I had clean needles. I still almost died twice.

I was standing on a street corner in San Francisco, unable to carry a large bottle of laundry detergent. My boyfriend was screaming at me to run, and I couldn’t move. I was swaying. I didn’t know it yet, but I had an infection eating my heart valve alive.

I had clean needles at home. A whole supply of them. That’s important. Remember that part.

He wanted me to go to the hospital right then. I told him not until we scored. Because if you’ve ever been a drug addict admitted to a hospital, you already know — they will give you the bare minimum to keep you from going into full withdrawal, and the second you start feeling dope sick, you will walk out of there no matter what they say is wrong with you — so you go in with drugs already in your system, or you don’t go at all. That’s not a character flaw. That’s survival math inside of addiction.

We sold the detergent. I scored. I went to the hospital and told them my back hurt because it did. They assumed I was there for pain meds. I remember sitting in my SRO earlier that day, next to an open window facing Market Street, smoking a cigarette, sweating what I can only describe as bullets. Literal large drops of sweat falling from my forehead. I’d nod out and wake up soaked. My pillow drenched every morning. I didn’t know what that meant yet.

The last thing I remember from that first hospital was them drawing blood.

I woke up in a completely different hospital, in a room, hooked up to IVs, with no idea where I was, what day it was, or how much time had passed. A nurse told me I’d be having open heart surgery soon and that I was lucky to be alive. I was sure they had the wrong patient.

Then the withdrawals started, and I told them I needed to leave.

The doctor came in and told me flat out: “You have endocarditis. An infection on your heart valve. You need open heart surgery, or you will die.” And I told him that if I stayed dope sick much longer, I was going to die anyway, so what was the difference?

He offered me methadone if I would stay. I agreed. But they gave me the bare minimum. My boyfriend was banned from visiting after a nurse walked in and caught me trying to push a syringe of heroin into my IV. I grabbed it back from her faster than she could react and muscled the shot into my bicep before security got there. The doctor came in and asked me why I did that. “Don’t you understand you’re going to die?”

I understood. I just needed more drugs than they were giving me.

Nobody ever asked me if I was using clean needles. My arms answered that question before I could. But the answer was yes — I had them. I just didn’t always use them. I’d find a vein, draw blood back, miss, and rather than waste the shot, I’d squirt the blood and drugs into a new syringe, water it down, and try again. I almost never used an alcohol pad. That takes too much time.

I had the surgery. I woke up in the ICU alone. My family was two and a half hours away, and we were barely speaking. My boyfriend was nodded out in the hallway bathroom. People looked at me like I was crazy for wanting to leave. I was calling him to bring me more drugs before I was even out of recovery.

Two weeks later I was back in emergency surgery. Then 90 days in a skilled nursing facility. My boyfriend brought me drugs there, too.

People told me over and over how lucky I was to be alive. It didn’t sink in. Not after the first surgery. Not after the second. Not during those 90 days. I went right back to using every single time.

Here’s what policymakers need to understand: No clean needle saved me. No harm reduction kit changed my path. I had the supplies, and I still got endocarditis twice. I still overdosed to the point of waking up with two black eyes and urine-soaked clothes. And here is the part nobody wants to say out loud — a lot of us take those clean needles and sell them on the street for drug money. We sell the [harm reduction] kits. We sell the pipes. And then we’re left with one or two needles we just keep reusing anyway. And that kit you handed out with such good intentions? There is no way of knowing it wasn’t the very kit someone used the last time before they died.

I’m not saying stop caring about addicts. I’m saying that keeping us alive in our addiction without equal investment in actually getting us out of it is not compassion. It’s just a slower version of the same ending.

What finally made me stop wasn’t a clean needle. It wasn’t a sobering center. It wasn’t a $14.5 million contract with a 25 percent success rate written in. It was me, when I was finally ready.

The question I want to ask every policymaker spending money on harm reduction is this — where is the equal funding for the moment when someone like me becomes ready? Because that moment is everything. And right now, the system is much better equipped to keep us using “safely” than it is to catch us when we finally decide we want out.