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HOT TOPICS: Alcoholism  Addiction  AA  Cocaine  Heroin

The Loneliness of the Addict Activist

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Howard Josepher photo

By Maia Szalavitz

03/24/13

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The lure would also be that those who graduated the program could get jobs as outreach workers, often at ARRIVE itself—and that they’d have a place where they were welcomed and respected. Crucially, people didn’t need to stop using drugs in order to participate. Lots of active users just out of prison who were not interested in staying drug-free were willing to attend a program that could provide employment and didn’t require or even focus on abstinence.

For many, the certificate they received upon graduation represented the first voluntary course they’d ever completed. Today, more than 9,500 people have graduated, many going on to become leaders in New York’s AIDS and addiction programs. Twenty years later, Josepher’s organization, Exponents Inc., is still going strong.

When ARRIVE began, the idea of having active and recovering users in the same program was seen as untenable, practically blasphemous. But soon, ARRIVE found that the mix was actually therapeutic: often, the active users would cut down or quit because they were inspired by those who were abstinent. And even if they didn’t, a study showed that they reduced their HIV-risk behaviors.

Even among people recovering from addiction, the drunks looked down on the junkies and the junkies despised the drunks.

But Josepher wasn’t content to simply provide jobs and training. He saw that political action was needed as well. And so ARRIVE soon began turning up at AIDS demonstrations or doing their own street actions, bringing dozens of users and ex-users to call for change.

Of course, I don’t mean to imply that ARRIVE was the only face of addict or user activism in New York: There was also Housing Works, which grew out of ACT UP, a group called Stand Up Harlem and several others that rose and fell quickly for different reasons. My own relationship with these organizations was complicated: As a journalist, I had to keep my distance, but I also wanted to help make change. This led to a great deal of agonizing on my part over what I could and could not do, at a time when journalism itself was changing its notions of “objectivity” and “advocacy.” 

During this period, I also learned about the enormous challenges such advocates faced, challenges that went beyond the stigma and hatred experienced by gay people. These related to the facts about drug use and addiction and made even the question of “coming out” much more complicated.

Basically, most drug users were not addicts—so they didn’t care about the issue much. Sure, you had avid marijuana smokers who identified themselves as such, but this group often disdained “hard drug” users, particularly injectors. Cocaine and heroin addicts, of course, had their own problems. And then there were the conflicts among addicts. Even among people who identified themselves as recovering from addiction, the drunks looked down on the junkies and the junkies despised the drunks. Let’s not even get into the debates over that type of language and what people involved in drug taking should be called.

There was also the split between active and recovering people. Active addicts were often too dysfunctional to sustain activism without significant support. People in early recovery either didn’t feel safe around them or were too busy with their own recovery to become activists—outside of the oases of harm reduction provided by programs like ARRIVE and needle exchanges.

To make matters worse, those who were beyond early recovery often wanted to put the past in the past—or thought that 12-step anonymity meant no activism related to addiction. Finally, there are the deep divisions of race and class faced by all activism, but made even more acute in relation to drugs and addiction. And, of course, the problem of relapse.

Once you did get beyond all that and found a few people who agreed that something needed to be done, there were arguments over policy and strategy. Should the focus be needles or treatment? What about legalization and decriminalization? If we call for more money to spend on our issues, where should it go?

These conflicts, divisions and arguments have meant that there are still very few “out” users and former users organized politically around addiction to this day. The groups that do exist, like Faces and Voices of Recovery (FAVOR), do important work, even if I often wish they would take bolder and less conventional stands.

And while the urgency of the AIDS crisis has waned with the development of effective treatment and prevention—interventions that would have come far later or never at all without the activism that did occur—drug policy remains harmful and oppressive.

For example, if there were an antidote to HIV—like naloxone, the antidote that can reverse opioid overdose and save lives—that was nontoxic but available only by prescription, would ACT UP have let the FDA get away without changing the law pronto? I don’t think so. Drug users, ex-users and people who care for them need to think long and hard about why even these obvious and non-radical changes aren’t being demanded.

Having experienced them firsthand, I don’t minimize the obstacles: They need to be taken seriously, studied and understood in the context of other, related movements that have faced them, such as activists with mental illness and disabilities. But as ACT UP proved, a small group of committed people can absolutely change the world

Maia Szalavitz is a columnist at The Fix. She is also a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006)..

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