Maia Szalavitz On a Quarter Century of Addiction Activism

By Anne Giles 05/29/17

Author and advocate Maia Szalavitz discusses activism, stigma, compulsive behavior and the progress she sees in drug policy reform.

Maia Szalavitz
via Ash Fox

"People don't think of addicts like me when they imagine intravenous drug users. I'm a white woman who works as a producer for a national PBS talk show. Five years ago I was shooting cocaine and heroin up to 40 times a day." Thus begins Maia Szalavitz's Washington Post article published on May 7, 1993.

Twenty-four years to the day after she "came out" as an addict in The Washington Post, Maia Szalavitz's Unbroken Brain: A Revolutionary New Way of Understanding Addiction - a New York Times bestseller in hardback - was released in paperback on May 7, 2017. Spanning a quarter of a century, her advocacy efforts were marked by the publication of Unbroken Brain in April, 2016, but extend well before and continue with a prolific writing and publishing schedule.

Given the stigma surrounding addiction, "coming out" as an alcoholic was hard enough for me in 2014. But I can't imagine what it must have been like in 1993, going public with the information she was an IV drug user. In the previous year, 1992, AIDS had become the number one cause of death for U.S. men ages 25 to 44, due in large part to IV drug use.

I emailed Maia Szalavitz questions about her continuing addiction activism and she kindly replied.

Why did you go public about addiction in 1993? How did you weigh the pros and cons, the costs and benefits, prior to deciding?

Actually, I went public even earlier than that. In 1990, I wrote for the Village Voice about needle exchange. As far as I can tell, it was the first article by someone who was out about her own IV drug use that debunked the myths that were standing in the way of needle exchange. I felt that only by sharing my experience could I strongly make the points that needed to be made, i.e., that people with addiction don't like sharing needles and that we will change our unsafe injection behavior if given the chance to do so. I backed it up with research, but since people who shot drugs were rarely heard from directly, my experience made the piece much more potent.

That helped me get more work writing for the Voice and then when I applied for my first TV job (I was a producer for Charlie Rose for a while), I used my clips to help get the job. So I was open about my addiction with all of my employers right from the start.

By 1993, I'd become really fed up with how people in recovery meetings were apolitical while ACT UP was changing the world. It drove me nuts to see that gay people were out there fighting while IV drug users just seemed OK with letting each other die. So, that's why I wrote the article.

I was really honored when I got a call from Bill Clinton's AIDS advisor who said the president had read it. But, sadly, Clinton didn't do the right thing on needle exchange and later admitted he knew that he should have overturned the federal funding ban.

I didn't really think about not being out about it - it just didn't seem feasible. While it's quite possible that I lost opportunities as a result, I never knew about them, and there were also opportunities I got because I was out that I would never have had otherwise.

How have you kept up your advocacy efforts for nearly a quarter of a century? Your Twitter stream flows with direct statements pointing out addictions policy errors, multiple times nearly daily, and citing the research that explains why. How and why have you done this?

I think I'm just as compulsive and obsessive about my work in this area as I was about the addiction. You would call it a substitute addiction, except, because it doesn't do harm (at least I hope not!), it's actually just obsessive drive. Or, a "special interest," as one might say in the autism field. Sometimes repetitive and compulsive behavior is useful: you don't think about doing anything else because you can't or just don't want to.

Lest this sound like I'm completely unbalanced, I do actually do a lot of other things to make sure I'm not too single-minded, like hang out with my friends and my cat and my husband. And I also do more general neuroscience writing so I don't burn out.

With people with substance use disorders being gunned down in the Philippines, they - and their toddlers - being forcibly catheterized for urine specimens, and new U.S. opioid laws decreasing the availability of medication for addiction treatment and for pain patients, how in the world do you keep up your hope?

I think I was blessed with some kind of naturally optimistic nature. And I have seen real change over the last 25 years, even though bad stuff still occurs. In the 1980s and 1990s, supporting any type of legalization or even decriminalization made people freak - you were a traitor if you didn't support the drug war. The drug policy reform movement was like 30 people. Harm reduction was a few guys in Liverpool, Rotterdam and a couple of folks in New York and Seattle. 

Now, all of that has become an international movement that truly does threaten prohibition. Even hardcore prohibitionists no longer support jail for possession. They want to force people into treatment, true, but even they understand that locking up users makes no sense. 

I've seen my views move from being insanely outside to being almost conventional wisdom. Even with the setbacks, there is slow progress.

Anne Giles, M.A., M.S., is writing a memoir, published as a serial for The Fix; wrote a review of Maia Szalavitz's Unbroken Brain for The Fix; and blogs at

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Anne Giles, M.A., M.S., is a counselor, writer and business owner. As of this writing, she has been abstinent from alcohol since December 28, 2012, and is in remission from alcohol use disorder. You can find Anne on Linkedin and Twitter.