Can Addicts Finally Force the War on Drugs to End?

After decades of false starts, a legit political movement aimed at addressing addiction as a public health problem and led by those who are most affected by it may finally be taking shape.

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Sep 28 2015, 7:00pm

Photo via Flickr user Sacred Heart

For over a century, activism in the drug addiction sphere has been dominated by calls to expand the war on drugs. Lobbying from self-interested politicians, the rehab industry, and law enforcement has resulted in draconian policies that are far better at sending racist messages and increasing incarceration than saving lives. People who use or have used drugs rarely have a seat at the table when policy is set—and are heard from mainly in the form of stories of sin and repentance.

But now a group called Unite to Face Addiction is planning a massive rally in Washington, DC, to attack stigma and call for change. On Sunday, October 4, big names like Steven Tyler, Joe Walsh, Jason Isbell of the Drive-By Truckers, and Sheryl Crow will perform. Speakers will include former Congressman Patrick Kennedy, former baseball player Darryl Strawberry, author William Cope Moyers and current "drug czar" Michael Botticelli, who is in recovery himself.

After decades of false starts, a legit political movement aimed at addressing addiction as a public health problem and led by those who are most affected by it may finally be taking shape. Buoyed by a growing push to end mass incarceration and the emerging consensus that the drug war has failed, people in recovery are starting to speak out against policies that have hurt them. But while there's general agreement about what not to do, the movement will ultimately face a difficult battle over its agenda and how, exactly, to address drug addiction without waging "war."

Spearheaded by Greg Williams, a 32-year-old filmmaker who kicked OxyContin and other drug addictions 14 years ago, the organization has what he says is a "multimillion-dollar" budget. Over 650 different addiction-related groups are sending members. Among the biggest donors are the Conrad Hilton Foundation and Marriott. "We have [around] 100 different major sources of funding, meaning $10,000 or more," he tells VICE.

"We want to raise awareness and educate the general public and open people's hearts," Williams says, adding that keeping the agenda broad was necessary to the goal of bringing together the extremely fractious groups that focus on addiction.

Legalizers will march alongside staunch prohibitionists. Those who see "public health" as just requiring a bit more emphasis on treatment—but not decriminalization of drug use—will face people who want policing of drugs ended entirely. Groups that define of recovery as total, lifelong abstinence will mingle with those that see medications or even moderation of drinking and other drug use as valid pathways to change. Some are fighting for needle exchange programs and overdose reversal trainings; others have traditionally opposed these "harm-reduction" approaches. And some view addiction as a disease, while others see it as a social problem or even a choice.

The biggest challenge—other than fundraising—was trying to build a coalition, according to Williams. "How do we get prevention and harm reduction and recovery and treatment people who all disagree, how do we get them under a broad umbrella?" he asks rhetorically.

Williams's first feature film was a documentary called The Anonymous People , which spotlighted nascent local organizing around recovery issues. It helped set the stage for the rally by generating interest among both people in recovery and foundations. But despite the title, Williams didn't want to limit his focus to those who recovered via "Anonymous" 12-step groups, as they are actually only a small portion of the 23 million Americans who report having ended addictions.

For one, past groups that had tried organizing 12-steppers only attracted small numbers of members who tended to see their road to recovery as the only way. In lobbying terms, this was the equivalent of trying to do breast cancer advocacy that pushed chemotherapy for all, rejecting radiation use as "not really recovery" and alienating many survivors and doctors.

And it's hard to generate enthusiastic activism in support of the status quo. "We want more of the same kind of treatment and more of us locked up if we don't accept it," isn't exactly an inspirational basis for a social movement.

Critically, for opioid addiction to heroin and/or painkillers—which is now killing record numbers of people—limiting advocacy to supporting abstinence-only 12-step programs can have life-threatening consequences. While some people with opioid addictions do recover through abstinence, indefinite maintenance on drugs like methadone is the only approach that has been proven to reduce the risk of overdose death by 75 percent.

So Williams and his fellow organizers broadened the tent. Zac Talbott, who describes himself as being "in long-term recovery thanks to methadone," is the director of the Tennessee and Georgia chapters of the National Alliance for Medication Assisted Recovery (NAMA-R) and will be participating in the rally. "For too long, the recovery community has not accepted us," he tells VICE. "Don't tell me I'm not in recovery because I take a legal medication once a day."

Talbott praises Williams and his film for bolstering activism and says he hopes to see a large contingent supporting medication-assisted treatment at the demonstration. "We have banners saying, 'Methadone saves lives' and, 'Medication-Assisted Treatment is Recovery.' My biggest hope and prayer is that we have a strong showing at the rally."

Talbott, who is active in his church, supports connecting across faiths and beliefs to emphasize shared values. "I have a parallel hope for an ecumenical movement in substance use," he says.

Another participating organization is the Missouri Network for Opiate Reform and Recovery. Co-founder Chad Sabora distributes naloxone (Narcan), a nontoxic drug that can reverse overdose, to people at risk and trains them how to use it—even though doing so is illegal in his state.

Sabora is a former prosecutor who himself struggled with heroin addiction. He believes the most important goal is saving lives. "We're losing too many people," he says. "That's why our focus is Narcan and needle exchange, because want to keep these kids alive long enough to want recovery."

Through the march and other activism, Sabora adds, "I hope to inspire people to come out of the proverbial closet. We can't live on 'just say no.' We have to be there to pick these kids up when they fall."

Sabora's organization doesn't take a hectoring or humorless view of "sobriety," however. The graphic the group used to illustrate its participation on the rally website is cheeky: It's a picture of a bumper sticker that says "I narcanned your honor student."

But that's not to say that more establishment-oriented groups aren't well represented. For example, Terrence Walton, the chief of standards for the National Association of Drug Court Professionals, will be there. "This rally is one of the ways we are really trying to better connect drug courts with what it's really all about: people integrating into a community that supports recovery," he says. "It's time for some of the stigma to be lifted off of this disease to [help] people get well."

The march comes at an especially significant moment for drug policy reform. For the first time in decades, both the left and the right agree that far too many people are being incarcerated in the United States— and for far too long, particularly for drug crimes. Only ancient hardliners like former drug czar William Bennett continue to make the case for intense criminalization; virtually no one can muster a good argument for why locking people up for simple possession of drugs is a useful policy. (If it doesn't even work for marijuana, why should it work for heroin or cocaine?) And states like Colorado and Washington are showing that full commercial legalization of weed doesn't produce disaster.

Walton agrees that the landscape is shifting. "I think that this rally and the energy behind it and the momentum sweeping the country that makes it possible is based on recognizing—whether it was intended or not—that the war on drugs, by and large, has had a disparate and negative impact on people of color and poor people," he says.

Williams points out that when both Republican Senator Rand Paul and Democratic Senator Cory Booker agree that mass incarceration has gone too far and introduce legislation to roll it back, there is real room for change.

But Howard Josepher, president of Exponents / ARRIVE, is more skeptical. An ex-addict and activist for more than four decades, he founded the organization to fight both addiction and AIDS, and he's seen many previous addiction activist groups shipwrecked by failure to agree on specific goals.

"I don't really get it," he says of the march. "What are we doing? Are we drawing attention to the fact that people recover? OK, but is there any real agenda? It seems to me that what they are saying in bringing people to Washington is, 'We are a political force.' But what do we stand for? I don't see anything that defines what are we going to do with this."

Williams sees the question of specifics as a distraction, wanting first to draw eyeballs to recovery and the problems of addiction, particularly to opioids. He wants to get people in the various factions talking to each other, starting from a place of common ground. After that, they'll work to create consensus on the easiest issues—for example, promoting the use of more respectful language like "person with addiction" rather than "addict—before tackling the thornier ones.

William White, a historian of drugs and addiction and longtime supporter of recovery activism, suspects the moment may be a special one. "I think the timing of the Unite to Face Addiction reflects a process of maturation of the recovery advocacy movement," he says, noting specifically its support for respecting multiple paths to recovery. Of course, he cautions that only "time will tell."

And at some point, Unite to Face Addiction is going to have to deal with tough questions. For example, do they support continued criminalization of drug possession—and if so, how do they hope to de-stigmatize addiction when the whole point of criminalization is to create moral stigma? And when funds are limited, what types of treatment should get priority? How much emphasis should be placed on fighting for more treatment funding—and how much on improving outcomes before pouring more money into a system that most agree is far from meeting standards of care for quality, compassion and evidence?

Way back in 1993, I wrote an op-ed for the Washington Post calling for people with addictions to come out of the closet and fight for more humane treatment and policies. My model was ACT UP: the AIDS organization that changed clinical trials and the FDA approval process to make them faster and better, which forced the legalization of needle exchange programs in New York and elsewhere and helped turn HIV into a chronic condition rather than a rapid death sentence, all the while making activism cool, even sexy.

At times, ACT UP was at least as divided as addiction advocacy: I spent countless hours covering apparently endless debates at its Monday night meetings in lower Manhattan, many of which were painful and contentious. But ultimately, the group became one of the most effective advocacy organizations in American history, changing policies not only for AIDS patients but for people with all types of diseases and inspiring other patients to take similar action. It didn't pull its punches, and it created small "working groups" to tackle highly specific issues, which would research them and provide guidance for the whole.

I hope Unite to Face Addiction—or at least some organization—can create a call to action and then drill down to details that will lead to better care for addiction. Gay people were criminalized and marginalized before they came out; people with addictions are now in a similar spot.

We can start by showing our strength and our humanity and our energy, but we can't stop there.

Follow Maia Szalavitz on Twitter.

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