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Tessie Castillo Tessie Castillo

Power to the People Who Use Drugs: America’s Drug User Unions

Formed to fight for "nothing about us without us" and promote health, drug user unions foster solidarity and some schisms. They're meeting in Baltimore next week to hammer out a national plan.

41 Substance

No more yielding to well-meaning reformists who try to help drug users without including them. Photo via

No more yielding to reformists who try to help drug users without including them. Photo via

In the smoke-filled living room of a condo in Greensboro, North Carolina, six people are engaged in a heated legal debate. For two days they scour state statutes on drug paraphernalia, propose and withdraw amendments, and deliberate over language for new legislation. They are not lawyers or, for the most part, even employed. They are heroin users, working even as fresh track marks heal on their arms. They are the Urban Survivors Union (USU), Greensboro chapter. And they are tired of being left out.

Over the past decade, as public opinion on drug policy has shifted, several drug user unions have formed across the US. From Seattle and San Francisco to New York, Boston and North Carolina, people who use drugs are organizing to influence policy that affects them. No more standing back while drug war proponents pass harsh laws that tear users’ lives apart. And no more yielding to well-meaning reformists who try to help drug users without including them.

“The first generation of gay people who came out were crucified, but things improved for those who followed them.”

“People who don’t use drugs always want to cure us or save us,” says Isaac Jackson, the leader of the San Francisco chapter of USU. “I don’t want to be rescued. I want to be involved.”

The original USU began in Seattle, born of a loose coalition of people in the university district who banded together to stop violence among homeless drug users. In 2009, the group formed an official union and in 2013 welcomed two new chapters in San Francisco and Greensboro.

Another organization, the VOCAL New York Users Union, was founded 10 years ago by a group of current and former drug users hoping to combat stigma. Today its 30 members, operating under the motto “Nothing about us without us,” meet monthly to promote syringe exchange and to work to eliminate drug overdose deaths in New York City.

Other drug user unions include Users United of New York, the San Francisco Drug Users Union and the New England Drug Users Union in Boston. These unions run such diverse programs as street outreach and syringe exchange, advocating for crack and meth pipe distribution, monitoring law enforcement to make sure officers respect the rights of drug users, offering HIV and hepatitis C testing and linkage to care, lobbying pharmaceutical companies to bring down the price of naloxone, distributing overdose prevention kits, and campaigning to combat stigma against drug users by phasing out words like “addict” and “junkie.”

With some exceptions, the unions’ leadership and membership is made up mostly of minority, lower income users—those most affected by drug war policies. Any drug users can join, but membership is often dominated by users of “harder” drugs, such as opiates or cocaine, who are bonded by a shared cultural experience and frequent encounters with stigma. The majority of members consider themselves functional drug users, meaning they are productive contributors to society while still using drugs, and argue that drug policy causes more harm than drugs themselves.

These unions are gathering momentum just as the drug policy reform movement celebrates victories like overdose prevention laws, marijuana legalization and reductions in sentencing for drug convictions. Recently, the various regional unions formed a coalition, the United States Alliance of Drug Users, in order to launch national campaigns around common issues, such as stigma against drug users, health concerns and criminal justice reform.

But broader inclusion brings some disagreements over tactics and messaging. Fissures are starting to form. The most polarizing topics include questions like: Should union membership be limited to active drug users (excluding people in recovery)? And, most controversial: Should drug users be open and proud about their use?

The VOCAL Users Union in New York represents the less radical end of that spectrum. The group welcomes current and former drug users and keeps its message pragmatic and health-centered. “We want to emphasize that we are not promoting drug use, but we acknowledge that it exists,” says Bobby Tolbert, a four-year board member of VOCAL and a person in recovery. “The best way to keep the public safe [from blood-borne disease and other harms] is to employ best practices [for using drugs].”

It’s a diplomatic message that resonates with a public that increasingly recognizes the failure of the drug war and sympathizes with people who struggle with addiction, but still sees drugs themselves as essentially evil (it should be emphasized that VOCAL does not share this view of drugs). It’s also a message that members of the more radical Urban Survivors Union utterly reject.

“The gay rights movement is succeeding because gay people stopped apologizing for who they are,” says Shilo Murphy, the founding member of the USU’s Seattle chapter. “Nothing will change until people stand proud to be drug users.”

To prove his point, Murphy and other members of his union have publicly stated that they actively use drugs. Murphy first announced he was a proud, active drug user in front of hundreds of people at the 2010 National Harm Reduction Conference in Austin, Texas.

“I use opiates, cocaine, hallucinogens and alcohol, but I am truly addicted to chai tea,” he says. Many conference members attacked him, saying “junkies shouldn’t run nonprofits.”

Shilo Murphy later came out to the press in numerous articles, television and radio interviews, including for Al Jazeera and Fox News. Though he clearly stated that he was a current drug user, these media outlets reported him as a person in recovery or edited out his comments altogether, claiming that they didn’t want to “promote” drug use by presenting him sympathetically. NPR was the first news organization to publicize his statements about current drug use in a radio interview.

Since 2010, about 50 other USU members have also come out publicly as drug users through articles, interviews and social media. In response, some of them have been terminated from jobs, the public health department cut program funding to the harm reduction nonprofit where Murphy worked, and many former allies in the harm reduction field (Murphy doesn’t want to name names) turned against them.

But Murphy makes no apologies. “The first generation of gay people who came out were crucified, but things improved for those who followed them,” he says.

All chapters of USU accept only active, illegal drug users as members. In Seattle, even people who exclusively smoke marijuana are not permitted to join, as the drug was recently legalized in Washington; Murphy explains that although USU will work with non-users or former users, nothing will change unless active drug users occupy leadership roles in the movements and bring their experience and passion to the cause.

“Drug users are some of the most talented, gifted people on the planet. But because of stigma and this failed drug war, they don’t always get the chance to show what they can do.”

But for Isaac Jackson of the San Francisco USU, many of the differences between the unions stem not from ideology, but from financial concerns. “It’s a money thing,” he says. “[USU] is run by independent users. But some of the other unions are under the umbrella of nonprofits. They have fiscal sponsors and they have to be careful about what they say.” (Non-affiliated unions like USU are funded through individual contributions and sales of merchandise such as T-shirts, and thus remain independent from the influence of sponsors.)

Louise Vincent, vice-president of the national USU and president of the Greensboro chapter, says that it is important for the unions to focus on where they can agree—namely, on the need to reform current drug policy.

“As drug users we see so much negativity in our lives, but how much is caused by drug use and how much is caused by drug policy?” says Vincent. “Certainly there are harms that can come from drugs, but because of drug policy we are felons shoved into a subclass of people with no right to work in certain fields, get into college, or even vote [in some states]. Until the laws change we won’t be able to isolate the harms of drug policy from the harms of drug use.”

Next week the various unions will meet at the 10th National Harm Reduction Conference in Baltimore to hammer out a national agenda for campaigns on drug policy reform. They may not agree on some issues, but empowering drug users to be agents of change in their own lives is an accomplishment that will reap benefits whether the focus is health, rights, pride or an end to stigma.

“Drug users are fed this narrative that we are bad, that we are weak, and that the only thing that will drive us to change is to hit rock bottom,” Vincent says. “But I believe that positive events can do the same thing. I started to slow down my drug use when I found things in the world that interested me, when I became passionate about goals that made me feel better than sitting around using drugs. When drugs started to interfere with activities I loved, it made me want to stop using them destructively.”

Robert Suarez, an organizer for VOCAL and a union leader for the past three years, says, “Drug users are some of the most talented, gifted people on the planet. But because of how stigma and this failed drug war have cast users into the shadows, they don’t always get the chance to show what they can do. It’s time for that to change.”

Over the next few years, as people who currently use drugs increasingly take on leadership roles in the movement to end the drug war—although they will likely encounter resistance from mainstream drug policy reformers, who may be reluctant to turn over the helm or follow the ideals they preach—it will be interesting to see how public opinion and policy shift further.

Perhaps the unions will unite on common ground to create a wave of rapid drug policy change, or perhaps fractures over ideological differences will foster bitterness and opposing agendas, delaying progress. Only one thing is sure: That destiny rests increasingly in the hands of people who use drugs. And that’s the way it should be.

Tessie Castillo is the communications and advocacy coordinator of the North Carolina Harm Reduction Coalition (NCHRC). Her last piece for Substance.com addressed the impact of widespread acceptance of naloxone on the underground needle exchanges of the South.