In a small room at a health clinic in Greensboro, North Carolina, five people are gathered around a wide table beneath a whiteboard bearing inspirational slogans.
An addiction recovery meeting, right? Well, kind of.
“We’re a national drug user union,” a woman tells the newcomers around her, explaining that in addition to Greensboro, they have chapters in Seattle and San Francisco. Together, they are the Urban Survivors Union (USU), an organization that advocates for better public health and criminal justice policies at the state and federal levels.
The woman is Louise Vincent. She founded the USU of North Carolina (USU-NC) chapter in 2013 and was recently named national director of the organization. Though short, Vincent has a commanding presence, her voice gravelly, with a strong Southern accent. Her jet-black hair bobs restlessly as she shifts in her seat.
Vincent explains to the group that the Seattle and San Francisco USU chapters can be, as she puts it, “hard to tame.” The policies they are working on would be impossible to pass in North Carolina. For example, she says, they forget that syringe exchange, while legal on the West Coast for decades, is not yet legal in North Carolina.
The other members—men and women aged from 25 to 45—laugh, understanding. “So,” Vincent concludes, “we are waybehind the times.”
Advocacy is a key element of the organization’s work, but it isn’t the only one.
At the meeting, one USU-NC member, who prefers not to be named, shares his goal for the week: to snort cocaine instead of injecting it.
“I think it’s just training your brain,” he says. “I used to have to [snort cocaine] just to go to work or get up in the morning. I was just feeling bad. Then I progressed to shooting up. Now I sniffed the last time I did it. You can’t find clean needles anywhere.”
Vincent supports him. “I think one of the things we get taught is there’s no moving backwards with your drug use, [that] once you’ve come out this far, you can’t come back,” she says. “That’s not true. A lot of what we’ve learned about drugs isn’t true. I have to use my own mind to find what my recovery story is going to be, because I don’t want the one the world is offering.”
The Urban Survivors Union
The USU is formed entirely of people who currently or formerly use illegal drugs (usually so-called “hard” drugs). It was founded in Seattle in 2009, and a second chapter started shortly after in San Francisco. USU-NC currently has 25 members, and the national USU has over 100.
Vincent founded the North Carolina chapter after completing her master’s degree in public health, and after many years of what she describes as chaotic drug use. She spent her teenage and young adult years in and out of abstinence-basedtreatment facilities. She’d been through Narcotics Anonymous and Alcoholics Anonymous, but continued to relapse. With every relapse, she sank deeper into self-harm and despair.
Her life changed when she learned about drug user-led harm reduction work. She visited a needle exchange in Atlanta, run by the Atlanta Harm Reduction Coalition (AHRC), and was overwhelmed by the AHRC staff’s compassion for drug users. It changed everything for her. She decided to go back to school and study public health in order to found a similar group in North Carolina.
These harm reduction organizations play a vital role. You’ll be familiar with the headlines about increasing use of heroin and other opioids. And although it’s important to remember that the large majority of drug use is not problematic, The New York Times recently reported that since 2003, heroin-related deaths have risen in every county in the United States, with the Southeast the most affected region. In North Carolina, rates of heroin use have quadrupled over the last five years.
USU-NC meets with state and federal legislators to advocate for policies that could improve drug users’ lives. They collaborate with other advocacy groups and lobbyists to achieve this. The USU trains members on media advocacy, public speaking and policymaking, and USU leaders bring drug users to legislators to tell their stories. They particularly seek out lawmakers who have been critical of drug war policies. They also target legislators with a libertarian bent, critical of Big Government control over citizens’ lives.
Shilo Murphy is one of the founders of the Seattle USU chapter and the national USU, and he’s currently the national USU’s board treasurer. He describes the culture clash that can happen when he and other drug users meet with policymakers in Washington state, where he lives. “People see me and they just turn the other way,” he says.
Legislators may not be interested in listening to Union members at first and often resist their proposed policies. But Murphy knows that while a legislator may not care about an issue, they do care about constituents in their district. There’s power in people sharing their stories.
Murphy, who identifies as a current drug user, was spurred to activism after the deaths of close friends. He decided to take action against policies that limited harm reduction organizations’ abilities to help. He has become a well-known and respected leader in national harm reduction movements, and has helped USU-NC strengthen their organizing and advocacy.
Murphy says their key strategy is presenting drug users’ stories not as a demographic, but as constituents. “We can say, hey, you say the drug war is bad. In your district, this person was just arrested for possession. He has a job, all these things. And [the legislator] can be touched by that person. These are powerful stories. But it’s not going to happen unless you put drug users in positions of power.”
The USU wants to build relationships with legislators by listening to them. But they are not afraid to hold them accountable for promises they make.
“I think the legislators should be afraid of the people,” Murphy says. “I tell people in the Urban Survivors Union every day: Your job is to offend and harass the people who are oppressing you. Their lives should be stressful.”
Murphy and Vincent want the Urban Survivors Union to mean something in North Carolina and across the US. “If you’ve got a user union that is active, then public health institutions and government legislators will need to listen,” Vincent says. “I am not doing something illegal. The people that are doing something illegal are the people who know exactly what’s going on and are not taking action. This is what I would consider a public health emergency.”
Achievement and Pride
Louise Vincent and USU-NC have a long—and growing—list of accomplishments.
In addition to their advocacy, USU-NC members do direct service with people who use drugs. They distribute naloxone, the lifesaving overdose reversal drug, through networks of drug users, dealers and sex workers. They host trainings on how to reverse overdoses and how to inject or smoke drugs safely.
In the counties where the Union does outreach, rates of drug-related deaths stand at up to four times the national average. Vincent has been organizing focus groups with sex workers to understand how USU-NC can tailor to their specific needs. They organize an annual Overdose Awareness Day in Greensboro to share resources, and they present at national harm reduction conferences.
The trusting relationships USU-NC builds with fellow drug users not only builds a support network. It also saves lives.
To date, USU-NC has received 764 reports of people successfully reversing drug overdoses using naloxone supplied by USU-NC. Over the past year, USU-NC members also exchanged over 420,000 clean syringes with over 2,000 drug users across the state, helping to prevent the spread of diseases like
HIV and hepatitis C. Vincent has cultivated a grassroots network of activists across North Carolina, mobilizing both people who use drugs and people who have lost loved ones to overdose.
This work hasn’t been without struggle. Traditional public health institutions—such as nonprofits, health departments and treatment centers—haven’t always embraced USU. For years, Vincent has tried to distribute naloxone and lead overdose-reversal trainings at rehabs and drug treatment clinics, but the institutions haven’t allowed it, claiming it muddies their abstinence-based recovery message.
But even other harm reduction organizations sometimes behave disappointingly by not appointing drug users to meaningful roles or involving them in crafting policy.
“Sometimes harm reduction organizations abuse drug users, saying they represent them but they don’t,” says Murphy. “Laws are changed constantly that have no effect on drug use and drug users. And [advocates] always say it’s a win because it’s a morality win for them. But they aren’t from the community. So how can you make a law change about drug users without including drug users?”
Vincent believes some harm reduction advocates won’t include drug users on the front lines, fearing for their perceived legitimacy. She tells me about a trip she and another active drug user made to Washington, DC, to speak to legislators alongside members of an advocacy group. The professional advocates expressed concern about bringing the two drug users to speak with them. At the presentation, Vincent spoke last—and excelled.
“Where they had choked, I shined,” she recalls. “One [lobbyist] said to me, ‘You’re pretty good at this.’ I think we often surprise ourselves, and we definitely surprise others.”
“One of our slogans is, ‘We’re proud to be a drug user,’” says Murphy. “We saw the gay rights movement. If it had been a bunch of straight men fighting for gay rights, it never would have happened. It was because gay men and women came out and said, ‘We’re out, we’re proud, and we’re not going anywhere.’ And that’s how we’re going to change people’s perceptions. We’re going to introduce ourselves as drug users, and we’re going to show how there are functional drug users and responsible drug users.”
For Louise Vincent, the USU also opens up a world of support for drug users like herself who want to make a difference in each others’ lives.
In USU-NC, support goes hand-in-hand with advocacy. Meetings operate as a non-judgmental community for members, as they set weekly goals—like the man who wanted to snort cocaine instead of injecting it—for their drug use, with the mantra of “any positive change.” Vincent and Murphy believe that in order for members to feel they have the power to change policy, they need to start by finding the power to direct their own lives.
Vincent says that her role as USU-NC’s leader is telling drug users that they have the power to change laws and their own lives. By setting their own weekly goals and cultivating a supportive environment, she sees that people can seek help while still actively using drugs.
This self-definition of recovery from problematic or addictive drug use—whether that definition means some degree of continuing use or not—is key to the group’s philosophy. And some members’ version of recovery can be found through activism itself.
“One of the things we’ve learned,” says Murphy, “is when you tell people they’re loved and that they have a community, people’s choices change. We tell people to look in the mirror and love what you see. But if there’s something you see in the mirror that you don’t like, you have the power to change it. No one else. Those words can change people’s lives. Those are people who change for the better.”
In doing so, they can become powerful advocates for other drug users.
“I don’t believe you have to reach rock bottom to change,” says Vincent. “Having pain sometimes makes us change, but more pain for me just makes me want to die. I need hope, I need reasons to live. When I’m in love with living and have hope and passion for life, then drug use gets in the way of what I’m doing and I don’t want to drown myself in drugs. I need someone to light that fire and show me that I should be existing.”