USU Drug User Think

WINTER 2021

DRUG USERS THINK NATIONAL URBAN SURVIVORS UNION

2

From Dr. David Frank: USU's own Dr. David Frank recently published a crucial article arguing that COVID-19 gives us a valuable opportunity to reform methadone maintenance treatment by shifting the dialogue from abstinence to harm reduction.

Frank, D. (2020). A chance to do it better: Methadone maintenance treatment in the age of Covid-19. Journal of Substance Abuse Treatment, 123, 108246.

Congratulations Dr. Frank! We are so proud of his involvement in our Methadone Reform Team!

In this issue: Announcements, p 2 Covid Vaccine Info, p 3 Harm Reduction in a Pandemic, p 7 Nas/Lauryn Hill - (1996), p 12 Methadone, p 13 Drinking and Covid, p 26 Margo St. James, p 27 My Least Traumatic R*pe, p 28 Destin Declaration - p 33

Announcements About Harm Reduction Support Groups: Every Thursday at 7:30pm EST, USU and NCSU host Substantial Improvement! Call 1872-240-3412, Access Code 177-648-909 or log in at http:www.gotomeet.me/usucall Or check out Harm Reduction Works!

Calendar is here!

Fundraising: NCSU: Closing the Funding Gap! North Carolina Survivors Union (NCSU) aims to improve the lives of people who have been targeted by the war on drugs by. Your donation can help the work continue!

For

More

Donate

info

and/or

click

to

here!

https://gofund.me/5fc47a3b Photo credit to DEA-These stamp bags made the news.

Upstanding citizens everywhere were once again shocked and outraged.

3 What

You

Need

to

Know

Covid-19 Vaccines

4 W h a t

Y o u

N e e d

t o

K n o w

COVID-19 VACCINES

5 What You Need to Know

COVID-19 VACCINES

6

Frequently Asked

Questions

References

Covid-19 Q&A - National Institute of Allergy & Infectious Diseases Vaccines for Covid-19 - Centers for Disease Control & Prevention

7

Harm Reduction in a Pandemic--What We've Always Been Doing, Anyway

When I began having sex for money, I immediately accepted the sex worker identity, delighted to be a

BY ALEX

whore. And I have never shied away from drugs, loving the magical experiences they provided me and not feeling at all guilty about my use.

But there’s another side to me. I believe in science. I believe in risk management. I believe in emergency preparedness. In fact, my husband and I were something like preppers for a while, without the conservative bullshit and class privilege the name implies. I use condoms with clients. Whenever I can, I have at least some savings stored up. I weigh out my molly so that I don’t use more than is safe for my brain at one time, and I wait patiently for three months so I can roll again--I like to avoid neurotoxicity and I want to keep the magic.

We certainly didn't invent sex work--risk is here to stay Photo credit: wikimedia

When the pandemic began ramping up in the U.S., but before it presented a real threat to me and my community, I found myself very torn. I wanted to do the

I have always been willing to take risks to feel alive. It’s a

right thing, to protect the people around me. I knew the

part of my identity. Way back when, I was a couchsurfer,

guilt would be enormous if someone died because of my

staying on strangers’ couches all over Europe and

irresponsibility. Formerly homeless, I had recently

welcoming large groups of people I’d just met at a pool

become secure in my housing situation and I wanted to

in Palm Springs into my home. One year, I hosted seven

leverage it: I realized that, from my newly privileged

handsome Austrians who took up the entire available

position, I would have the ability to make safety choices

floor space in my small SF apartment. My roommate

not everyone else would. I also am very used to not

baked them a cake covered in sprinkles.

trusting scare tactics--DARE and the entire drug war have taught me that official government sources do not

When my husband asked for an open relationship, I was excited to have a new alternative identity to embrace. Later, in a triad with two lesbians, one of my favorite parts was going to the grocery store together, out and proud in public.

effectively communicate actual facts about risk. I don’t want to think of myself as the first person who slams the door shut to the world in the face of danger.

My last meal before California went into lockdown in

8

Nic.Rey.Foto

March (a lockdown we never really fully came out of) was with a new friend and activist. She was visiting me to pick up these amazing “Sex Workers Rights are Human Rights” shirts I had been selling for her at conferences. She was so cool, and I really really wanted her to like me and my family. I was not cool.

My anxiety was palpable. I’d had a cough from postnasal drip since September, and I was stressed out that she would be scared of catching something. Over dinner, which was delicious, I started to choke on a piece of food and had to step outside. I saw people

Photo credit: Nicole Reynolds, USU member

down the street stare at me coughing and gasping for breath with looks of sheer terror. I came back inside,

It seemed like nobody else’s public reaction meshed with

and confessed to my new friend that my obvious stress

my values. My foster mother and many others spoke of

was from being torn between identities--the sex

pandemic restrictions as a communist conspiracy against

worker/couch surfer who would never be afraid to help

Christians. My hometown gained national attention for

a fellow human being choking on the street and the

an outdoor maskless caroling protest against what my

part of me who wanted to be smart about my safety

foster mother’s pastor referred to as “cowardice.”

and do what was right for my community. I didn’t know how to weigh the risks. She totally understood,

My liberal friends essentially engaged in a pissing

but we reached no firm conclusions. I haven’t seen her

contest, with the winner being whoever most completely

in person since.

isolated. Their mantra: wearing a mask is no big deal, and only selfish idiots refuse to wear them. I see them

As the pandemic wore on, reality hit: Californians were

constantly insulting people who don’t “get it” across

not just supposed to flatten the curve but were

Facebook. They have no compassion, for example, for

actually charged with avoiding all people whenever

the panic attacks that wearing masks can bring on--as

possible for the next one to two years. I began to

soon as I get far enough away from a grocery store, I have

reconcile my identities, finding a groove that worked

to rip off my mask and do deep breathing to calm down. I

for me. I marched because Black Lives Matter, and I

become a klutz--I lose body awareness as I fight to stay

wore a mask. I hugged a beloved partnery person I

calm in my mask. I wear one anyway, whenever I go to

hadn’t seen in months who met me there. I don’t

the grocery store, but I recognize that the switch isn’t

regret it. She died of a blood clot three weeks later,

easy for many--and is not likely to happen when your

and I will always be grateful that I got to hold her. I

pastor and your president are both telling you that

went to another friend’s outdoor funeral, and made

masks are unAmerican.

the decision to eat inside with the family afterwards-another decision I don’t regret, as his beloved aunt snuck me some of his ashes so I could do my own ceremony for him. I saw my immunocompromised foster mother, but set up camp in her backyard and hung out with her by the pool instead of going inside.

I hugged a beloved 'partnery' person I hadn’t seen in months who met me there. I don’t regret it.

She died of a blood clot three weeks later.

9 A third group of people enraged me the most. They just used the pandemic as an excuse to be assholes. They kicked my deaf girlfriend Jackie and her autistic son onto the streets because the son had to live at his father’s part time and they were worried about the risk. They hired poor people to guard homeless encampments in Santa Cruz with tasers and not let people out--true story! My sugar daddy’s girlfriend was hired there!

I noticed that my leftist, activist, and drug-using friends Despite my liberal friends arguing on Facebook that you

were in the same place as me. We didn’t feel included in

need a mask any time you are outdoors, even if you are

the debate: we knew the risk was real, and we also knew

far away from people, I certainly am not about to wear a

that complete abstinence from human interaction

mask on an empty beach with my family. California

ranged from being very impractical to constituting a

closed the only accessible hiking trails near my house for

death sentence. We are at risk from overdose when using

no real reason, causing my disabled sugar daddy who

alone, and we have always relied on each other to

relied on them for mental healthcare months of anguish.

sustain ourselves when the entire world is against us.

They weren’t making decisions based on actual risk

And financially, we often have very little say in our

factors. It seemed they were focused on the “look,” and

housing and survival situations. Some of us gave into

seeing people happy outdoors was a “bad look,” even if

conspiracy theories about COVID (“it’s all fake”), some of

it was a low-risk activity. And they didn’t care that much

us doled out impractical advice (“homeless women

if their safety advice was completely impractical or

should wash their hands with water after using hand

impossible for the very people who are most at risk.

sanitizer only twice”), and some of us tried to explicitly frame the conversation in terms of harm reduction, but

And, worse, the people loudest about the need to socially

more of us just continued the best we could, bending or

distance often turned out to be the most inconsistent.

making up the rules as we went along, fighting for each

Gavin Newsom, the California governor who instituted

other and pulling each other up--as we always have

some of the strictest social distancing requirements in

whenever we are warned that something that we view as

the nation, got caught with his pants down, eating with

intrinsic to our survival is dangerous or deadly.

multiple other households around the holidays indoors at French Laundry, one of the most expensive

My household--my immunocompromised sugar daddy,

restaurants in California. It fueled hatred from people

my husband, and I--had to decide how to respond. Our

like my mother, and--combined with the hard line he had

first decision was to not be shitheads, and we made this

taken--caused more people to reject anything he had to

commitment out loud to ourselves. We knew we couldn’t

say at all.

let the pandemic prevent us from housing Jackie and helping her son--even though it meant a higher risk. We

They kicked my deaf girlfriend Jackie and her autistic son onto the streets. They hired poor people to guard homeless encampments.

also realized that telling her what to do with her body or life wouldn’t work, so we were opening ourselves up to having a household member who was not in step with our risk-taking norms.

10

Photo credit: Alex, that very day

We also decided to view risk as a budget, rather than

I had planned a weeklong event at my childhood

take every piece of advice in a black-and-white way.

campground to spread my dad’s ashes. When it rolled

When trying to drink less, you are more successful if you

around nine months later, we went despite the pandemic

don’t view a single drink as a loss of everything you’ve

and the raging wildfires that had forced us to evacuate

fought for. That will only make you binge if you

our home. We invited my sister and her boyfriend as well

eventually slip up. It’s the same with everything. Having

as my long-distance person Ana to visit us. We staggered

Jackie live with us--and not being controlling or

our visitors, giving them their own tent. We were

assholish about her more libertine behavior--meant that

privileged--with my sugar daddy’s financial support, I

we were using up some of our risk budget.** Instead of

was able to use a soccer-mom level of organization,

throwing caution to the wind because hey, we were

which helps in any risky situation. We kept everything

already somewhat exposed, we reduced harm by distancing in other ways. Jackie cut back on sex work voluntarily, and I kept my sugar daddy as my only inperson client, even though it meant much less financial independence. We reduced our trips to the grocery store, wore masks, and rarely ate out. We tried to exercise outside and find happiness in new ways.

We learned as we went along. I discovered I don’t feel joy from replicating everything via webinar. I declined an invitation to a zoom rave, deciding to focus on saving up for a wild EDM experience for me and my loves postpandemic. My husband gardened. When the liberals finally realized there was no good reason to close outdoor activities, my sugar daddy resumed swimming and walking, regaining much of the mobility and some of the mental health ground he had lost earlier in the pandemic.

outdoors and I brought rolling papers to make joints for everyone, knowing ahead that we wouldn’t be able to puff puff pass. We set up a handwashing station and I regularly bleached the kitchen area. It worked fairly well with my sister. I made sure I was the only one who cooked and I kept my hands clean. It did not work with Ana. There was absolutely no way I was going to leave Ana to stand six feet away from our group as I hugged my husband, my sugar daddy, my girlfriend, and her son. All it took was a little molly and Ana and I were rolling around on the sand, frolicking in the water, and generally forgetting that one of us could die. I don’t regret it, but lesson learned--if I want to socially distance myself from a friend, they better bring someone to hang out with, because in no way am I going to ostracize someone I love.

I also learned that, like harm reduction with drugs, harm reduction with COVID means facing down peer pressure. I

Ana and I were rolling around on the sand, frolicking in the water, and generally forgetting that one of us could die. I don’t regret it.

cannot count the times that I was asked to take off my mask or come inside someone’s home even when I tried to say no--even when I knew that person was on Facebook saying people who don’t distance deserve to die.

11 It reminded me of a time I had been getting ready to khole with my ex boyfriend and we only had two unused syringes. I needed a way to precisely measure out both the ketamine and, for later, some alcohol to eventually store some 4-AcO-DMT. I gave him a clean syringe and used the other for alcohol before I muscled the K. He couldn’t believe I was willing to put a needle into alcohol

Drug users, whores, and poor people around the world have still never escaped the HIV, overdose, tuberculosis, or viral hepatitis epidemics.

and then into my body but wasn’t willing to mess around with his used syringe--when we had two new syringes on hand! No matter how many times I explained that he was an organic being and the alcohol was, well, alcohol, I could see the rage and hurt on his face that I wouldn’t share his syringe. I slammed my head on the fake wood table, speechless, imprinting the ugly “wood” pattern into my memory. Standing on the street as my mother’s next door neighbor yelled at me for not dining inside at

And now, here we are, almost a year later. The pandemic is ongoing. And drug users, whores, and poor people around the world have still never escaped the HIV, overdose, tuberculosis, or viral hepatitis epidemics. Long after everyone important in the US is vaccinated, we will still be fighting these and probably COVID too. And we can’t just block ourselves off from humanity forever. We

restaurants when there was perfectly good take out

need each other, and we need harm reduction. But we

available, I pictured the table’s cheap veneer over and

can do our best to stay as safe as possible, to protect

over.

each other, and to choose our own limits.

Finally, I did activism that took advantage of the pandemic, much in the same way that shitty people tried to take advantage of it to harm us. With USU, I helped write a letter demanding methadone take homes so that

*All names changed!

people dependent on opioids didn’t have to go to

**Although we viewed risk as a budget-like situation from the

dangerously crowded clinics daily or use supply

beginning of the pandemic, we found the language to describe

increasingly poisoned with fentanyl. We organized sex

our strategy as a “budget” from this NPR interview.

workers to push back against dangerous legislation. My fellow organizers and I taught vulnerable people in our communities how to access pandemic assistance, getting Jackie and others back on their feet.

Nas/Lauryn Hill 1996

12

BY DINAH ORTIZ, LEADERSHIP TEAM MEMBER LIFE I WONDER, WILL IT TAKE US UNDER … HELL NO Imagine a black mom smoking weed in the streets without cops and ACS harassing, calling her a bad mother Imagine going to court with no trial ‘cause it’s about a child, no marks no bruises no proof ‘cept a few missed days of school so they remove, HA! Photo credit: Dinah Ortiz

No welfare supporters--equality gave us means to raise our daughters Nights are shorter, smiles are longer, happy We know surveillance days are over!

Just some thoughts for the mind, I take a glimpse up to the stars, watching the blimp read “THE WORLD IS OURS” If I ruled the world imagine that I free all our sons, fuck that Open their eyes to the lies, history’s told foul The way to paradise be like relaxin black, latinx, indigenous just maxin Gimme one shot to turn trife life to lavish Political prisoner set free stress free No kids snatched under me, no work release Feel the wind breeze in the West Indies I’d make Coretta Scott King mayor of all our cities, unchain all babies It may sound crazy to you but this the path I’d take Open every cell in Attica send them to Africa ya snake If I ruled the world You’d rethink whats behind my door, could it be the .44 You got no right to take what’s mine Turn ya ass around and find another train line Stand up for yourselves fam or wait in line else we’ll be giving birth for a system who only see dolla signs

Inspired by If I Ruled the World (Imagine That)

By Nas feat. Lauryn Hill

Yes, 2020 was a wild year, but it brought with it a unique and unprecedented opportunity for reforming the current methadone system. As COVID-19 took hold and the pandemic forced us into isolation, virtual platforms became the new “normal.” This ushered in a new era of methadone activism, advocacy, and organizing in an epic and inspired way! As we met for our Monday Night Methadone Call, one thing became increasingly clear: Improving access to methadone was more urgent than ever in combating the violences of the drug war. For far too long, lack of access and other barriers to treatment have plagued the current methadone system. These injustices have been ignored, explained away, or worse--just allowed to continue with little or no regard for those of us this very system is supposed to “help.” Throughout the pandemic, with supply chains breaking down, isolation, job loss, and even more fentanyl or other poisons being introduced into our supply, opioid deaths skyrocketed.

Throughout 2020 our work focused on reforming the system through activism and advocacy. And we have continued those efforts into 2021! We started this new year with a clear message--Methadone is our communities’ only current safe supply! It’s the gold standard of treatment for opioid use disorder and, as current and former methadone users ourselves, we have to do everything we possibly can to get methadone right! Failure is not an option. We continue our efforts to advocate and work to create real change! Read on to learn more about USU’s Methadone Reform team, our work past and present, and what’s to come and how to get involved and advocate for methadone reform.

I n T h e

S o l i d a r i t y ,

M e t h a d o n e

R e f o r m

T e a m

13

What

has

the

advocacy

methadone team

what

’s

been

to

reform

up

to

and

and

come?

The past year was huge for our methadone reform team. We worked harder than ever in unabating ways, ensuring that far-reaching education, awareness, and advocacy through community-led efforts were on the forefront.

Now, as we move into the new year, we continue to expand on those efforts, collaborating on actions, projects, and all our work in substantially impactful ways. We are acting out for methadone in 2021!

SAMHSA released relaxed (COVID-19) Guidelines for OTP's With relaxed guidelines in effect after March 16th 2020, take home medication was increased dramatically. Stable patients were offered 28 take home doses at a time, and “less” stable patients were offered 14, to hopefully prevent patients from having to come to crowded clinics daily and to make methadone a more realistic option for people at risk of dying from poisoned supply. Telemedicine became permitted for counseling, medical, and other doctor appointments, and toxicology--aka piss testing--was scaled down.

But while some clinics (OTP's) implemented these improved practices immediately, others dragged their feet.

Worse yet, some clinics refused to take advantage of these improved federal guidelines at all, leaving the health of a marginalized population more vulnerable than ever to COVID-19 and overdose. USU immediately moved into action and began organizing, fighting to make our voices heard and advocating for our rights!

14

#MethadoneIsOurSafeSupply OUR

OPEN

DEMAND

LETTER

We wrote an Open Letter to stakeholders, demanding that clinics implement the improved SAMHSA guidelines and pushing even further for methadone treatment reform. Over 140 different organizations signed on, and we were also joined by many prominent individuals, including the Obama-era Drug Czar Michael Boticelli. It also received significant media coverage throughout mainstream media outlets.We held a heavily-attended webinar, "It took a Pandemic to get a Take Home," which was and is the first and only one of its kind.

It

took

get

a

a

Pandemic

take

to

home!

We held a heavily-attended webinar, "Change at Last! Maintaining Methadone Take Homes & Safety". This was the first and only webinar of its kind addressing methadone, Covid-19 and rights of people on MMT.

15

16

Methadone Manifesto: Our collectively-written methadone manifesto is our living document recognizing the issues plaguing our communities and offering personcentered solutions: We are the ones most directly impacted by the punitive methadone system, and our voices must be heard!

Community-Directed Research and Broad Patient Survery Over the summer, our union conducted community-directed research, creating an online survey on methadone and COVID-19, asking for patients’ perspectives on how their facilities were implementing the relaxed SAMHSA guidelines. We collected 391 viable survey samples, offering a wealth of information to use for two additional projects.

One paper that came out of this research has been accepted and is currently undergoing edits for final submission to the International Journal of Drug Policy.

We will soon be completing a second paper, also to be submitted to prominent journals.

The American Journal of Public Health has also requested we write and submit a third article, and we will begin our collective writing process soon.

Our methadone team presented our work to the California Department of Public Health

Liquid Handcuffs: A Documentary to Free Methadone, Live Stream Events We held two live streamings of the award-winning documentary Liquid Handcuffs. Each streaming was followed with impactful and informative question and discussion sessions with attendees and activist panelists, with the first featuring the producer and director Helen Redmon.

WEBINAR METHADONE WEBINAR: THE METHADONE REVOLUTION IS NOW The Methadone Reform & Advocacy Team held our April 13 Webinar event highlighting our Methadone Manifesto and it's first official release. If you missed this powerful event, we invite you to watch by clicking the link on the following page! If you attended our live event, Thank You and be sure to take our webinar survey by clicking the survey link on the following page as well.

17

Methadone Manifesto

Check out the Methadone Manifesto HERE! https://sway.office.com/UjvQx4ZNnXAYxhe7?ref=Link

And Watch the Webinar Right HERE! https://attendee.gotoweb inar.com/recording/39065 39938993777423

Webinar Evaluation Here! https://forms.gle/e7H62iqFgPNb2eDi6

18

19

Methadone in the

Media

The Methadone Manifesto is a brilliant, badass, long-overdue gut punch to the antiquated US methadone clinic system. Written by members of the Urban Survivors Union’s methadone advocacy and reform team, composed of current and former methadone patients and allies, it centers the voices of methadone users.

Written by: Helen Redmond

Check Out the Article @ https://filtermag.org/methadone-manifesto/amp/

METHADONE IN THE

Media

(CONT. )

I was petrified.

How could my years of work be jeopardized by a person so eager to dole out punishment?

- Nick Voyles

Check out the Article HERE @ https://filtermag.org/arbitrary-methadone-take-homes/amp/? fbclid=IwAR16mpUtqkLzZ2y9pUbTwvDLByqUxNIB54ZPqA16xKTXaS42bFzFrkNe_nI#

20

Why is methadone advocacy important to drug user activism?

In the era of synthetic opioids, drug user communities have long felt the effects of the poisoned drug supply. COVID-19 amplified these effects, which plague our communities at an ever-increasing and alarming rate. As we continue into 2021, almost a year into the pandemic, the drug war continues its death toll. We are ordered to social distance without any real support from the institutions we are supposed to rely on, forcing many of us to use alone. We can see this reflected in the Official CDC Health Advisory released December 17, 2020 via the CDC Health Alert Network. (HAN) Specifically the most recent provisional data shows that the largest number of overdose mortality ever recorded, an approximate 81,230, took place in the 12 months ending May 2020. Significant worsening of overdose deaths are shown in the increases that appear in February, March, April and May of 2020, aligning with the declaration of the Covid-19 pandemic and shelter in place restrictions. Meanwhile, the resources we have relied on in the past (SSPs, clinics, social services, etc)--which were already struggling to meet us ‘where we are at’ prior to 2020--are failing to pick up the slack. The little institutional support that has been offered to the American people (Pandemic Unemployment Assistance, stimulus checks) is inaccessible and inadequate for many of us.

As drug user activists, we push for the decriminalization and legalization of substances, safe injection spaces, safe supply, and harm reduction treatment. Often, we are turned away and told these lofty goals are years away from being achieved. While it is important to imagine and create new systems, we continue to lose our leaders and comrades to the lethal combination of COVID-induced isolation and poisoned supply. Some of us might have been saved by methadone access, but were unable to receive adequate treatment because of the barriers and associated stigma. It’s those same barriers and stigma that keep even current methadone patients from receiving adequate services. As we mourn our lost comrades, we can’t help but wonder if they could have been helped if obtaining access to methadone wasn’t such a restrictive and humiliating process.

It is in the memory of those we have lost to the drug war that we fight to reform clinic policies. As experts in our own use, our perspectives and experiences are vital and need to be centered as we fight for the future of methadone access and clinic operations.

21

22

What are some of the things we are fighting for?

Effective IMMEDIATELY because of unsafe conditions caused by COVID-19, WE DEMAND:

We demand abolition of policies based on punishment instead of compassion.

Safety We demand continued implementation of SAMHSA's relaxed COVID guidelines and immediate reinstatement of these practices at those facilities that have prematurely rolled them back.

We demand access to PPE throughout the duration of the pandemic, including FREE masks.

We demand overdose prevention, including requiring naloxone distribution at our clinics.

Evidence-based Treatment We demand evidence-based treatment that sets us up for success! Initial starting doses of 30mgs leave many of us without even the slightest relief from withdrawal symptoms. This as well as the the lagging or stalled dose increase practices have been a long time road block for many of us at reaching optimal dose levels. With the emergence of synthetic fentanyl and its analogous, the problem has only worsened making therapeutic stable doses more important than ever.Stable dosing: People who are not able to succeed with methadone are often given doses too low to allow them to regain stability in their lives. Evidence shows that people are able to reach and maintain more stable, productive lives when they are on doses that work for them and can rely on the dose not being punitively changed.

EVIDENCE No

mandatory

BASED

counseling:

TREATMENT

There’s

no

evidence

to

(cont.)

suggest

that

methadone

with

counseling is more successful than methadone alone. Regulations should mandate person-centered care. Among other things, this means no punitive dosing

from

either positive tests or from speaking up about our treatment! We deserve to be judged by our behavior, not the content of our urine. And, often, a positive urine test means that our doses are not stable enough, not that we need less access to lifesaving

healthcare.Health

and

SafetyFREE

MASKS

(Access

to

PPE)Overdose

PreventionRequire naloxone distribution

Accessibility and Disability Justice Shorten intake procedures Third party dispensation. Some people with disabilities need a caregiver to pick up their medicine. Methadone should be no different!

Tele-medicine Eliminate strict requirements for take homes Increased clinic hours. We shouldn’t have to show up at clinics at 5am every morning.

Reduced urine screening Primary Care Provider prescriptions (Eliminate DATA X-waiver). The DATA X-waiver makes it harder for doctors to simply prescribe life-saving treatment to their patients.

23

24 Patient Rights and Autonomy We demand the right to ask questions and get adequate, fact-based answers from well-trained and compassionate staff within our clinics.

“Abstinence only” kills/Abstinence has a death toll.

All Pathways to Treatment means ALL pathways of MAT as well! Some people push other forms of medication-assisted treatment over methadone, even though different pathways work for different people and in spite of the fact that methadone is the gold-standard treatment for opioid dependency) Patient Bill of rights Reproductive rights The rights of pregnant people: Methadone is the recommended treatment for pregnant people who are opioid dependent! It protects against overdose, poisoned supply, and many other risks associated with illicit drug use. What’s good for the parent is good for the baby! We insist on evidence-based pre-natal and neo-natal care.

The rights of parenting people

Privacy

Eliminate lock box requirements: Even the federal government recognizes that requiring us to buy and carry around lockboxes for our medicine makes it harder for the most vulnerable among us to get treatment while putting a target on our backs for those looking to steal our methadone. Lock boxes are especially dangerous for homeless sex workers, who have to work with lock boxes advertising that we are dependent on opioids and have valuable prescriptions with us!

Photo credit: Peter Moinichen, USU member

25

How can YOU support our efforts?

Come to our meeting! You don’t have to be a patient (or even an opioid user) to join us. We need people amplifying the voices of those on methadone and advocating for patients’ rights and safety.

Meeting Info: Every Monday @ 8p ET www.gotomeeting.me/usucall/methadone-mtg Access Code: 289-450-221 Or dial in via phone U.S. @ +1(872)240-3212

Drinking and COVID ANONYMOUS Before the pandemic, I usually drank once or twice every two weeks. When COVID started, I began to drink constantly, everyday. I wake up and take a drink; I go to sleep after a long day of drinking. So much has been going on in my life since this pandemic: people close to me have died from COVID or contracted the virus. One moment in particular stands out: my 17-year-old niece called and told me she tested positive. I couldn't begin to handle this, so I drank and drank and drank. It felt as if as long as I had a drink I could deal with this situation. Being trapped in the house, not being able to hang out with friends, not being free in this world like I was before COVID--drinking made it possible to cope. Dealing with my sick father, who has a bad attitude, made me drink even more. Without a drink, I would not be able to deal with him.

So COVID drew me to drinking more than usual. Just the other day, I wondered to myself if I was becoming an alcoholic and what this means for me. I was asked to write this essay about using substances during COVID, and so I had a chance to talk to USU members about my essay. I realized a few things. First, society doesn't treat alcohol the same as we do other drugs. It is much more socially acceptable to drink during COVID then it is to use "harder drugs." Also, society tells us to be ashamed of our substance use. But I realized that drinking during COVID doesn't make me a bad person, and that being hard on myself for drinking won't make me drink any less. I realized that whatever I needed to get through is okay, and I can think about whether more drinking in my future is helpful or not without all of the shame that society wants to put on drinking.

26

27

Margo St. James SEPTEMBER 1937 JANUARY 2021

USU's Sex Worker Organizing Group honors Margo St. James. Founder of St. James Infirmary--the first health clinic by and for sex workers in the world--as well as the founder of seminal organic shine WHO (Whores, Housewives, and Others [Lesbians]), and COYOTE (Call Off Your Old Tired Ethics), she created foundational alliances between sex workers and civilian women with the wages for housewives campaign. COYOTE successfully overturned SF policies which mandated coerced STI testing for those arrested for prostitution, with those testing positive held in quarantine. She was and is a hero to many of us, and we are profoundly changed because of her ground-breaking activism.

My Least Traumatic R*pe ALEX

I couldn’t really turn my head to see her. I kept having this feeling that there was something I just needed to

TRIGGER WARNING: graphic desicription of rape The weirdest thing: we were in full view of about forty

remember, something that I should do to attract attention, to get help. “Is there a phrase you are supposed to say in these situations?”

Bay Area social justice warriors. People who took care to use the correct pronouns. They had posted plaques

I felt nausea rising. I sat as an observer to my internal

on the wall about enthusiastic consent. They reblogged

dialogues. “Okay, you don’t want to die being raped in

Everyday Feminist articles and discussed risk-aware

Harley Quinn lingerie and pigtails.” “That’s right! I

kink.

didn’t come all this way to drown in my own vomit at a play party.” “There’s something you need to do if you

The costumes were also bizarre. I have been raped

are drugged and about to throw up. You have to move a

plenty of times--that’s just my life as a female, a drug

certain way.” “What way is that?” “You have to like, lay

user, a sex worker--but never have I had anything so

on your side, girl. Move your body!”

surreal happen to me. Wonder Woman moaned next to me, thoroughly spanked by the Incredible Hulk.

But then I remembered the ongoing rape. “I don’t think this dude will be cool if I try to change positions. Maybe

I slowly reached for my date’s hand as my head rolled

turn my head.” “No, not towards the unicorn. She’s

on the filthy cushion on the floor of the “Play Area.”

being raped too. Well, I guess not at the moment.”

Emmy had dressed as a unicorn, refusing to go along

“Maybe I can wait to throw up until he goes for her

with the super hero theme of the night, opting instead

again! That will get me time to roll over!” “No, there’s

for a polyamory joke--the “unicorn” is the hot bisexual

no time. You better turn your head.” “I hope Wonder

woman willing to become a plaything for a

Woman isn’t mad at me.”

heterosexual relationship. And she had been. In fact, maybe if this dude had just asked her instead of cutting

In retrospect, had Wonder Woman noticed, I’m sure she

our molly with some unknown substance, she would

would have put an end to it. Or maybe she did and just

have been giving him head by now.

ignored me because it was gross. I don’t know.

29

TRIGGER WARNING: graphic desicription of rape

The bathroom was abandoned now. We cleaned up at

30

the sink. We instinctively knew a rape kit was out of the question--we had done something ... illegal. As an onand-off homeless person, I am great at ho baths. Emmy was less experienced, so I taught her the art of the public clean-up. I tried to make her laugh, and succeeded.

I got us water, and we sat on cushions against the wall in another room of the building, waiting for me to be okay to drive. She lay her head in my lap, sobbing on and off, but I kept reassuring her that everything would But I was jubilant. I was so much less nauseous, so glad I had successfully not drowned, so proud of my achievement. “I think my throwing up turned him on.

Like in porn!”

After he was done I spent what seemed like hours lying there next to Emmy trying to become okay-enough to walk. Time dilation is one of the things I don’t love about drugs--at least, whenever they aren’t going right.

I drifted in and out of consciousness, wondering why I wasn’t feeling super traumatized. “Maybe the molly is preventing me from registering this as trauma?”

The same wasn’t true for Emmy. As soon as we could talk and move, she was sobbing. Then people noticed, but the dude was long gone, and by that point we just wanted to be left alone. Emmy shooed them away. I helped her to the bathroom. Tank Girl was being fucked on the sink by some guy in a shirt that said “This shirt is my costume.” I held Emmy’s hair as she kept throwing up, over and over, sobbing.

I think Tank Girl got concerned because an event organizer knocked on our bathroom door, concerned we had gotten too drunk. That’s a violation of the rules.

So was using drugs, so we decided not to tell. I became the spokesperson. I apologized in a clear, strong voice.

“She’s not drunk; she’s ill. We are leaving as soon as I sober up enough to drive.” He didn’t believe me but walked away.

be okay. Apparently she had liver and gallbladder issues, and certain drug combinations are life threatening for her. And of course, nobody like us had insurance back then.

I drove us to the motel, stopping frequently for her to hop out and throw up. We arrived at 4am, and slept until my phone alarm went off at 11.

I brought her home when she refused the emergency room. She told me to go, but first I tucked her in bed and set up a handy trash can. She thanked me for being a good human being.

Later I texted her. After a couple hours of silence, I messaged again: “Emmy, you never have to message me again, I get it, but please text me a thumbs up if you are alive and I don’t need to call 911.” I got a thumbs up. I fell asleep. The next morning I messaged: “Final check in.” Another thumbs up.

31 TRIGGER WARNING: rape This is one of the traumas of my life that never really hit; maybe the molly did in fact prevent it from ever really cementing itself the way so many other violations have.

I saw Emmy at a burlesque show last year. She was with a boy and I was holding hands with my fuck buddy/BFF. Emmy chatted with us for a minute then gracefully left the event. I gripped Calysta’s hand.

“That’s the girl I was raped with,” I whispered.

This story was written by Alex for her participation in WHRIN (Women in Harm Reduction International Network) and USU’s collaboration on 16 Days of Violence Against Women. Alex wrote this story as a crossover project between 16 Days and NCSU’s (North Carolina Survivors Union) Narcofeminism Storytelling Project, where women and non-binary people learn to break down common tropes they are indoctrinated into incorporating into their stories and begin to tell their own stories with their own voices. Alex wrote this story to illustrate the casual way that women in her community are accustomed to dealing with violence and to showcase the lack of support that women who use drugs have from law enforcement, social justice movements, and the medical profession.

Photo credit: Knina Strichartz, USU member

DESTIN DECLARATION art 2 P g n i n n Pla Strategic We decided to make USU Strategic Planning Part 2 an in-person event for those of us who were able and vaccinated! And of course rocked it virtually for those that couldn't join us on location. So we headed to Destin Florida to connect, build capacity and spend some much needed time with together.

Connection is EVERYTHING! And after being locked down and away from one another, we needed this so MUCH!

32

Connection

S u p p o r t

33

LOVE

FAMILY

34

35

If you're interested in getting involved or joining U.S.U. go to our website, one of our social media platforms linked below or reach out via email to one of the contacts listed below!

www.facebook.com/urbansurvivorsunion/

Instagram.com/usu_media

www.ncurbansurvivorsunion.org

nick@urbansurvivorsunion.org abby@urbansurvivorsunion.org