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Like so many activists, Jess Tilley discovered grassroots organizing through personal hardship. In 1997, she was living in Northampton, Massachusetts, regularly injecting heroin. A limited access to clean needles led her to reuse dulled equipment, and she developed an abscess.

Through friends, Tilley learned of a program where users could get free new syringes鈥攏o questions asked. At Tapestry Needle Exchange, she also discovered a community of people eager to improve their lives and the lives of others addicted to drugs.

鈥淲e started talking about the mistreatment we received in emergency rooms,鈥� Tilley remembers. 鈥淚 told them, 鈥榃e need to advocate for ourselves. They might not listen to just me, but if all of us share our experiences, maybe someone will listen to us.鈥欌��

Twenty years would go by before attempts to organize drug users would help to ignite a national movement. Last month, Tilley was among more than 50 active users from across the country who traveled to St. Louis for a first-of-its-kind meeting to lay the groundwork for a coordinated response to America鈥檚 war on drugs.

The Urban Survivors Union had arranged to attach a side conference to the annual meeting of the non-profit Drug Policy Alliance so members could discuss crucial next steps for growing the movement.

Addressing the historic gathering of the USU on that first morning of the convention, Tilley, the group鈥檚 co-director declares: 鈥淭his is a labor of radical love. When I started doing drug-user organizing in 1998, there were just two of us in the room. And now, as a woman who injects drugs, I鈥檓 a little teary-eyed standing up here, looking out at a whole room full of people.鈥�

Robert Suarez, a veteran activist from New York City, then rallies the crowd. 鈥淣o longer are we going to wait for the slow ticktock of politics,鈥� he tells the group. 鈥淲e are organizing, we are building power, and we are going to take it to them.鈥�

The union鈥檚 first chapter was formed in Seattle in 2009. Other locations followed, and over the past 18 months leading up to St. Louis, the organization established chapters in more than 30 cities across the U.S.

Members say this recent period of rapid growth reflects the new challenges users face. A reinvigorated drug war has the Trump administration instructing prosecutors to impose for drug crimes and against high-level traffickers.

Meanwhile, the opioid epidemic and the spread of fentanyl, a dangerous synthetic-opioid, has sent overdose deaths skyrocketing. There were an estimated in 2018, 69% of them involving opioids such as oxycodone, heroin, and fentanyl. That鈥檚 down slightly from in 2017, but far exceeds a rough annual average of 15,000 fatal overdoses each year through the 1990s.

Louise Vincent, the USU鈥檚 other co-director, describes the epidemic鈥檚 impact this way: 鈥淵ou don鈥檛 remove 72,000 people from a community without touching people and their families,鈥� she says. 鈥淧eople are feeling this shit hard core and feeling a damn need to do something about it.鈥�

Impact of the War on Drugs

No group is more affected and simultaneously more-often excluded from debates on drug policy than drug users themselves. The St. Louis convention was organized to change that.

鈥淲e鈥檙e doing this with a team-based system and sharing decision-making 鈥� working together to a build a national union that can get shit done,鈥� Vincent tells the group.

Most of those who came together in St. Louis are addicted to hard drugs such as heroin and cocaine. Many live in poverty. They鈥檙e stuck with criminal records and marginalized in countless ways that push them to the edges of society.

Everyone has a story about how the war on drugs has harmed them. Tilley, for example, was evicted from her apartment in Northampton after a friend suffered a nonfatal overdose there. 无码视频 recently, her open identity as a drug user has prevented her from gaining meaningful employment.

Vincent says she lost her leg to stigma intrinsic to the drug war. She was hit by a car and her history as an intravenous-drug user led hospitals in her hometown of Greensboro, North Carolina, to treat her poorly. She was denied adequate pain medication and doctors failed to provide procedures that were required for her damaged leg鈥檚 long-term recovery. 无码视频 than a year after the accident, an infection festered and her leg was amputated.

In addition to reducing overdose deaths, these sorts of incidents are what the USU is organizing to prevent. As with a labor union, the idea is to bring a strength-in-numbers approach to their cause. The group intends to function as an advocacy network, lobbying city, state, and federal governments to enact policies that will save drug users鈥� lives and alleviate the worst harms of America鈥檚 persecution of people who use drugs.

鈥淣ine-tenths of the pain I鈥檝e experienced in my life was caused by the drug war,鈥� Tilley says. 鈥淚 can look back at so many periods of my life and say, 鈥楳y habit was totally manageable. It was the drug war that made me miserable.鈥� It was a fear of arrest, fear of discrimination, fear of losing my job鈥攁 fear that had nothing to do with my job performance. That鈥檚 what has always haunted me.鈥�

Coming Together

There were many steps on the way to St. Louis. One of the largest was taken in New Orleans in October 2018. Drug users met there for the annual conference of the Harm Reduction Coalition (HRC), which advocates for policies such as needle exchange and supervised injection. The HRC has long welcomed drug users under its large umbrella. But in New Orleans, users broke away and marched in the streets on their own, signaling their autonomy and their power as a community with unique demands.

鈥淚t鈥檚 time for us to stand together,鈥� shouted Shilo Jama of Seattle, who is one of the USU鈥檚 founders. He spoke through a bullhorn as their demonstration wound its way along Canal Street from the HRC conference headquarters. 鈥淲e need to stand here and fight as one.鈥�

Tilley was among about 30 people who walked to a park on the banks of the Mississippi River, quietly calling out the names of friends and family members lost to an overdose or the war on drugs. She cried and buried her head in the shoulder of a friend. After several minutes, the group fell into silence.

Vincent spoke next. 鈥淭his was put together by people that use drugs, people that sell sex, people that they say can鈥檛 do these things,鈥� she said. 鈥淲e have done them. And we will continue to do them. We will grow bigger and grow stronger. We will not stop until we are fucking free.鈥�

Thirteen months later in St. Louis, Jama reflects on that night. 鈥淭hat was a really big growing-up moment for us,鈥� he said. 鈥淚t was the first thing that we did as a national movement all by ourselves. And so it was incredibly powerful鈥�.If the drug-user movement was in its infancy, it became a teenager at that moment.鈥�

After New Orleans, the St. Louis convention was the next step 鈥� and a greater stride forward.

Pulling together a national event for active drug users didn鈥檛 come without challenges. It was understood that members would not stop using while in St. Louis. Moving into a legal gray area, organizers made loose arrangements for people to inject drugs in as safe a manner as possible. They encouraged everyone who was going to use drugs to never use alone and to always go slow in a new city with an unfamiliar supply of illicit narcotics.

Other arrangements had to be made for those who wanted to receive opioid-substitution medications such as methadone or buprenorphine. It turned out that the nearest clinic offering those services to out-of-town patients was a 45-minute drive from the conference site in St. Louis. Ensuring those who needed it received medically assisted treatment became one of the most challenging components of the entire affair.

Growing the Movement

At the union meeting, members had to work through a long list of decisions. But Vincent remarked that simply bringing everybody together was a victory in itself. 鈥淛ust sitting in a room with 60 drug users, that shit felt powerful,鈥� she says.

They agreed that going forward, they鈥檇 need to address three basic questions: What is the Urban Survivors Union鈥檚 mission? Who gets to be a member? And how should the national organization make decisions? Agreeing on answers is the USU鈥檚 next step. Today those conversations continue online.

In the meantime, the attendees in St. Louis have determined that the USU should maintain space for people who have entered recovery and no longer engage in regular drug use. In response to questions around how drug-users鈥� allies might interact with the organization, one idea was to create an advisory board composed of non-drug users, similar to how public-health authorities and research groups sometimes create advisory boards composed of drug users (flipping the common power structure on its head).

There were also vocal demands for the guaranteed representation of marginalized communities, including sex workers, people who identify as transgender, visible minorities, and homeless people, among others.

鈥淲e鈥檙e going to take two years to really make sure the structure works,鈥� Vincent had mentioned during an online meeting ahead of the St. Louis conference. 鈥淭his allows us some room. Then we鈥檙e going to have quarterly meetings where major decisions around change can happen.鈥�

Looking ahead, Tilley says, it is imperative for drug users to have a say on health care programs designed for those who use drugs. 鈥淭reatment on demand,鈥� she says. 鈥淲e know that is the answer to ending overdoses. Access to Suboxone and methadone鈥擬AT [medically-assisted treatment].鈥�

Tilley says the USU also intends to provide input on criminal-justice initiatives that have arisen out of the opioid epidemic. A USU campaign called Reframe the Blame, which challenges favored by the Trump administration, is already underway.

She recalls that during the HIV/AIDS epidemic of the 1980s and 鈥�90s, public-health authorities were initially reluctant to involve LGBTQ community leaders in decision-making roles. When they finally did, Tilley says, the expertise of people affected quickly proved invaluable to turning the tide on the crisis.

鈥淒rug-user unions are going to play a major role in ending this overdose epidemic,鈥� Tilley says. 鈥淲e have the knowledge and the tools to do that, we just don鈥檛 have the money and the resources. But with sustainable unions across the country, we cannot be ignored any longer.鈥�