Almost a decade after beginning his recovery from heroin addiction, Brett Bramble is undertaking a new challenge. Accompanied by his dog Domino and a small group of fellow activists, Bramble set off on foot in mid-January on a six-month-long, 2,400-mile journey from Florida to Maine. His walk seeks to raise visibility, foster conversations and find solutions to the skyrocketing rates of opioid addiction and overdose that have become a nationwide public health emergency in recent years, killing over 140 Americans a day.
“For me, it all started when my sister died from a heroin overdose [nearly four years ago],” Bramble said. “She only started using in the last three months of her life. That’s all it took.”
Bramble’s walk is one piece within a broader “recovery activist” movement that has been gaining momentum around the nation over the past decade. Led by people living in recovery or still facing addiction — along with family members whose loved ones died from overdose — the movement is becoming increasingly organized by targeting a variety of actors, drawing in key stakeholders and incorporating a range of tactics to pressure for change. Activists are becoming more strategic in their actions — staging rallies and die-ins across the country, drafting petitions and launching lawsuits.
One such activist is Nan Goldin, a 64-year-old photographer in recovery from addiction to OxyContin. In January, Goldin and her group, Prescription Addiction Intervention Now, or PAIN, launched a petition targeting Purdue Pharma and its owners, the multi-billion dollar Sackler family. With nearly 25,000 signatures gathered so far, they are demanding that Purdue fund recovery services, opioid addiction education and public dispensers of Narcan, the emergency medicine dispensed to counter a drug overdose.
Goldin’s petition and Bramble’s walk are evidence that the recovery movement is shifting from raising awareness of addiction to pressuring for immediate, tangible action that saves lives. According to Dean LeMire, a New Hampshire-based activist in recovery, “The movement exists in waves.” The first wave involves standing up, identifying oneself as someone living in recovery, and thereby showing people that recovery is possible. The second wave, he explained, is telling elected officials: “We need dollars for this stuff.” That means educating the general public about recovery services and building the political will to allocate adequate funding to prevention and recovery.
This “second wave” shift is creating an increasingly mobilized, politically-active base of recovery advocates and activists. Their work has included educating and registering voters — particularly people who are facing addiction or are in recovery — as well as pressuring for legislative change, funding for recovery services and corporate accountability. While such efforts have led to the creation of initiatives like the 2016 Comprehensive Addiction and Recovery Act, or CARA — which funds prevention, treatment and recovery initiatives nationally — much more is needed to address the scale of the growing epidemic.
At the same time, the movement’s so-called “first wave” efforts — reducing prejudice and increasing awareness of addiction — is far from complete. Ryan Hampton, a prominent voice in the recovery movement, compared the stigma surrounding addiction to the social ostracism people faced during the HIV/AIDS epidemic in the 1980s. Much like back then, “the shame keeps people silent,” he explained. “People are dying now from overdose because they’re mortified to come out and identify as a drug user.”
Hampton said his life changed when he watched the 2013 film “The Anonymous People,” a documentary featuring the stories of people living in long-term recovery from drugs and alcohol. Having confronted his own addiction to heroin, Hampton started the Voices Project in 2017, which encourages people to “come out” and share their recovery stories, using social media as a platform for people to connect with and support one another.
Despite steps towards destigmatizing addiction, the movement faces a somber uphill battle, as its leading participants must also deal with the ongoing challenges of long-term recovery. “For everybody who is in recovery, it is a daily fight to [survive],” Hampton said. Still, in many ways, that struggle is aided by channeling grief into action. That’s one reason Hampton was able to register 100 new “recovery voters” in just three weeks time by simply saying: “Are you sick of your friends dying? Well here’s something you can do.”
Tactics and visibility
So far, some of the movement’s major actions have promoted visibility and solidarity among people in recovery, often through coalitions with other campaigns. Since 2014, Families of Addicts has brought together thousands of people for the annual “Rally 4 Recovery” in Dayton, Ohio, which includes a 5k run, a raffle and a balloon launch, as well as resource tables for people facing addiction.
On the national level, activists came together in October 2015 with a coalition of over 450 organizations from around the country for the UNITE to Face Addiction rally and concert on the National Mall in Washington, D.C. The rally was hosted by Facing Addiction, a national organization that advocates for the over 85 million Americans affected by addiction around the country.
Some of these actions, which aim to destigmatize addiction, have taken place on social media, where Hampton plays a central role in mobilizing numbers to respond quickly when a situation arises. For example, when Arizona House Majority Leader Kelly Townsend posted offensive comments about drug users on Facebook in 2016, Hampton quickly shared her contact information on his page, which had around 40,000 followers at the time. According to Hampton, she was flooded with 1,500 phone calls in just three hours. But rather than shame her or call her names, Hampton recalled people saying things like, “‘Hey, I just want you to know I’m in recovery, here’s who I am today.’ Or, ‘My kid died of an overdose. He was a good kid. Let me tell you about him.’”
These actions played an important role in humanizing the issue and gaining a spotlight to tell the personal stories behind recovery and addiction. “We saw that storytelling — kicking down those closet doors — could have a massive impact,” Hampton said.
Meanwhile, other actions have fallen more squarely under the “second wave” category of mobilizing political pressure. In 2015, activists with the Weed for Warriors project dumped pill bottles and syringes in front of the White House lawn to drawn attention to the overprescription of opioid drugs to wounded veterans. Then, last May, protesters held a “die-in” at the New Hampshire State House when U.S. Health and Human Services Secretary Tom Price visited the capitol.
As with the reaction to Townsend’s insensitive remarks, many of these direct actions occur through mobilization over social media. When one woman shopping at the cosmetic store Sephora discovered a line of makeup products called “Druggie,” she posted about it on social media, creating an instant internet sensation. The incident quickly went viral, and activists again flooded the company with phone calls and social media posts condemning the product line. Sephora eventually discontinued the product, and — according to Hampton — he and other organizers within the movement were contacted by a public relations firm asking them to “please call off the dogs.”
While these incidents make headlines and gain public attention, much of the movement-building work is comparatively slow and incremental, enacted more at the local and state levels. This includes seeking government support and funding for harm reduction strategies, including the formation of recovery community organizations, or RCOs, which are nonprofit organizations that plan recovery advocacy efforts, as well as community education and outreach. Activists are also pushing for syringe exchange programs, increased health care access for drug users, and safe injection sites like the ones San Francisco plans to open in July — the first in the nation.
Much of this may not look like activism, LeMire acknowledged — at least not in the sense of crowds swarming in the streets, chanting and demanding change from the government. “This is all slow-cooker stuff,” he said. “But none of [these] formal supports were around three years ago, so I know we’re headed in the right direction.”
Mobilizing a wide spectrum of allies
A significant advantage to the recovery activist movement is the sheer number of people it stands to reach. One in three people in America are directly affected by addiction, either through personal experience as a user or through a close friend or family member. The movement therefore holds immense potential to mobilize a wide range of stakeholders, a base of supporters, which — unlike many current movements — spans both sides of the political divide. According to a Pew exit poll conducted after the 2016 election, both Republicans and Democrats consider addiction to be a “very big problem.”
“I’ve met parents who were enthusiastic Trump supporters because they had been fed the message of building the wall and keeping the drugs from Mexico,” Hampton said, adding that he would then tell parents to think about how a “repeal and replace” of health care legislation would affect their son or daughter. “It’s like a lightbulb goes off in their heads, and they don’t want to see another four years of Donald Trump.”
President Trump has repeatedly declared the opioid epidemic a major problem, but does not allocate funding for it to be systematically addressed. In October 2017, the Trump administration declared the opioid epidemic a public health emergency, but did not request emergency funding from Congress and did not declare a national state of emergency, which would have allowed states to use the federal Disaster Relief Fund to address the crisis.
Recovery activists described how the escalating crisis of addiction and overdose — as well as the government’s inaction to address it — is increasing the movement’s sense of urgency to take more extreme measures. People have long sought to earn a seat at the table with important decision makers, both Hampton and LeMire explained, but now they may be compelled to take more direct or confrontational measures.
“We’re just getting a pat on the head,” Hampton said. “It’s an affirmative action play that policymakers need to have that seat for us, but don’t actually have to listen to us. We’re sick of that. We don’t need a seat at that table if that’s how we’re going to be treated. People are building their own tables, and that’s more powerful.”
LeMire echoed Hampton’s sentiments, saying, “We finally got a seat at the table, but this president is hostile to any social or mental health services. People are trying to give him more chances, thinking that maybe he will listen. But now we are seeing activists starting to understand that we need to just totally refuse this administration. We need to take to the streets.”
The shift towards direct action is a challenging one to make for a community so frequently criminalized. People have identified as “advocates” in recent years and sought to make change through official channels, but many are skeptical of making the shift towards more confrontational “activist” tactics. Hampton said that when he started using the word “activist,” people groaned and asked him, “Are we there yet?” He told them, “I don’t think we have a choice.”
“For so long we have been trying to ingratiate ourselves to a society that distrusted us, to decision makers who distrusted us,” LeMire said, adding that people have long been trying to counter the perception that they might “steal your wallet.” But now, he reflected, “We have to break away from this.”
While the stigma against people facing addiction serves as a major challenge to the development of an activist movement, one important set of allies is trying to change that: parents who have lost their children to overdose. The testimonies of these parents appeals to public sympathy and outrage, making the movement more relatable to the average person and increasing public pressure for political change.
“Most of the [parents of loss] that I’ve met have dedicated their lives to ending overdoses,” Hampton said. “They’ve made treatment more accessible, taken on Big Pharma and taken on big policy leaders on Capitol Hill.”
These parents and family members are playing a vital and visible role in the movement, countering some of the negative associations that can be tied to recovery activism with the power of their personal stories, which help to humanize the abstract, demonized image of an addict.
A generational shift
Another major challenge the movement faces exists within the divided approaches to recovery. Hampton described this as both a generational and cultural change within the recovery community, from abstinence-only programs to those focused on “harm reduction.”
“In my personal experience, some of the hardest challengers of the movement have been from within the recovery community itself, mostly the 12-step group,” Hampton said. While these programs have helped a lot of people on their journey to recovery, including Hampton, they represent a different approach to overcoming addiction that is shifting with the new wave of activism and advocacy today.
Twelve-step programs promote full abstinence from drug use, and often highlight the role of religion and the importance of anonymity. The emerging recovery movement, on the other hand, encourages people to “come out” and share their recovery stories. It promotes an approach to recovery that seeks to “meet people where they’re at,” LeMire said, “which may well be face-down in a public restroom or hotel.”
This new approach advocates syringe exchange and other services that allow people to continue using drugs, but in a safer, more controlled environment. According to LeMire, this creates a rift between the two approaches because both look at each other and think, “You’re killing people.”
Meanwhile, their concern is real because people are dying. Movement organizers are highly vulnerable themselves to overdose. Numerous advocates and activists have already died, and many other potential supporters are incarcerated or living on the margins of society. “In the past 19 months I’ve had 13 friends die,” Hampton said in December. “It’s not a question of when it’s gonna happen anymore, it’s a question of who.”
Two months later, Hampton had lost four more friends.
Challenging the movement as a ‘sea of white’
An important consideration for the movement to achieve long-term, systemic change is its ability to be representative of all people facing addiction. This means, according to activists at the forefront, that the movement must also recognize its own implicit biases, particularly the predominance of white, middle- and upper-class people it engages.
Although the movement is gaining ground today for criticizing the pharmaceutical industry and government policies around addiction, the criminalization of drug users began long before Nixon’s “War on Drugs,” with the persecution of black and Latino communities, and the targeting of jazz musicians like Louis Armstrong and Billie Holiday by Commissioner Harry J. Anslinger, who headed the Federal Bureau of Narcotics from 1930-1962. This history is one reason why LeMire is pushing the current recovery movement to recognize and incorporate the dangers faced specifically by communities of color.
“The rallies and protests — they’re a sea of white,” LeMire said. “[People of color] are almost totally missing from the movement, but they have the most to lose.” This shapes one of the movement’s ongoing challenges, addressing the addiction crisis while elevating the voices of marginalized communities.
This poses a conundrum to the movement’s current successes, and requires the white, educated people within the movement to question the reasons many people have been sympathetic to their stories. LeMire, who once served as the face of an awareness campaign for Narcan, the emergency medication used to reverse an opioid overdose, said it was telling that they chose someone like him — “a white, bespectacled college grad.”
“Minority communities,” he explained, “have historically been disproportionately mistreated — not just untreated, but mistreated — as a result of the drug policies that created this situation.” A greater understanding of the way race and privilege have affected the criminalization of drug use and the services available to drug users could lead to what LeMire called the movement’s “third wave.”
If the second wave of the movement establishes more understanding, compassion and education surrounding recovery, it will only be accomplished, according to LeMire, “by addressing deep-rooted injustices,” particularly those that have been brought to the forefront under the Trump administration. Addressing the historical factors underlying the oppression of people with addiction, he concluded, “will mean passing the megaphone to those who have not yet had it.”
For some, the recovery activist movement aims to help people “find ways to not die today,” as LeMire put it. Yet, on a broader, systemic level, the recovery activist movement holds the potential to activate a massive, invigorated voter base on both sides of the political divide. It gives voice to those who feel powerless or unheard, and shapes the movement as one in which the fight against addiction and injustice will be led by those who have experienced it firsthand.