Lillian “Lill” Prosperino, Beloved Harm Reduction Advocate and Community Healer, Passes Away
Lill Prosperino’s life was anchored in the belief that every person deserves dignity and care—regardless of their circumstances. Known for their tireless advocacy and innovative spirit, Lill worked on the front lines of harm reduction in Virginia, West Virginia, and beyond. As Southern States Regional Organizer for the National Harm Reduction Coalition and later Executive Director at Mountain State Harm Reduction, they helped transform national strategies into grassroots lifelines
Pioneering Harm Reduction with Heart
Whether distributing naloxone, organizing syringe exchange programs, or offering herbal salves for wound care, Lill approached harm reduction with both pragmatic action and deep empathy. Their creative outreach—such as homemade abscess salves or meeting people where they were—helped bridge barriers for marginalized individuals who often feared judgment when seeking care
A Voice of Trust and Leadership
Lill’s work resonated far beyond one region. Beth Macy, award-winning author of Raising Lazarus, shared how Lill’s Appalachian ingenuity and public health leadership “makes the hair stand up … they’re doing it not just by their own ingenuity, but with help from addicted folks …” Their presence uplifted communities, built bridges with faith-based groups, and quietly saved countless lives.
A Life Silently Celebrated
Though Lill was rarely in the public spotlight, their impact was profound:
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They led outreach efforts in rural areas often overlooked by mainstream public health services.
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They fostered trust with people who inject drugs, offering vital resources and attention.
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They helped shape professional and grassroots conversations around harm reduction and destigmatizing addiction.
Words from the Community
Lill’s peers remember them as a “hill witch” with a healer’s heart—someone who guided community members toward self-care, whether through salves for abscesses or simply listening without judgment Their gentle leadership and advocacy for marginalized voices made them not just a colleague, but family to many.
A Space Now Emptied
Lill’s passing in July 2025 leaves a void in public health advocacy, harm reduction, and community care. Organizations across Virginia and West Virginia are mourning the loss of a leader, mentor, and friend. Those who worked beside Lill now honor their memory by carrying forward their vision—compassionate, harm reduction-based support for vulnerable populations.
Legacy & Remembrance
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Continued Advocacy: Those inspired by Lill’s work are committed to expanding naloxone access, syringe service programs, and nonjudgmental care across the South.
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A Call to Action: In Lill’s spirit, communities are urged to elevate grassroots, stigma-free health programs and to trust people who use drugs.
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In Memoriam: Memorial gatherings will honor Lill’s life. In lieu of flowers, donations to regional harm reduction nonprofits—including Mountain State Harm Reduction or the National Harm Reduction Coalition—are encouraged.
✨ Closing Reflection
Lill Prosperino wrote their own chapter of change—one marked by radical care, quiet resilience, and unwavering hope. They challenged us to honor humanity in every person, led with ingenuity, and transformed empathy into action. Their legacy lives on in every overdose reversed, every wound healed, and every person who felt seen and supported.
May Lill rest in peace, and may their work continue to flourish, lighting the way toward health and dignity for all.