Dream big: When a peer leader turns up the volume
Annie Madden is a global drug user activist with living experience of injecting & illicit drug use, hep C and opioid treatment. She has spent decades promoting the health, rights and dignity of people who use drugs around the world. She was CEO of the Australian Injecting & Illicit Drugs Users League (AIVL) from 2000-2016 and CEO at NUAA from 1996-2000. Annie was awarded an Order of Australia in 2019.
UN: What is it about drug use that is so central to your identity?
AM: For over 20 years, I’ve been a dependent, daily user of opioids. I started on methadone for the first time in the early 1990s and without a break for around 25 years. I’ve also been injecting heroin daily for all that time. A long time. It’s such a marginalised thing; very few people inject drugs.
The impact that stigma and criminalisation has on every aspect of a drug user’s life means that being a user is central to your identity. There’s not many people you can bring into your inner circle, so those you can talk to, you have very intense relationships with.
As a user, who you are is shaped by prohibition. My political activism has been a source of strength to me; it helps me to overcome the stigma and isolation. But I’ve done it through sheer determination and hard work. I’ve been lucky to have a university education, which opens doors for me, and I’m white, so I have privilege and opportunities that have reduced the force of criminalisation and prohibition on my life. But it’s still been really fucking hard to survive.
Because prohibition increases the price of drugs so that daily use can cost a few hundred dollars a day, your drug use becomes your #1 focus. It doesn’t have to be that way, but prohibition makes it that way.
When you are an injecting drug user, the world is a really harsh place. People literally hate you and say: ‘Go and die, scum’.
Drug user organisations (DUOs) and the drug user movement have been central to my survival. My rock and my place to hide, a port in a storm. A place to feel whole, and to know there’s somewhere in the world that really understands you and doesn’t judge you.
UN: What made you step up?
AM: I was always using drugs from my teenage years onwards. I was attracted to pushing boundaries. Then, when I started injecting, there were no Needle and Syringe Programs (NSPs) yet. They were only just starting to be discussed.
We could see what was going on with HIV/AIDS for people who inject drugs (PWID) in the USA and knew it would become an issue here. We decided to start the QLD IntraVenous AIDS Association (QUIVAA) [now the Queensland Injector’s Voice for Advocacy and Action: Ed] and with it, one of the first peer-based NSPs in Australia. It was a time of ‘firsts’. I was involved in getting the first NSPs in Brisbane. I did some of the very first HIV prevention campaigns for PWID. ‘Fuck Safe, Shoot Clean’ was one of my campaigns.
I was quite a political person even before I started getting involved in DUOs. I melded it together with being an injecting drug user. Since then, I’ve had a lot of roles, but at the heart of it all is my interest in political activism and standing up for people’s human rights.
After getting experience as a CEO in a short-term role at the Gold Coast AIDS and Injectors Network (GAIN), I got 2 jobs in Sydney at the same time, at NUAA and SWOP (Sex Workers Outreach Project). I had to decide: “Where does my heart really lie?”. It was a big turning point in my life. I had a background in sex work, but I realised the right decision was to focus on drug use - the bigger part of my identity and where I thought I could make the most difference.
UN: How do you know when you’re ready to step up?
AM: Surround yourself with people you trust who can give you good advice, and listen to the feedback they give you, because there will be clues in it. People will demand that you step into your power and leadership potential. They want it for the movement.
I didn’t see myself as being ready for my first CEO job, but I was encouraged to apply, and I got the job! I did it for 7 years and loved it. It just goes to show how important it is to have encouraging people around you who can say: ‘You can step up, what’s stopping you?’ That person saw something in me that I couldn’t see in myself — and I now know what it is. Leadership is a funny thing, because people can find it easy to see in others but harder to see in themselves.
UN: Do you have advice about working for change under prohibition?
AM: For people looking to step up, you need to hold your core values tight, and really believe in them. Then, you have to be open to working with the system you’re in. That doesn’t mean being complicit in it but you can always find ways to work or people to work with.
You can get support from unusual places sometimes. While they are not natural partners, conservative governments can be willing to take more risks compared to Labor — even if only to take away Labor’s ammunition. Don’t underestimate what you can get done through relationships with people. Keep an open mind to the people you’re working with – they may have a personal connection to the issues or be willing to find ways to make things happen.
UN: What are you working on at the moment, and what’s next for you?
AM: Getting treated and cured for hep C has made a huge difference for me! I now have the energy for all my work! I am currently working on a PhD at the University of NSW (UNSW); I have a consultancy business – 2SquarePegs; and I have a podcast - SpeakEasy.
I would never have seen myself doing a PhD. I’m one of the few drug policy researchers who is ‘out’ as a drug user. My PhD has given me a chance to think about things I’ve never had the time to think about. The title of my PhD is “Drug-user representation in high-level policy environments”.
Through 2SquarePegs, I’ve been doing lots of work with our international drug user organisation, the International Network of People who Use Drugs (INPUD). For example, I was a co-author on a paper called “Drug Decriminalisation: Progress or Political Red Herring?” It looks at how ‘decriminalisation’ in different countries can still harm people who use drugs because there are still punishments for using drugs, just different types.
I have a podcast series called SpeakEasy with Dr Carla Treloar, a professor at UNSW who is one of my PhD supervisors. We’ve tagged it: ‘A comfortable space for uncomfortable topics’. We interview researchers about their work to take the mystery out of research and help people understand why it’s important.