Q: What is the Urban Survivors Union?

The Urban Survivor’s Union is a grassroots coalition of drug users (both former and active) dedicated to insuring respect, dignity and social justice for our community. We contest the dominant culture’s misguided attitudes and biases about drug use and drug users.  USU stands for a new direction by centering our programs on putting the drug user first and foremost.We believe that efforts to advance our agenda must be guided by democratic principles, and a dedication to diversity.  All USU activities are directed and carried out by drug users (former and active) in order to insure the integrity of our mission and that of the drug user’s movement.

Q: Where do you currently have chapters?

A: We have 4 official chapters – in Charlotte and Greensboro/Piedmont, North Carolina; San Francisco, California and Seattle, Washington. We are always looking to add more – get in touch and we’ll do our best to give you any support we can.

Q: Are there other drug user unions?

A: Several. Drug User Unions exist in at least 20 countries, world wide. In addition to direct USU affiliates, other drug user unions in the US include:

Q: What is Harm Reduction?

Our friends at Harm Reduction Coalition defines Harm Reduction as:

A set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

Harm reduction incorporates a spectrum of strategies from safer use, to managed use to abstinence to meet drug users “where they’re at,” addressing conditions of use along with the use itself. Because harm reduction demands that interventions and policies designed to serve drug users reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction.

HRC considers the following principles central to harm reduction practice.

  • Accepts, for better and or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them.
  • Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others.
  • Establishes quality of individual and community life and well-being–not necessarily cessation of all drug use–as the criteria for successful interventions and policies.
  • Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live in order to assist them in reducing attendant harm.
  • Ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them.
  • Affirms drugs users themselves as the primary agents of reducing the harms of their drug use, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use.
  • Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.
  • Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.

Q: What are Syringe Exchange Programs (SEPs)?

SEPs collect used and potentially contaminated syringes from people who inject drugs and exchange them for sterile syringes in order to prevent HIV, hepatitis C, and needle-stick injury. Most SEPs also offer a variety of social services, including access to housing progams, career services and addiction treatment.

Q: Doesn’t that encourage drug use?

No. Decades of scientific evidence have concluded that SEPs DO NOT cause any increase in drug use*. In fact, many studies have demonstrated that SEPs decrease drug use by effectively connecting people who use drugs to treatment.

*Institute of Medicine. Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries. An Assessment of the Evidence. Washington, D.C.: National Academies Press; 2006.

Q: How many states have SEPs?

A: Twenty states in the U.S. explicitly authorize SEPs, including Kentucky, Indiana and Nebraska. Georgia and West Virginia also have SEPs in some major cities.

Q: How do SEPs decrease crime?

A: SEPs decrease crime by connecting participants to drug treatment, housing, food pantries and other social services. In one study, Baltimore neighborhoods with syringe exchange programs experienced an 11% decrease in crime compared to those without syringe exchange, which saw an 8% increase in criminal activity.*

*Center for Innovative Public Policies. Needle Exchange Programs: Is Baltimore a Bust? Tamarac, Fl.: CIPP; April 2001.

A: How do SEPs save taxpayer money?

The lifetime cost of treating an HIV-positive person is estimated to be between $385,200 and $618,900[1], while hepatitis C costs $100,000-$500,000 to treat[2]. Since most people who inject drugs are uninsured or reliant on programs such as Medicaid, taxpayers bear most of this cost. With individual needles and syringes costing less than 50 cents, it is far cheaper to prevent a new case of HIV than to assume many years of treatment costs. According to a recent analysis, every dollar spent on SEPs would save at least an estimated three dollars in treatment costs averted.

  1. Schackman, B.R., Gebo, K.A., & Walensky, R.P. et al. (November 2006). The lifetime cost of current Human Immunodeficiency Virus care in the United States. Medical Care, 44(11), 990-997.
  2. Mizuno, Y. et al. (2006). Correlates of health care utilization among HIV-seropositive injection drug users. AIDS Care,18(5):417-25.

Q: How do SEPs decrease HIV, hepatitis C and hepatitis B among injection drug users?

A: SEPs decrease the transmission of bloodborne disease by decreasing the likelihood that people who inject drugs will share syringes and by collecting used syringes from the community and properly disposing of them. Studies show that SEPs decrease hepatitis C transmission among people who inject drugs by as much as 50%. * HIV infection rates have decreased by as much as 80% in areas with SEPs.

*Des Jarlais, D.C., Arasteh, K., & Friedman, S. R. (2011). HIV among drug users at Beth Israel Medical Center, New York City, the first 25 years. Substance Use & Misuse, 46(2-3), 131-139.

Q: Why a Union? 

A: In many other sectors of society, unions exist to help people have strength in numbers, unity of purpose and protection from forces that may seem otherwise insurmountable. Union’s provide dignity, power and protections for it’s members that no single member could provide for themselves. While unions have been under fire in recent years for several politically motivated reasons, it is still clear that many of the major accomplishments of labor forces in the United States and throughout the world have been achieved only because of the collective power that a union can provide.

As it stands, active drug users are among the most ill considered members of society, especially in the eyes of law enforcement. Because of the disastrous and ill considered War on Drugs in the United States, every day drug users are put in prisons for offenses ranging from major to increasingly and arbitrarily minor ones.

Elsewhere, in the Philippines, their dictatorial President Rodrigo Duterte has undergone his own War on Drugs, with thousands of drug users murdered ‘like animals’ in the streets and wherein the President has essentially deputized the jobless in his country to murder their own people in cold blood for the crime of being a drug user. This story may seem remote and foreign to many in the United States, and yet, as seen by President Trump’s congratulatory phone call, in which he specifically praised the War on Drugs and invited Duterte to the White House, these actions have been shown to not be contrary to our federal government’s views on the fundamental human rights of drug users. (1, 2, 3)

A drug users union, then, exists for many purposes. In addition to such ideals as empowering these citizens to have a voice in their own defense, however, it also empowers them to make their own choices as to what changes ought to be made. In Sweden, at one of the world’s earliest drug user’s unions, one of the key leaders made a major platform the want to eliminate terms like ‘junkie’ and ‘abuser’ from common use when speaking of drug users. (4) The San Francisco based ‘SF Drug User’s Union’ has within their principles finding public policy accommodations to create safe use areas and to protect users from harmful chemicals and materials being laced into drugs. (5)

At USU, like with our other friends around the country and across the globe who support and belong to drug user unions, we subscribe to a simple motto: ‘nothing about us, without us’. Drug users need to have an active role in deciding their own futures and the laws, policies and decisions made about their lives. Drug user unions, such as USU, then, are one of the major ways in which users can come together to put their voices into these conversations – amplified by the voices of their brothers and sisters in arms.

  1. https://www.usatoday.com/story/news/world/2017/01/06/rodrigo-duterte-philippines-drug-war/96062066/
  2. https://www.nytimes.com/interactive/2016/12/07/world/asia/rodrigo-duterte-philippines-drugs-killings.html?_r=0
  3. https://theintercept.com/2017/05/23/trump-called-rodrigo-duterte-to-congratulate-him-on-his-murderous-drug-war-you-are-doing-an-amazing-job/
  4. https://www.vice.com/sv/article/all-drug-users-arent-junkies
  5. http://www.sfdrugusersunion.com/#!purpose-&-principles

Q: How do I create an Urban Survivor’s League chapter in my area?

(coming soon)

Q: What services do you/should I provide?

A: To date, all of our chapters have 4 major components: Leadership Development/ Training, Community Organizing/Grassroots Campaigns, Civic Engagement and Direct Services for people who use drugs.

In addition, we have a series of trainings that we use to teach effective leadership development. We accomplish leadership development through local and national trainings and retreats.

If you are looking to create your own chapter, many of those in the leadership of current chapters will be glad to assist you with learning materials and strategies that have worked for their chapters, in order for you to better serve your members. Remember that one of the core properties of a union is solidarity. While it is also up to you to do the needed work on your end, those who are able will always do their best to give you support when asked for or needed.

Q: What are some of the methods you recommend for ‘safe drug use’?

A: There are many resources online to find safer drug use methods. There are constants, such as using clean needles if injecting but other methods take a little more explanation.

One place to find good resources is:




We should have more information forthcoming in this section but both have great information to keep you safe, including the Straight Dope Education series that provides information for drug users by drug users.

Q: What does ‘Any Positive Change’ mean? Why not encourage abstinence?

A: We encourage abstinence for those who are seeking abstinence. No one is likely to begrudge someone who wishes to stop using and seeks help to do so. However, at the same time, that choice is one that many do not wish to make or do not feel able to fulfill at their current stage of their lives. For those people, we are steadfast in valuing their continued improvements, even if they are not actively striving to stop their use.

Examples of positive change can mean such things as moving from injecting to snorting drugs. While snorting drugs is still not seen as the healthiest choice, nonetheless, it is an improvement, health-wise, from injection. Perhaps instead of that change, the person is instead seeking out our needle exchange programs? Yet again, this change is a positive one that shows thoughtful consideration of the health concerns that may come along with drug use. Neither change leads directly to ending the drug use and yet both, we believe, should be celebrated as positive developments.

Positive changes, in fact, may be separate from the drug use entirely. Any change that is made in the life of an at risk drug user that drives them toward more positive outcomes and a reduction of harm can be seen be part of these positive results. The positive change method is more likely to include the considered and proactive goals made by the person who is undertaking the change, rather than being dictated by others. We believe that the users themselves have the most knowledge over their own needs and that by trusting and empowering these people we are likely to see better results. Someone who does not wish to stop is unlikely to stop, however, someone wishing to make positive changes in their life and putting themselves in the position to do so often will be able to take steps to make that goal a reality.

Q: Why are you involved with Sex Work/Race and Gender Issues etc.?

A: People of color, the LGBTQIA community and so many other outsider groups have been marginalized in society much the same as drug users. Many of the issues facing them also face our community and many people of color, gay, lesbian, transgender and queer people also use drugs. It is common knowledge that the War on Drugs has disproportionately targeted black and brown people. This is not to say that white drug users are not themselves marginalized but we stand in solidarity with the struggles of people of color. If we wish to combat the disastrous War on Drugs, there are few better allies to have.

Likewise, the LGBTQIA (lesbian, gay, bi-sexual, transgender, queer, intersex and asexual) community has faced major obstacles to their own rights and freedoms, as well. A staggering amount of queer and trans youth become homeless each year, at percentages far higher than any other group. While notable gains have been made in respect to such concepts as gay marriage and transgender visibility, the work of these groups to be truly accepted in society is far from done.

As for sex work, there exists few more intersected communities with our own than theirs. Not only is there a notable intersection of users and sex workers but their goals, in many ways, mirror our own. They look to escape marginalization, to push for legalization and to fight stigma about their lives and their work.

In these and many other cases, we at the Urban Survivor’s Union stand in solidarity with those struggling for their rights and dignity. We believe that Black Lives Matter, that no person is illegal, that persons should be empowered to make their own choices about how they identify and who they love and that sex work should be decriminalized and that those working in fields related to it should not be scrutinized for their choices. We hope this solidarity is met in kind, however it is given freely and with love and respect, regardless.

Q: What should I know about Sex Work?

A: From our friends at Sex Workers Outreach Project (www.swopusa.org):

What is Sex Work?

Sex work is any type of labor where the explicit goal is to produce a sexual or erotic response in the client. Sex work includes prostitution, but it also includes a bunch of other things like erotic dancing, pro-dom/pro-sub work, webcam work, sensual massage, adult film, phone sex,  being a sugar baby, etc.

Media Myths on Prostitution

Most media coverage on the sex trade focuses on street prostitution, youth prostitution, and trafficking. Incidentally, a substantial portion of the facts and figures referenced are misconstrued or based on studies of particularly vulnerable populations of sex workers globally. For example:

Myth: 300,000 children are trafficked in the U.S. each year.
Fact: This statistic, collected by the Center for Missing and Exploited Children in 2001, is the high-estimate of all male and female children not living at home, who are viewed as vulnerable to exploitation of any kind.

Myth: The average adolescent prostitute is a female who is virtually a slave to a pimp.
Fact: According to a study of New York adolescents in the sex trade, nearly half of adolescents are male or transgender. Only 8% were coerced into entering the sex industry.

Myth: 68 percent of sex workers report post-traumatic stress disorder on the same level as those who served in military combat.
Fact: This statistic refers to individuals in nine countries who were contacted via social service organizations, and the methodology behind this study has never been released to the public. The psychological affects of prostitution are remarkably variable depending on the sector, country, and individual worker.

Myth: The average age of entry is 13 or 14.
Fact: This figure references informal knowledge of social workers working with adolescents and ‘survivor’ organizations. Indoor sex workers, who comprise over 80% of the industry, are significantly less likely to enter as adolescents.

Myth: The sex trade is inherently harmful.

Fact: Violence, mental and physical health risks, and marginalization are not inherent to the sex trade, any more than they are inherent to sexual identity or orientation. Stigma and criminalization are the root causes of harms directly related to sex work. These harms are compounded by intersecting oppression for large numbers of sex workers.

Myth: Prostitution is violence against women (or gang rape, or slavery)
Fact: Although violence, particularly against street workers, is common, most violence is perpetrated by non-clients, individuals who pose as clients, law enforcement officials, and a very small proportion of clients. The same goes for clients of indoor workers.  While news reports frequently vilify clients of sex workers, even abolitionist organizations recognize diversity in what motivates clients to solicit prostitutes.

In other words, the overwhelming majority of sex worker clients do not perpetrate violence against sex workers. And the central cause of violence is institutional alienation of sex workers from law enforcement protection and a justice system that leads most sex workers to distrust and fear law enforcement officials. Violent individuals do not fear repercussions and prey on sex workers in particular. Most interactions between sex workers and law enforcement involve arrest, and law enforcement and judicial system officials frequently ignore or doubt reports by sex workers. So sex workers either do not report sexual and physical assault to law enforcement or law enforcement officials do not sufficiently respond to complaints, and individuals remain free and continue to perpetrate crimes against sex workers.

Q: What is a ‘Federated System’?

Q: Where can I get more information?

(coming soon)