NC nonprofit pays drug users to get sterilized. Critics call it ‘coercive abuse’
A North Carolina nonprofit that pays drug users to undergo birth control procedures faces criticism from drug safety advocates who say the approach exploits vulnerable people and recalls the country’s history of forced sterilization.
Founded in the late 1990s and based in Cabarrus County, Project Prevention says its mission is to reduce the number of children in foster care, lower abortion rates and raise awareness about the risks of substance use during pregnancy. But local advocates argue the group’s methods cross ethical lines and manipulate the reproductive choices of people with addiction.
Lauren Kestner, who oversees Queen City Harm Reduction, said offering cash to drug users who use long-term or permanent birth control is not an effective way to support people with substance use disorders.
“It’s coercive abuse. If there are people who, with their own autonomy, want to be on birth control, who want services, that’s harm reduction,” Kestner said. “You don’t push sterilization in the loud and obnoxious, and quite honestly abusive, way that they are. It leaves a horrible taste in my mouth.”
Project Prevention did not respond to multiple requests from The Charlotte Observer for comment via email and phone call.
What does Project Prevention do?
In April, The Charlotte Observer’s news partner, WSOC-TV, reported on a car seen in Charlotte with the words “attention addicts” and “get birth control” on it. The car states addicts can receive $300 for doing so and lists the phone number 1-888-30-CRACK. According to WSOC, the group has paid over 9,000 drug or alcohol users to get on long-term birth control or get sterilized.
“We are lowering the number of children added to foster care, preventing the addicts from the guilt and pain they feel each time they give birth only to have their child taken away, and preventing the suffering of innocent children,” the website states.
Barbara Harris, the founder and director, told WSOC it is a “win-win,” for the mother and child. Harris said she has saved billions of taxpayer dollars by keeping kids out of the foster care system.
According to the group, most participants choose tubal ligation, a permanent sterilization procedure for people with female anatomy. Other popular choices include implants, IUD, contraceptive injections and vasectomies.
The introduction letter for interested people says they could receive $300 for sterilization procedures. Those who opt for implants could receive $75 at the time it is inserted, $100 six months after and $125 one year later. Participants are required to show a documented history of drug or alcohol addiction and a proof of procedure form.
‘Not a sustainable solution’
Kestner said she understands the motivation behind Project Prevention. Substance use can cause harm, and the foster system has flaws, she said. But sterilization, especially for quick cash, is not the solution, Kestner said.
“You’ve got to dig deeper. If you want to really meaningfully reform what is happening to innocent children, to people who are struggling with mental illness, substance use disorders and other things, then you really have to look at the systems that are providing treatment,” she said.
The Center for Prevention Services, where Kestner works, is funded mostly through federal and state programs, according to its website. The group distributes safer drug usage supplies, Narcan, contraceptives and offers STD testing. It also connects people to health care and social services.
“It’s not a sustainable solution. What happens after these people get sterilized?” she said. “Where does that person go next? Are you supporting their food? Are you supporting their home life?... How are you really peeling back the layers?”
The Project Prevention website states the founder regularly writes to participants to applaud them for sobriety efforts and has referred hundreds of clients to drug treatment programs.
Eugenics in North Carolina
Phoebe Zerwick, a Wake Forest professor who served on a 2011 task force under former Governor Beverly Perdue’s Office of Justice for Sterilization Victims, worked to compensate victims of forced sterilization in the state. To her, aspects of Project Prevention are reminiscent of the state program that forcibly sterilized people between 1929 and 1974.
According to the office’s website, an estimated 7,600 people were sterilized by the N.C. Eugenics Board.
Under the program, Zerwick said, doctors referred people deemed mentally unfit to have children to the eugenics board to be sterilized. While many chose to undergo these permanent procedures, others were forced or coerced. In the ‘60s and ‘70s, Zerwick said, women in hospitals were sometimes sterilized after giving birth.
“They gave consent, but the question was whether it was really informed consent. Like in the delivery room, are you in a state of mind to give informed consent over permanent sterilization, irreversible sterilization?” she said. “That seems more akin to what this group is doing. Is somebody who’s in the throes of addiction really able to give informed consent?”
Project Prevention addresses this on their website.
“If you can not trust someone with their reproductive choices, how can you trust them with a child?” the website states. “The decision to use long term birth control in some cases is the first responsible decision these addicts have made in their addiction which may lead to more good decisions.”
This story was originally published May 15, 2025 at 5:00 AM.
