Four years ago, Anastasia Ryan argued in an openDemocracy article that supporting sex workers’ rights shouldn’t feel like a stretch for the drug reform movement. She stated that there were many obvious overlaps between the movement for the decriminalisation of sex work and the movement for drug reform, and asked us to consider “why a shared platform of advocacy for rights, recognition and respect has not emerged within the landscape of UK activism.”
While we take seriously Ryan’s call to broaden solidarity and join together in struggle, we think she missed something important. The parallel to the movement for sex workers’ rights isn’t the “drug reform movement” – it is the drug user movement. It is here that real questions arise of bodily autonomy and medicalised dehumanisation caused by public health strategies seeking to win short-term policy gains.
Those strategies hinge on conveying us – drug users and sex workers alike – as vectors of disease and public health threats, which are used to justify the criminalisation of survival activities. The movement for drug policy reform may touch on some of these same points, but the key difference here is that their main advocates aren’t organising while navigating related risks in real time.
This distinction is important. As drug users, we know that mainstream drug treatment spaces also function as sites of surveillance. They bring us within the reach of state actors who have the power to imprison us in jails or hospitals, or to take away our children. The drug reform movement is at times complicit in the violence we experience, and it often colludes with the treatment sector to set demands.
In 2024, we formed the drug user union RATS (Radical Acts to Survive), based in London, as a means of resisting this violence. We do not claim to represent all drug users, and we recognise that drug using communities are not monolithic. Our founders were drug users who were also sex workers, queer and trans people, and migrants – all people who experience heightened risks of criminalisation and surveillance, and the harms that those phenomena bring.
We were already in a drug-deaths crisis at the time of Ryan’s article, but in the past four years we have seen drug death numbers continue to rise. The drug market is growing increasingly dangerous, with novel synthetic opioids known as nitazenes claiming countless lives up and down the UK. Now is the time to strengthen solidarity across our movements – we’re all going to need it if we’re to survive.
Infantilised and excluded
There are several ways in which the drug reform movement may appear progressive, but in fact places drug users at further risk of harm. One of those is the movement’s long-standing support for drug diversion programmes, which offer engagement with treatment services as an alternative to arrest or incarceration. These programmes prioritise the material interests of treatment organisations at our expense, with service users often coerced into engaging with programmes – a misguided response that can cost drug users their lives later down the line. Organisations offering treatment services win additional financial resources by being included within criminal justice budgets, while we are left with policies that entrench prohibitionist logics that see us as either sick or criminal.
The message we receive as drug users is that we are unknowledgeable about a phenomenon which is killing us en masse
Service users also face racial disparities, with studies indicating that people of colour are routinely denied access to alternatives to the criminal justice system – reinforcing the message that only some of us deserve support.
Furthermore, the drug reform movement is at times willing to make concessions to achieve their short-term goals. In practice this excludes us as drug users from fully partaking in the movement. Police officers are often welcomed into drug reform spaces as important advocates, while organisations such as our own are left out of consultation.
Even with a well-meaning project – such as in the 2023 public campaign ‘Stayin’ Alive’, authored by a historic harm reduction organisation and some of the country’s largest drug treatment agencies – the message we receive as drug users is that we are unknowledgeable about a phenomenon which is killing us en masse.
This particular campaign was produced ‘for us’ as drug users, to warn us about the increasing presence of nitazene in heroin and cocaine, and associated risks of overdose. But it totally misses the point. First, it disregards the fact that some of us intentionally use nitazenes. Second, it seems to suggest that drug users are dying in such high numbers due to individual self-esteem issues, rather than because they’ve been made vulnerable through structural violence. This is especially conveyed through the repeated printing of the infantilising, patronising message, “you are important”.
A campaign like this would be infinitely more helpful if it prioritised practical information, such as notice of specific drug supplies that have been impacted by contamination. But as it is, this kind of public messaging fundamentally destroys trust between drug users and the treatment sector by regurgitating infantilising assumptions that are used to justify the dehumanising treatment we are subjected to.
Drug services are too often spaces of violence, not support. At RATS, we support cross collaboration, but only with people who are truly pursuing drug users’ broader liberation – not those using us to further their own material or political agendas. We refuse to allow our experiences of harm and our community’s deaths to be converted into their profits any longer. Rather than struggle individually for scraps in that system, we have come together to pool what we have and begin to organise towards a better future.
Building alternative solidarities
Both criminalisation and the sale of unsafe drugs result in sudden and unexpected harm and death in our spaces. We are also exposed to myriad other risks simply because we are known to be drug users. These factors make sustainable organising a challenge, and we benefit from allies and spaces who provide us with cover so we can achieve our aims.
One of our first projects at RATS was to launch a coalition to fight for a safe drug consumption space in London. The London Harm Reduction Collective (LHRC), a collective of 18 organisations, brings us together with allies and provides us with a space in which to stay alive. Members work on drug policy-related matters and a range of social justice issues that are crucial for communities impacted by drug-related harm. These include houselessness, decarceration (being released from prison), racial justice, and labour and sex workers’ rights organising.
Communities like LHRC are vanishingly rare. While many social justice campaigners recognise the importance of an intersectional approach to broader struggle, most fail to materially commit to that need in their day-to-day work.
As drug users, many movements regard us as too ‘risky’ to include. Even in the sex workers’ rights movement, we’ve seen that drug-using sex workers cannot talk about their experiences in full without compounding judgement against the broader community of sex workers. In the drug user and sex workers’ rights worlds, compounding stigma, risk and resource scarcity reinforce the instinct to stay siloed in our work as a means of self-preservation.
We are stronger together and we are all carrying risks that can combine when we come together, producing greater vulnerability for all
To counter this, we should co-produce and adopt organisational red lines that prevent any of us from being expendable or neglected in each other’s movements. Even better, we should intentionally cross boundaries and develop deeper understandings of one another’s struggles.
There have not been many intentional attempts towards this at RATS, but, on multiple occasions, it has simply happened. One member reflected on a day earlier this year when some of these siloes unexpectedly broke down:
The tables we used at our event demonstrating an Overdose Prevention Site (OPS) in June were borrowed from the Sex Workers Advocacy and Resistance Movement (SWARM), thanks to the last-minute arrangements of a joint member of RATS and SWARM. The next time I saw those tables was about a month later, when they were holding two massive bags of marinated raw chicken chunks. I had been directed to join a group of people in skewering these meat chunks as part of the monthly Tower Hamlets Community Meal at Pelican House. These meals are a response to the rise in fascism, nurturing community links and bonds as a way to enable antifascist resistance.
Only a few days ago, the same grill master of that particular meal turned out to be volunteering as the Arabic interpreter for a workshop that Hackney Anti-Raids and Migrants Organise were running with some local refugees.
In a last testament to the smallness of our organising world and to bring this story full circle, after the workshop I had to rush over to an unrelated Palestine solidarity meeting coincidentally held at The People's Letters, a cooperative bookshop with deep ties to the sex worker movement. This shop had kindly stored LHRC's demo OPS materials after we held an event there last weekend, which I was able to pick up and take back to our Harm Reduction Hub at the end of the day.
The risks of combined action
While a lovely image, we are also wary of narratives which make solidarity seem so simple and serendipitous. Two things can be true: we are stronger together and we are all carrying risks that can combine when we come together, producing greater vulnerability for all.
The answer is never to refuse solidarity up front, but to manage it. We must attend to the specifics and ask: who is involved, what sorts of risks does their involvement expose us to, and what is at stake in this moment? This must remain a specific and materialist assessment.
A group seeking to partner with us is not risky because we believe them to have ‘poor moral character’, as is often deemed the case with drug users for instance. However, working with a group comprised of people who are experiencing heightened criminalisation might mean that there is greater probability that they are more likely to be surveilled. If we involve ourselves with them, we risk exposing ourselves to heightened surveillance as well. This does not mean we do not support one another. But it does mean we need to construct thoughtful risk mitigation plans.
For instance, after an Overdose Prevention Site demonstration earlier this summer, one member of LHRC came under scrutiny for their organisation’s involvement. They feared they would lose a contract to provide a community health programme as a result. This, we knew, would endanger lives, and was a previously unconsidered risk which we took very seriously.
Simultaneously, we knew that such scrutiny meant we were probably doing something right. Recalibration was necessary, but we didn’t want to panic and throw the baby out with the bathwater. We thought hard about the current composition of LHRC and who within it could afford to hold certain types of risks going forward.
In the end, we provided support to this partner to de-escalate the concern with the relevant stakeholder and accounted for the feedback from their meeting in the planning of the next action, to support repairing their relationship. This allowed for continued solidarity, but along lines which didn’t endanger either our partner’s or our projects.
Never enough support
As always, no matter how much brilliance is in the room, capacity remains a challenge. One issue plaguing both RATS and LHRC is that we tend to recruit reliable members from other movements, in large part because we do not have a robust process for bringing someone from a place of understanding or concern to a place of action.
To give an example, one RATS member encountered someone at a festival who strongly supported the creation of an Overdose Prevention Site in London. He was keen to talk about his support for the project and was willing to display that support on a petition. But he was unwilling to work to create such a site himself. The question of how we move people from interest to action is something we (like so many other movements) must improve on, and fast.
Despite the political climate being one which affords us less and less humanity, the Greens have not succumbed to vilifying us for a few extra votes
We are better at finding strange bedfellows to bring people out when it really counts. For instance, as one can imagine, RATS members are generally sceptical of mainstream party politics. You don’t have to be a drug user to see how both Labour and the Conservatives have done their fair share to screw us over. Yet LHRC’s work unavoidably includes engaging in conversations with mainstream politicians.
We originally thought that more establishment-minded members of the collective would carry out that work out. Instead, it has been us. Within the LHRC, RATS members are now the closest connected to politicians within the Green party, who reliably come to our support when called upon. Despite the political climate being one which affords us less and less humanity – particularly those of us pushed into using in public, into injecting, and into committing various forms of ‘anti-social behaviour’ – the Greens have not succumbed to vilifying us for a few extra votes.
Solidarity, step by step
We are still in the process of learning how we all fit together, support one another, and grow our membership and our impact. Within RATS and LHRC, we have learned to be generous and to allow capacity to fluctuate amongst us, but to also call upon others to step up to maintain overall momentum while allowing different members their turns for rest.
We are realistic about the fact that things are getting worse for our communities, and of course getting worse faster for some. But in staying true to our name, we seek to make opportunities for ourselves in grim conditions and chaos. We take great inspiration from the Drug User Liberation Front in Vancouver, who in 2022 operated a pioneering community-led safe supply programme in the wake of devastation from their toxic drug supply crisis.
Over a 14-month period, the programme provided low-cost, quality-controlled illicit substances to individuals at risk of fatal overdose in Vancouver. This project was the first recognised model of its kind, operating through an explicitly community-led and not for profit model.
The Drug User Liberation Front not only kept their local community alive through that programme, but changed the way the whole world now talks about harm reduction, by opening up space for non-medicalised safe supply to be recognised as a legitimate intervention. They didn’t need to think about scalability, voters, or grant application cycles to do that. They weren’t playing the drug reform movement’s games. They were doing real drug user movement work. And it saved lives.
We have to stay agile in navigating rollbacks of our rights, but also keep in our hearts and minds that we are still stronger together, our best chances might crop up in the direst of circumstances, and we can win if we strike when least expected. And let’s be real: we are always the ones they least expect.
Explore the series
- Solidarity beyond silos is our best bet for fighting exploitation
Ella Cockbain, Joel Quirk, Cameron Thibos and Melissa Pawson - We fight for sex workers’ rights. This is what solidarity looks like
Chanelle Gallant and Elene Lam - How Wages for Housework sparked an international solidarity movement
Jake Hall - ‘An indictment of the trade union movement’: Why no one is organising seasonal workers
Emiliano Mellino - How one case made unlikely allies of police and sex workers
Alex Andrews - As drug users, solidarity isn’t just important – it’s survival
RATS (Radical Acts to Survive) - Why can't anti-trafficking be more radical?
Sophie Otiende and Chris Ash - A bizarre new alliance is coming after sexual freedoms. We’re ready
Maya Linstrum-Newman - Clover in South Africa: where workers’ rights met Palestine solidarity
Maya Bhardwaj
RATS – Radical Acts to Survive, is a drug user union resisting the violence and neglect of the War on Drugs and organising for harm reduction and collective liberation. RATS was set up in 2024 largely by queer and trans drug users, many with lived and living experience of sex work, in the spirit of ‘solidarity, not charity’.
