What If Drug Users Organized Like Unions?

The name of the group was only meant to be a placeholder. Until the union’s rank-and-file could settle on a more permanent title, the organizers needed something to write on their grant applications and to give to community center staff when signing up for meeting space around the Tenderloin and the Mission. It was during one of those meetings in late 2009 that someone suggested San Francisco Drug Users’ Union. It wasn’t a name calculated to win the endorsement of a focus group, but then again, neither was the organization.   

Three years later, the name has stuck.

“It really says what we’re about unequivocally,” says Isaac Jackson, senior peer organizer and co-founder of San Francisco’s first drug user group. They could have gone with a more politically palatable designation, but the group wasn’t founded to be politically palatable, he says. The name is unapologetically self-descriptive because drug users shouldn’t feel the need to apologize. “Drug use in and of itself is not a negative. Having the name we have kind of ensures that the people who join are comfortable with their identity.”

Even in San Francisco, a city considered to be at the forefront of progressive (or, alternatively, permissive) drug policy in this country, the idea that drug use merits a union ― and not a stint in rehab or a prison sentence — is one that still raises eyebrows. But following in the tradition of other North American user groups which have sprouted up in cities like Vancouver, New York, and nearby Oakland, SFDUU members aren’t just interested in making drug laws less punitive, they want to change the way that people see users. As a philosophy, theirs is strikingly straightforward: people who use drugs are citizens too.

When the union finally moved into its permanent digs after spending its first year roving from community center to clinic to office space around the city, the landlord was happy to have them. With a rescue mission, an SRO and a windowless beer hall all within throwing distance of the space’s iron-gated entrance on Turk Street, it was the union’s willingness to sign a five-year lease and pay for new wooden flooring that most appealed to the owner of the railroad office suite.

The group’s charter and membership roster were of less concern to the neighborhood at large as well. In an area of the city long associated with poverty, substandard housing, homelessness, and crime, the sudden appearance of a scruffy union with a strange name was met by the surrounding tenants with shoulder-shrugging equanimity.

“We’re just a group of self-contained adults holding meetings,” Isaac says matter-of-factly. While a few local dealers dropped in at the first meet-ups, none have returned since, evidently satisfied that the union was neither a “narc group” nor a source of competition. Since then, says Jackson, there have been no complaints. “We’re good neighbors,” he says.

The union may not sound like a “typical” crowd of drug users, but as Jackson argues, there’s no such thing. Case in point: Isaac Jackson, Ph.D. Bespectacled, soft-spoken and sporting a bushy beard of more pepper than salt, 56-year-old Jackson looks more absent-minded professor than meth addict.

Asked about his early life, he describes none of the predictably tragic rites of passage one expects from a regular user. Growing up in New York City, he did not spend his childhood surrounded by addiction. As a teenager, he didn’t fall in with the wrong crowd. In his late-20s, he received his masters degree from a private college in Manhattan and in 1992, he was awarded a doctorate from MIT’s Media Lab. It wasn’t until he was in his mid-30s, freshly transplanted to San Francisco, that he first sampled what has since become his drug of choice.

Jackson says he doesn’t like to talk about his educational background. “People” -- and by people, he certainly means reporters -- “always want to talk about how I went to MIT,” he says. But while a Ph.D. with a crank habit might strike some as a novelty, he says his current place in life owes more to his work with the San Francisco AIDS Foundation. Jackson went to work with the organization after losing his high-paying tech job in the dot-com crash, falling into a prolonged depression and quickly letting his self-medication slip “out of control.” After a few run-ins with SFAF outreach workers, Jackson scored himself a job passing out syringes, condoms and racy but informational zines targeting gay speed users. It was during those years that Jackson taught himself to use “responsibly” — to set schedules for himself and to put certain obligations over the pressing desire to get high.

It was also during this period that he became versed in the philosophy of harm reduction.

Coined in the 1980s by British public health specialists working to control the spread of HIV/AIDS among intravenous drug users, the term “harm reduction” has since become shorthand for any policy that puts the welfare of someone who engages in victimless illegal behavior over the need to penalize that behavior. In drug policy, this might mean establishing needle exchanges or simply ensuring that users can access health and other social services.

But when Jackson started to seriously consider forming a users’ union in late 2007, it was with one considerably more radical initiative in mind.

That year, the San Francisco Public Health Department sponsored a symposium on supervised (or, safe) injection sites — facilities where intravenous drug users are invited to shoot up under the watch of medically trained staff. While such services have existed for decades in the Netherlands, Germany and Switzerland, the symposium was largely inspired by the success story of Vancouver-based “Insite,” the first legal SIS to open in North America.

Looking at the available data, it’s hard to argue that Insite is anything but a success story. Since opening its doors in 2003, the project has been credited by dozens of studies with reducing needle sharing and the transmission of bloodborne disease, while acting as a one-stop-shop of other health, rehab and other social services, for an otherwise difficult-to-reach demographic. Maybe most importantly, of the nearly 500 overdoses that occurred at Insite during its first year of operation, thanks to the two trained nurses on staff, none resulted in death.

Jackson calls that symposium the union’s “catalyst moment.” Before attending the event, Jackson had watched a documentary about the role the Vancouver Area Network of Drug Users had played in pushing their city’s government towards its uniquely progressive stance on drug policy. Now, with a specific goal in mind, Jackson turned a colleague, Ned Howey, who in turn recruited a local housing activist named Alexandra Goldman. In 2008, the three started holding meetings. The following year, the group applied to the Drug Policy Alliance (DPA) for seed money.

Three grant cycles later, both Howey and Goldman have left their leadership roles, but Jackson is as determined as ever to achieve his “big goal.” This summer the union hosted a design exhibit, inviting a handful of California designers to create their own model sites, based on the preferences of union members.

Behind the scenes, SFDUU has teamed up with the DPA to organize a broader pro-SIS coalition. Members include the San Francisco AIDS foundation and the Harm Reduction Coalition.

Beyond these direct (and predictable) supporters, Jackson points to a growing number of city politicos who have publically declare their support for an injection site. Counted among that group include the current district attorney, George Gascón, and John Avalos, the de facto leader of the city’s progressive bloc on the Board of Supervisors. While Mayor Ed Lee is not on board, his official legal council, City Attorney Dennis Herrera, announced his own personal support for an injection site last year, prior to taking his job. According to Jackson, a staff member from the City Attorney’s showed up to observe a recent meeting.

Political momentum is slowly shifting toward the pro-SIS position, says Laura Thomas, deputy director of the Drug Policy Alliance in California — and that’s hardly surprising.

A facility in San Francisco should appeal to everyone, she says, “whatever your goal is.”

“If you’re you looking for better medical outcomes, if you don’t want to see drug use on the sidewalks, if you want to save money in your community, if you want to end drug use itself — supervised injection facilities address all of those things,” she says.

On these points, Thomas is supported by a recent report published this June by the Global Commission on Drug Policy. A coalition of reform-minded luminaries (among them, former presidents of Mexico, Columbia, Brazil, Chile, and Switzerland), the GCDP report credited supervised injection sites in Switzerland and British Columbia with dramatically reducing the spread of HIV in both jurisdictions. The report goes on to point out that SIS “have proven to increase the use of addiction treatment and to reduce rates of drug injecting.”

In the face of such evidence, the report argues that a government’s refusal to adopt drug policy oriented around a harm-reduction philosophy (which might incorporate supervised injection facilities, along with non-restrictive needle exchanges, low-barrier medical services for users, heroin or opiate maintenance programs, and a law enforcement approach that stops targeting users) is, in a word, “criminal.”

But good policies don’t always make for good politics. Even if everyone in the city were in abstract agreement over the wisdom of SIS, there’s a big difference between supporting a policy proposal and inviting a legally sanctioned shooting gallery into your neighborhood.

That’s the argument made by Alice Gleghorn, San Francisco’s alcohol and drug administrator, who wrote in an emailed response: 

“In a densely populated city like San Francisco with rapidly expanding tech business and high end housing, and gentrification of previously ‘less desirable’ areas, there are no neighborhoods that would welcome this type of facility.”

In any event, she continues, the city has been formally on board with the harm reduction philosophy since 2000. Among others initiatives, the Department of Public Health offers or funds one of the largest needle exchange programs in the country, numerous opiate replacement therapy programs, and aggressive overdose prevention efforts. Harm reduction isn’t the issue; cost-benefit is. An injection site, says Gleghorn, would not necessarily do a better job than those programs already in place, but would certainly be more expensive to administer — and, inevitably, to defend in court.

On this latter issue, both Isaac Jackson and Laura Thomas concede that the biggest challenge in setting up a site is the legal one. No matter how compelling the public health argument, federal law is unambiguous on this issue: the so-called “Crack House statutes” make it illegal for an owner or renter of a piece of property to knowingly allow or enable the use of narcotics on that property.

In response to this law, Thomas poses the hypothetical argument that the 1986 law was never intended to get in the way of addressing a public health issue, and therefore does not apply. But she admits the legal reasoning still needs to be honed further. Alternatively, if recent history serves as a guide, the city could simply declare a public health emergency and defy the higher statute, just as San Francisco’s Mayor Frank Jordan did in establishing needle exchange programs in 1993, contrary to California law. But not with this mayor.

As progress on the SIS campaign grinds slowly forward, the union itself continues to expand. With that expansion, come certain complications. Today the union has some 30 “hardcore members” (there are more names on the membership list, Jackson says, but not everyone shows up to the meetings —“drug users’ lives can be complicated”) and among many of these new members, Jackson concedes that “some don’t agree with the site as a goal.”

As a result, he says the union is broadening its mission.

Last spring, the union organized its first non-SIS related campaign. Under the management of new member, Brian Schullz, who recently earned his masters in social work from the University of California, the union put together a pamphlet that aims to instruct staff at local hospitals how to best interact with drug users.

But for some in the union, like Gary West, campaigns of any kind may be beside the point. The union’s community coordinator, it is West’s job to “work the street” and swell the ranks of the union. It’s a job that suits him, he says. Up until only a few months ago, West had been homeless for nearly a decade.  

“I don’t have a Ph.D. like all the others got,” he says. “But I’m living proof that not all people who use drugs are idiots.”

West says he joined the union in 2007 after moving to San Francisco from Michigan’s upper peninsula. In the once thriving iron town of Ishpeming, he recalls being unable to hold down a job and losing the support of many friends and family members — all, he insists, because he uses marijuana. In San Francisco, thanks to the union and thanks to the city’s laxer attitude about so-called soft drugs, he says he’s finally moved into a supportive housing unit. Though his position at the union pays him only a meager salary, it is the first full-time job he’s had in a long time.

“I grew up totally straightlaced, but I guess I had to become a drug user to become a success,” he jokes. “This is most stable I’ve been in at least eight years.”

When asked about the supervised injection site campaign — something meant to benefit heroin and injectable cocaine users, primarily — he counts himself a supporter, but lacks Jackson’s enthusiasm and single-minded determination. Jackson may have launched the union with a specific policy in mind, but West joined for a very different reason.

“I imagine this being something like the Teamsters,” he explains.

According to West, the Teamsters of Drug Users would pool their funds for collective health treatment and legal protection. He describes one member of the union, a 68-year-old woman and heroin addict, who was recently arrested for possession. If the union had the resources, he says, “this place could be there for her.”

But in the absence of financial support, West says that SFDUU’s most important function is social. The weekly meetings are more than opportunities to mull policy proposals and organize outreach efforts. They also provide something that so many disadvantaged users and addicts most sorely lack — a community.

“I see this union as just that — a union!” he says, looking around the office. “These people are all I’ve got.”


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