prime example of that. I was as stubborn as they get until I finally decided for myself that I was tired of it.”
In the early 2000s, Bigg’s advocacy led him to try something new. Raymond said Bigg was the first to promote the broad availability of naloxone to stop opioid overdoses, even though the drug had been restricted to paramedics and emergency room personnel.
“The thought of taking the medication out of the health care system and putting it into the hands of the people who were trying to survive an overdose was revolutionary,” he said.
The concept was not universally accepted, with some arguing that the prospect of rescue would cause drug users to take greater risks. But Bigg’s insight became the prevailing wisdom, and today, people can buy naloxone at pharmacies without a prescription.
“I went to conferences with him in the early days, and he would bring bags of naloxone and say, ‘Who wants to start a program?’ ” said Suzanne Carlberg-Racich, the alliance’s director of research and a public health professor at DePaul University.
“There would be lots of stares until someone stepped forward. Then there would be a rush to grab supplies and get going.”
She said naloxone and training provided by the alliance have led to at least 15,000 overdose reversals — a number that is likely far too low since many are never reported.
The alliance aims to carry on after Bigg’s death, with a new focus on treating hepatitis C, a blood-borne disease. On Wednesday, the silver van was making its rounds as usual, Carlberg-Racich said.
In recent years, Bigg was honored by the International Drug Policy Reform Conference, which cited his work with naloxone, and by Chicago Magazine, which named him a Chicagoan of the year. For all Bigg accomplished, though, Parts doubted his friend would be satisfied.
“I’m sure he would look back with pride on all the lives he helped to change and the people he helped to protect,” he said. “But I don’t think he’s the kind of person who would say, ‘I’ve been successful,’ and would relax in any way. There’s always more work to be done.”
Survivors include his wife, their daughter, Sophia; another daughter, Alexandria Hinkle; and a son, Zachary.
God bless the revolutionaries in this world who strive for the greater good!