As greater Boston continues an all-hands-on-deck response to the coronavirus pandemic, advocates on the front lines of another, overlapping health crisis — that of overdose deaths — are reeling from the unexpected loss of a leader.

Aubri Esters died last week at age 35.

People who knew Esters describe her presence as larger than life and say she made an indelible mark on Boston’s attempt to support people who use drugs, who may be homeless, who are struggling.

“Aubri just spent, it appeared to me, every waking hour trying to hold people’s attention on the fact that women and men who are using drugs come across obstacles. You just can’t believe how difficult we make it for people who are trying to get control of their drug use,” said Jim Stewart, director of the First Church shelter in Cambridge, who worked with Esters for years on drug policy.

Stewart said Esters wasn’t always seeking the spotlight, it’s just that she didn’t shy away from standing up for what she believed in and eloquently sharing her own experiences. She made it a point to describe herself as a “person who happens to use drugs.”

“I started using drugs when I was 18. Within a couple years I had a $200 - $300 a day habit. I used mainly by myself, I had a lot of abscesses, my doctor at one point thought I was going to die,” she said, candidly, on a panel at Boston University in 2016.

That year, the number of people dying annually of overdoses in Massachusetts had eclipsed 2,000.

“I think part of the problem is that there's so much shame and stigma in talking about drug use and people identifying as a drug user, that people isolate and they isolate their use, they isolate themselves. Isolated selves and isolated use often leads to accidental overdose — as we’re seeing in Massachusetts,” she continued.

Esters knew first-hand the dangers of that isolation, of being homeless and of hiding. She had lost friends, too. But her message was about sharing the times when she felt like she was treated without judgement and able to disclose the realities she faced and get help so she could use in a less harmful way. That approach made all the difference in curbing her chaotic drug use. She’d been on methadone for many years.

Esters was instrumental in several activist and drug user-run groups, including SIFMA-NOW, which has been pushing for supervised consumption sites in Massachusetts, a controversial proposal that doesn’t legally exist anywhere in the U.S.

She spoke up about this and other related issues in forums and at the State House, often with a deep sense of urgency, said Dr. Jessie Gaeta, medical director of Boston Health Care for the Homeless.

Gaeta recalled how as a co-member with Esters on a statewide harm reduction commission last year, whose other members included local law enforcement, state health officials and Mayor Marty Walsh, Esters at one point — impatient at the slow pace of moving forward on supervised consumption — interrupted the mayor, saying, “I’m sorry, this is personal, my people are dying!”

In part thanks to her advocacy, the commission last year recommended the state set up supervised injection site pilots.

Last week, a few days after returning from seeing her mother in Florida and not responding to her calls, police followed up and found Esters dead in her apartment.

News of her friend’s unexpected passing, in her prime, was deeply unsettling for Gaeta.

“I was really shocked,” she said. “It’s just such a massive loss.”

Esters had helped design programs Gaeta’s organization now runs, including a van that distributes naloxone and buprenorphine to people who wouldn’t otherwise come into a clinic.

“I’ve learned from her that in medicine in particular, we kind of conceptualize drug use and pathologize it in a really profound way that isn’t necessarily valid,” Gaeta said.

Aubri Esters (R) with her sister Cheraya and mother Laura.
Courtesy of the Esters family

The cause of Esters' death is unknown, and the toxicology reports are pending. Esters' younger sister, Cheraya Esters, said she and her mother have been moved by the overwhelming response to her sister’s death, which came as a complete surprise to them.

Esters was born in Beverly, Massachusetts. Her family lived in Revere but then moved around. She attended Massachusetts College of Art and Design on a scholarship for two years. In her late teens, she transitioned to being a woman. Her sister said that cost her close relationships, but it also shaped and fueled her passion and activism, which inspired Cheraya, too.

“I’m queer and she trailblaized for me. She helped me feel safe in my family and my world to do that, no matter the loss. And I don’t know if I would have had the strength to have done that if she hadn’t done it,” Cheraya said.

While Esters had several health issues, including fibromyalgia and a heart condition, Gaeta and other advocates said that if she were to have died of an overdose, Esters would want the world to know it.

“I think about how she would be using what happened to shed light on sociopolitical failures that we have in Boston and Massachusetts and this country that have led to this,” said Dr. Kim Sue. Sue is medical director of the Harm Reduction Coalition, a national group advocating for the health and wellbeing of people who use drugs. Sue said Esters made a mark in advocacy around the country.

Sue and others worry about the ways that COVID-19 is making it even more difficult for people who may be struggling with drug use to find stability.

Mayor Marty Walsh said in a statement that Esters challenged him to look at progressive drug user health policies in a different way and helped him to grow on these issues.

“I am very saddened to hear of the passing of Aubri Esters who was a staunch advocate for the rights of people who use drugs,” he wrote. “She will be greatly missed.”

Esters is survived by her mother, her younger sister and several half siblings. An outdoor and online memorial is scheduled for Thursday evening at 5 p.m. at First Church in Cambridge.

Elana Gordon is a global health reporter at The World. She moved to Boston in 2018 as a Knight Science Journalism Fellow at MIT. Before that, she reported for WHYY in Philadelphia and was a founding member of the station's weekly health and science show, The Pulse. She can be reached on Twitter @Elana_Gordon.