Active drug users – struggling for rights and recognition – by By Jørgen Anker, Roskilde University,15.5.2006.

By Jørgen Anker, Roskilde University

Active drug users – struggling for rights and recognition


This paper investigates the processes through which a group of drug users[1] seek to gain recognition and legitimacy as an interest organisation in The Danish Drug User’s Union [DDUU] (BrugerForeningen for aktive stofbrugere). The case of the Danish Drug Users Union is particularly interesting because the organisation seeks to organise and represent a group of citizens that are normally excluded from channels of participation and interest mediation. [2]


From a broader perspective, the attempt to form an interest organisation of drug users is interesting because it may form part of a process whereby different excluded groups and social clients attempt to gain rights to participation and voice in the welfare state. What is of particular interest here is how the DDUU attempts to change their stigmatised position as drug users into a position, where they are recognised as a legitimate collective actor/interest organisation.


The paper describes the position, aims and strategies of the DDUU. It explores how the DDUU seeks to advance an alternative image of drug users as able, respectable and active, thereby opposing the dominant image of drug addicts as irrational, passive and irresponsible. The paper also provides an insight into the strategic dilemmas of the DDUU. On the one hand the organisation receives public funding and seeks to use formal channels of interest representation, on the other hand the organisation struggles for an alternative drug policy, which challenges the official drug policies in Denmark.


Three questions will guide the discussion: First, the paper attempts to offer some explanations why and how an organisation of drug users is enabled to emerge, in spite of the strong stigmatisation of drug users in society. Second, the paper will dwell with the question of how the drug users attempt to overcome stigmatisation. Third, the paper attempts to offer an account of the impact of the organisation.


Empirically, the analysis is based on 7 tape-recorded qualitative interviews with activists in the DDUU, and 2 tape-recorded interviews with the Parent Organisation that is located in the offices of the DDUU. The analysis is further informed by observation and informal conversations with activists or users in the DDUU during opening hours or in late afternoons, participation in celebrations of the anniversary of the organisation and other acts or meetings arranged by the organisation.[3]  To this should be added analysis of the president’s annual reports, internal minutes (called duty reports) of daily activities, and other documents from the organisation. To supplement these data, other actors in the field that know or interact with the organisation have been asked for views and interpretations concerning the organisation in interviews and conversations. These interviews cover: 6 participants in other drug user organisations in Denmark,[4] 4 participants of associations of users of drop in centres, 3 participants in associations of ex-users, and approximately 10 actors with a professional position in the drug field. Finally, the study also includes analysis of 116 newspaper articles that deal with the organisation.


Social movement theory is used as the principal theoretical framework to examine the emergence and the importance of the organisation. The DDUU in itself is an interest organisation in the drug field. Yet it may be compared to a social movement organisation (Zald and McCarthy 1987), because it is one of a number of associations, networks and actors that form part of broader trans-national network which seeks to favour harm reduction initiatives (and seeking a liberation of drug control policies) globally. In this sense the DDUU, as a single organisation, may be seen as forming part of a broader social movement.



Drugs, control and stigmatisation

The use of drugs is condemned and rejected in most of the world. It is perceived as harmful, dangerous and leading people into unwanted destructive life-styles, perhaps because the use of drugs challenges the rational of the ascetic, hard working and self-controlled modern subject. Becker describes the situation of drug users in this way:


The drug addict, popularly considered to be a weak-willed individual who cannot forego the indecent pleasures afforded him by opiates, is treated repressively. He is forbidden to use drugs. Since he cannot get drugs legally, he must get them illegally. This forces the market underground and pushes the price of drugs up far beyond the current legitimate market price into a bracket that few can afford on an ordinary salary. Hence the treatment of the addict’s deviance places him in a position where it will probably be necessary to resort to deceit and crime in order to support his habit. The behaviour is a consequence of the public reaction to the deviance rather than a consequence of the inherent qualities of the deviant act. (Becker 1966 [1963])p. 35)


Drug users are often thought of as being incapable of involving in normal functions in life such as holding a job, maintaining a place to live and fulfilling the role as parents (Bluthenthal 1998). Moreover, drug users experience stigmatisation and are also often treated by state officials (police, health workers or personnel in the judiciary) as undeserving criminals (Valiente 2003). When new houses for homeless or drug users are planned, protests often arise from the neighbours. A national survey on relations of solidarity in Denmark thus showed that almost 20 percent of the population would involve in protest and 10 percent would possibly move to another place if a publicly supported community of drug users was established next door (Juul 2002).


The experience of stigmatisation is known by the participants in DDUU. One of the activists explains:


This is the lowest [position], you can’t get any lower in this country than a drug addict. I mean it’s much easier to come from Pakistan, to be black or woman or to belong to any other repressed group. But a drug addict, that is the worst… and moreover it is a dog’s life because you have to find money for drugs.[5]


In the interviews and conversations with activists from the DDUU and other drug users’ organisations, it is repeated that people who use drugs generally live a miserable life. The interviewees emphasise the very negative consequences of drug use and how these influence the overall life conditions of drug users. People who use drugs constantly have to consider how to get money for obtaining drugs, and some have to involve in criminal activities or prostitution. Moreover, once known as a drug user by the police repeated controls and searches come to form part of a very stressful life (Frantzen 2005). Attempts to organise drug users has to be understood in this light.


Compared to the other Nordic countries, Denmark has traditionally been represented as a country with a rather liberal drug policy where harm reduction aims have played an important role in determining concrete policies and measures since the beginning of the 1990s (Laursen 1996; Laursen and Jepsen 2002). Harm reduction can be defined as initiatives that aim at reducing the harmful consequences of the use of drugs or improve the (often horrible) life conditions of drug users without punishing the user for illicit drug use (Bluthenthal 1998; Asmussen and Jöhncke 2004). Concrete examples are syringe exchange programs, low threshold activities, outreach work and consumption rooms (consumption rooms are not allowed in Denmark, however). Denmark introduced many of these harm reduction measures earlier and in wider degree than Norway and Sweden (e.g. free access to needles and methadone treatment). Denmark has also traditionally maintained a more liberal attitude towards hashish and alcohol.


However, while harm reduction initiatives on the one hand have gained wider accept in policy formulations and in practice (as seen in outreach work for example, see Asmussen 2003), control measures have been tightened up simultaneously. As Laursen (1996) argues, it appears that a rather pragmatic and problem-solving Danish approach to criminal justice policy have given space to a combination of both liberal and conservative measures. Harm reduction initiatives are thus an integrated and accepted part of the official policy as long as they are not considered to contradict an overall aim of bringing the use of illicit drugs to an end. The abstinence oriented policy is emphasised in many policy papers, but it is also mentioned that to some of the most affected groups of drug users, harm reduction measures are more important because abstinence in practice remains unrealistic (Sundhedsstyrelsen 2004).


Defining the kind of initiatives that are acceptable under the heading of harm reduction constitutes one of the ongoing struggles between supporters of harm reduction initiatives and more sceptical actors. The Danish liberal-conservative government has emphasised the need to define some clear lines between acceptable and non-acceptable measures. In October 2003, the government published an action plan against drug abuse. < an intention of adopting a zero-tolerance policy on drugs.[6] In the action plan, the government emphasises the need to adopt hard measures on drug related crime, giving priority to law enforcement over harm reduction measures, although still involving treatment, prevention and harm reduction (Regeringen 2003). Penal policy and drug policy has been tightened up: This has resulted in increased levels of punishment, allocation of more resources to the police, construction of new prisons, prison departments for special groups etc. A more restrictive policy on drugs has also been effectuated through an increasing criminalisation of cannabis. Possession of drugs – particularly cannabis – for one’s own use has traditionally not been fined, but only released a warning from the police. According to bill no. 175, however, the first time reaction is now a fine, and repeated offences will give harder penalties (higher fines or prison) (Jepsen 2004). Moreover, the government rejects the idea of allowing consumption rooms or to allow treatment with heroine.


The Social Democrats (which are currently in opposition) have supported the tightening up of penal policy and the attempts to adopt harder measures on drug related crime. On the other hand, the entire opposition to the liberal-conservative government except the right wing party Danish People’s Party (Dansk Folkeparti) supports further harm reduction measures. In 2003 and 2005 the opposition proposed to legalise consumption rooms in Denmark, but the proposal was turned down by the government and Danish People’s Party.



The 01Danish Drug User’s Union

The DDUU was formed in November 1993, when a popular public activity centre for drug and methadone users was closed down. Some of the users agreed to form a drug users union in cooperation with some supporters (social workers and a group of relatives to drug users). In Denmark there are only a few organisations of drug users, and most of these only have very few (5-10) active participants. The DDUU, which is based in Copenhagen is the biggest and the most important of drug user organisations in Denmark. It has 160 paying members and 387 passive members who have not paid their membership fee this year (Hansen, Malmgren et al. 2005).


The character and the appearance of the physical facilities of the DDUU are rather remarkable. There is plenty of space, rooms are well-equipped, cosy and very clean, always ready to receive visitors and guests. The DDUU describes the facilities with these words on its own homepage:


700 square metres headquarter in a citizen house in central Copenhagen. Here the Drop in Centre’s cosy café is open daily from 10AM to 15 PM. After this hour all activities continues but now only for active members, who’s got a Fitness room, Gaming room, Healthcare room, Internet & computer learning centre, Bicycle service, Hobby workshop, Large specialized Narco related library, study room, 70 persons lecturing room with overhead & large video screen, as well as several high tech equipped administrative offices.


The DDUU is a formal organisation with elected chairperson, an elected executive committee, annual general meetings, by-laws etc. (Asmussen 2003). The overall aim of the organisation is to represent and further the interests of drug and methadone users. [7] Moreover the organisation opposes discrimination and it seeks to remedy powerlessness. It runs activities of support, information and advice. It works for exposing the social, political and economic conditions in the drug field and to uncover how these conditions affect the individual drug user. It attempts to generate debate, and it is stipulated that the organisation is dedicated to follow democratic means and practices to serve its interests. Finally, it is explicitly written that the organisation must be reliable in its relation to authorities, politicians and users.


To some of the activists, international contacts and networks are very important. It provides new inputs and arguments to the debates of drug policies in Denmark, and it serves as a form of recognition of the organisation. The DDUU has supported the formation of a similar organisation in Norway and Sweden and it has close contacts to other user organisations in Holland and England. The DDUU has a number of international contacts and participates actively in various conferences and harm reduction networks, e.g. NAMA (National Alliance of Methadone Advocates).[8]  The DDUU is also a member of ENCOD, which is a network of approximately 120 NGOs that seek to influence and reform international drug policies seeking more transparency and democracy in drug policy-making processes.


In practice the work of the organisation is divided into two equally important areas. On the one hand, the organisation serves as a national interest organisation for drug users in Denmark. On the other hand, the organisation carries out social work and functions as a drop-in centre (an open café) that is open to all drug users. In the morning breakfast is served and during the day there is always coffee and tea ready for visitors. The chairman explains:


“In the morning, people come in because coffee is free and a lot of other things, of course; free newspapers, and you can sit together with equal-minded people, and that is probably the most important. Here you don’t need a façade, and as a drug user you are very conscious about that anywhere else. Wherever you go as a drug user, you know with certainty if the others around you are aware that you are a drug user.”


With the experiences of stigmatisation and mistrust that often characterise the efforts for and offers to drug users, the drug users in the DDUU emphasise that the organisation and its facilities serve as a place where they can breathe freely, without being met with suspicion and devaluation because of their drug use.[9]


The activists carry out social work, advice and information. The organisation runs a newspaper archive with articles on drug related issues and it also has a library with literature on drug policies. It is mainly drug users who seek personal advice on different issues, yet relatives to drug users also contact the organisation to get advice or information. Moreover, social workers, students, health personnel and others often seek information in the DDUU.


In the internal duty reports it is documented that approximately 35 persons in average visit the organisation each day (Hansen, Malmgren et al. 2005). Approximately two thirds of the users are men, and an equal share of the users is more than 40 years old.[10] Nearly all the users (except two) started taking heroine more than 10 years ago, and one half for more than 20 years ago. The vast majority are in some kind of maintenance treatment with either methadone or buphrenorphin.[11]


The most active members stay in the organisation in the afternoon and evening. The activists dedicate themselves to different activities that support the organisation or they organise a different recreational activities. They go on picnic in the summer, go biking, bowling, and they also arrange a summer camp (team building). A group of activists celebrate Christmas Eve together in the organisation.


The DDUU collects used syringes that have been left by drug users in the streets in specific areas of Copenhagen. In 2004, they collected 301 kilos.[12]  When collecting used needles in the streets the activists wear yellow jackets with the words needle-patrol written in the back. This, on the one hand, serves to increase the visibility of the organisation in the public. On the other hand, it provides the activists that collect needles with a certain degree of immunity vis a vis the police.



The emergence of drug users as collective actors

The question of why social movements or social movement organisations emerge is probably one of the questions that are most frequently asked and sought explained in social movement theory (Goodwin and Jasper 2003). To explain why drug users began to organise as collective actors, I follow a broader line of explanation than the traditional political process approach (e.g. (Tarrow 1994; McAdam, Zald et al. 1996)), which often limit the scope of analysis to the political field and the concept of political opportunity structure. Political opportunity structure refers to the consistent but not necessarily permanent elements of the political environment that provide incentives for people to undertake collective action affecting their expectations for success or failure (Kitschelt 1986; Tarrow 1994).


Certain aspects of the DDUU’s action repertoire as an interest organisation are political in character. Due to the Government’s and the opposition’s different views on specific measures of harm reduction initiatives, the DDUU for example has an opportunity to seek alliance partners to forward its views and arguments in relation to concrete initiatives (for example in relation to a parliamentary debate on consumption rooms). The DDUU thus occasionally co-operates with some of the political parties of the opposition or other alliance partners to generate debate and advance its views. Being aware of the existence of potential political allies in the Parliament, who sympathise with the aims of the DDUU, activists will find it easier to expect that the organisation is able to make a difference. Some political dimensions (e.g. the government’s formulation of a drug policy and the existence of allies in the drug field) are thus important to understand the emergence, the consolidation and importance of drug users’ organisations in Denmark. But the political approach is generally better suited to explain the emergence of collective actors that engage in political conflict.


The emergence of the DDUU, however, is not an expression of genuine political protest. Moreover, the aims and efforts of the organisation are directed towards both political aims (influencing drug policies) and social aims (different kinds of self-help activities and initiatives to help and support individual drug users). In addition, the political approach often focuses on actors that are already united in some kind of pre-existing network or interest organisation (Melucci 1996; Crossley 2002). It is less useful when trying to explain how networks and unity is created.


For this purpose, Melucci (1996) provides a more valuable argument first and foremost because he insists that social movements (and social movement organisations in this case) are to be treated and analysed as social processes. Instead of taking a movement as the starting point, analysts should try to explain how the entity comes into being. One has to explain how the participants are united, and what kind of relations creates the foundation for some kind of collective unity.


So, how can the emergence of the DDUU be explained? I see the following dimensions as facilitating the process:


First, the emergence of the DDUU and other user organisations in the field are an outcome of the ways drug users are treated and dealt with by the treatment system.[13] This argument relies on the formulations and studies of Mik-Meyer and Järvinen (2003) and Gubrium and Holstein (2001) who have focused on the relations between welfare institutions and social clients and how identities of clients to a certain extent are formulated and formed by the features and rationality of the institutions. The welfare institutions – physical spaces with their own rules, rationality and power relations – come to form an important role in the lives and identities of their clients. The point is that problem-identities of homeless, drug users, alcoholics, or unemployed people are formed and influenced by the institutions that are set up to help. I do not question the influence of the welfare institutions on the lives of social clients, yet I will argue that welfare institutions may also provide spaces for alternative attempts to form more autonomous actors. Thus even if welfare institutions may be said to partially create ‘problem identities’ these categories and identities may eventually also come to form the basis of resistance and collective action.


My argument is that the drug users’ organisations did not emerge as an autonomous network of drug users who decided to organise independently of the treatment system. The conditions of drug users are often too extreme and many drug users struggle individually to survive and get hold of drugs. These life conditions limit the possibilities of creating a shared frame of reference from which a collective identity could be formed. Yet the treatment system, and the way the treatment system is organised and unites drug users, created a space from which user organisations in Denmark could be formed. The two oldest user organisations in Denmark were both formed by a group of users of particular treatment centres. Moreover, the issues that have mobilised drug users in protest are often related to practices at local treatment centres.


In the treatment system drug users are provided with a space where they meet, they are treated with some standardised measures and they are thereby enabled to acknowledge that they have many things in common and maybe share a number of interests. Moreover, the treatment system also opens for alternative ideas and interpretations which provide openness towards new forms of treatment (e.g. under the heading of harm reduction) and new forms of user involvement. Outreach work or low threshold offers are examples of  initiatives that aimed at reaching drug users by new methods opening for new ideas and practices of social work.


Second, the acceptance of methadone maintenance treatment was also important for the formation of drug users’ organisations. Methadone treatment enabled certain groups of drug users to create sufficiently stable life conditions to engage actively in the formation of organisations of drug users. In the 1990s, the acceptance of maintenance treatment in Denmark contrasted the situation in Norway and Sweden where a more restrictive policy was implemented. Drug users in Norway and Sweden may thus have had more difficulties reaching a sufficiently tolerable life situation, which could provide them with sufficient energy to form and engage in user organisations. This could be used as one possible explanatory factor for the later emergence of drug users’ organisations in Norway (1999) and Sweden (2002).


Third, harm reduction strategies in Denmark opened opportunities for drug user organisation. Bluthenthal (1998), (Friedman, Southwell et al. 2001), and Wieloch (2002) associate the appearance of harm reduction measures with the emergence of a harm reduction movement. The harm reduction philosophies and the harm reduction movement simply created a space for the acceptance and recognition of drug users’ organisations. Harm reduction arguments provided drug users’ organisations with an important basis from which, arguments and critique could be raised. Harm reduction approaches offer an alternative to traditional moral approaches; 1) the war on drugs and 2) the disease model of addiction (Wieloch 2002:47/48). Claiming that initiatives have to support drug users instead of punishing them or controlling them thus form elements of a larger cultural field or meaning system (Wieloch 2002). Relying on this meaning system facilitates drug user’s organisations’ opportunities to gain recognition and frame their claims.


Fourth, the existence of a favourable environment, with a number of supporting actors may also help explain the emergence of drug user organisations in Denmark. One of the clearest examples is a Parents’ organisation (“Parents Association to drugs-influenced children; Forældreforeningen til Narkoramte børn) that was formed in 1974. This organisation had the explicit aim of seeking to obtain a general acceptance and use of methadone maintenance treatment in Denmark. In practice, in the 1970s, before methadone was accepted as a treatment measure, the organisation attempted to find doctors who would prescribe methadone to drug users. A lot of the work of the president of the organisation consisted in co-ordinating and delivering methadone to drug users from doctors who were willing to prescribe methadone.[14] Later the participants in the organisation also supported the formation of the DDUU.[15]


Finally, a general trend of user orientation in welfare policies in Denmark created an institutional platform for user organisations. The Ministry of Social Affairs played an important role in this process, providing support and legitimacy to the DDUU.[16] On the one hand, this orientation secured resources and financial support, on the other hand, it opened channels for interest representation. The interest in user participation has been institutionalised in the social legislation (see Asmussen 2003), and the discourse which favours user participation has opened opportunities for drug users to make claims towards the system on behalf of their position as users. The status as users of social services thus provides drug user organisations with a certain degree of legitimacy, when they attempt to organise (Asmussen and Jöhncke 2004).



The self-representation of the DDUU

The DDUU attempts to construct an image of drug users that opposes the stereotyped image of drug addicts. This may be seen as part of a symbolic struggle, and an attempt to redefine the meaning of ‘drug user’. In short, the DDUU attempts to elevate a stigma to a position of status (Wieloch 2002). The organisation struggles for giving drug users a status or recognition as decent citizens and they claim a right to be treated with respect and to be heard when drug policy issues are discussed.


The DDUU seeks to advance a positive image of itself in the public towards the exterior. But the self-representation also forms part of a collective identity, a collective understanding of how ‘we’ – the group of activist and members/users of the organisation – are. This self-understanding is influenced by the ways drug users are characterised and dealt with by the welfare- and treatment institutions, the media, politicians and the public in general.


In the attempts to construct a specific image of itself the DDUU emphasises the word ‘active’, which is given a double meaning. On the one hand, it means that the users and activists of the DDUU have an active use of drugs, on the other it means being that the users and activists are ‘actively’ involved in different activities. The very existence of the DDUU and the fact that the DDUU is driven effectively and autonomously by active drug users themselves is emphasised as a living proof of drug users’ capabilities.


Active drug users

The name of the organisation is in itself a symbolic challenge to public stereotypes. In Danish the formal name of the organisation is the Users’ Union for active drugs users – Brugerforeningen for aktive stofbrugere. The chairman explains:


They wouldn’t call it the drug mis-user’s association or the association of drug addiction, but the users’ union.

But we agreed that the starting point is active users of drugs and we work for the active drug users. We don’t declare ourselves drug addicts. We make the distinction that if you pay your rent each month and take care of yourself, then you are a consumer, no matter how you use your money. And we, then, are consumers of drugs, but we also make a lot of activities, so it has double connotations: The union is for active drug users who take drugs, but whom also want to involve actively in different activities.


The organisation thus seeks to detach itself and its members from the denomination –drug addicts – or drug misusers, claiming that they rather be considered as consumers. Whereas drug addicts or drug misusers are persons that are so troubled that they need help and support, consumers are persons who have their own resources and follow their own interests. Moreover consumers have rights and ultimately they also have a right to use the kind of drugs they want and physically need.


Indicating that the organisation represents a group of people who have an ’active’ use of drugs (primarily heroine and methadone) in itself represent a symbolic challenge in a society where these drugs are forbidden. Additionally the name indicates a difference to groups of ex-users who organise in different groups of Narcotics Anonymous. Initially, the members of DDUU were afraid that ex-users should become too dominant in the organisation, so in the by-laws, it is stipulated that only active users of drugs can become board members. Yet ex-users are still welcome in the organisation if they stop using drugs and a former president who is no longer an active drug user is occasionally invited as a speaker to public meetings or celebrations.


But ex-users often tend to take on a very moralising attitude towards drug users, activists in the DDUU explain. This means that some ex-users can have difficulties accepting that others continue with their drug use, when they themselves have managed to stop. The DDUU does not condemn ex-users and the people who manage to quit, but the organisation claims a right to continue with drug use without being condemned by others.



Active participation

The meaning of active also in many ways provides the boundaries that are used to distinguish members and activists of the DDUU from other organisations and drop in centres in the field. It dissociates the organisation from places and drug users that are not formed around an intention of involving in collective activities.


The organisation is described as a place of activity. This means that the people who show up regularly are expected to participate actively in the different daily tasks. It is not well-seen, and it is commented, if people do not participate in any activities. Active in this sense thus signals that drug users are not just passive social clients but rather active and engaged subjects. The DDUU seeks to emphasise this through involvement in different events, teaching activities etc.


In practice the meaning of active, also serves as a differential mechanism, which defines who are included in the group and who are not. Being active means being involved in activities for the good of the organisation. The degree of activism forms one of the mechanisms of internal differentiation. Only a smaller group of people – an ‘inner core’ – holds the formal title of ‘activist’ (approx. 15-20 members). Activists take ‘duties.’ This means that they are responsible for the activities that take place in the organisation on the day of their duty. They have to make breakfast, answer the telephone during the day, say hello to visitors and a number of other practical tasks. Being an activist is a formal status that provides the person with a key to the organisation, and activists can thus come and go as they like. To become an activist, one has to follow one of the persons on duty for a longer period of time. Only after having participated actively in 15-20 or more duties, it is decided if people are trustworthy to be given a key to the offices. The key represents the ultimate symbol of trust. It serves as a sign of recognition and belonging. The chairman of the DDUU explains:


Well, we don’t make contracts with people… and anyway it wouldn’t help… [.. ]  so if we give a key to the wrong person, and this person empties the place for all values, then we can’t do anything…. [….] .. but we choose to be a little more strict on this issue and have the rule that the keys are something that people must qualify for. It is the ultimate sign of honour you can have… so to say.


As explained above this rather formal selection procedure of activists is meant to protect the organisation from unintended loss. The organisation has experienced various examples of theft and loss. To prevent theft, all offices are locked and have to be opened with a key, if there are no-one present in the office.


Gaining the recognition as an activist with a key thus provides an improved position in the internal hierarchy of the organisation and it also gives certain privileges (contribution to the payment of transport or mobile phone and possibility to participate in the team-building tour in the summer). To become an activist with a key, you have to show, – through your continued effort for the good of the organisation – that you have deserved to become recognised as an activist. The most active, the ones who work most are also the people that decide, the ones with status and power.


The meaning of name of the organisation is not just used to provide an alternative image of drug users in the public. It is also used as the logic through which internal hierarchies are formed and boundary work is carried out. It is used in the process of constructing a collective self (Hunt and Benford 2004).


Autonomous and able drug users

One of the issues that activists in the DDUU repeatedly raise, when talking about the organisation, is that it is an organisation driven by and for drug users themselves. The requirement of only letting active drug users into the board is meant to secure that the organisation remains controlled by the activists and members themselves. The issues of self-determination and autonomy are very important in the collective self-understanding of the organisation. It is not an organisation which is driven by or influenced by social workers – or others – who act on behalf of drug users. This creates a feeling of autonomy, a sense of being accepted among equals. The activists describe the organisation as a success, which is often related to a perception of self-reliance that also forms part of the narrative of the organisation’s history.


The history is told as a story of how the activists gradually developed a stronger belief in their own capacities. In the beginning, it is explained, people were clientilised,[17] yet gradually – after some unpleasant incidents with non-users who suddenly became too dominant in the organisation – the users realised that they were able to take the responsibility and manage by themselves. On this basis, the activists claim a right to live an autonomous life, without interference from people who believe they are more able because they do not use drugs themselves.


Another important and related aspect in the self-understanding of the activists is that the physical facilities always appear clean and tidy.[18] Keeping rooms clean and tidy, the DDUU seeks to gain and show an image of drug users which contradicts the normal stereotypes of drug users as messy and unable to take care of things. The image of a professional, well-functioning organisation with good facilities thus becomes an ideal expression of the position aimed at. This is how the organisation wants to be seen by others. This is the kind of recognition the active drug users seek: Perhaps different, but still basically the same, and in any case responsible and able.



Seeking legitimacy

Many of the activities which are carried out by the DDUU are directed at gaining recognition as a useful, serious and reliable organisation, which carries out important social work to help drug users, to gain a better reputation in society or to inform about drugs and drug users’ problems in the public. As mentioned, the needle patrol is one example of this strategy. Another example is the attempts to carry out social work for drug users in the street. A few years ago, the DDUU thus had a project where they carried out outreach work in Vesterbro in Copenhagen where many drug users gather. The activists made an effort to get in contact with drug users in the street and offer support, help or treatment.


The DDUU has gained legitimacy because of its work, and this may be illustrated by the public support to the organisation. To receive public funds for an organisation is also to be accorded legitimacy (Valiente 2003). Over the years, the DDUU has gradually gained more public funding to a degree where the organisation today appears to be entirely dependent on funding from the authorities. The DDUU has been able to adapt or translate its aims and strategies to projects and activities that are perceived as acceptable and needed by the local and national authorities. In 2003, the DDUU received a total of 1.7 million DKR. (approx. 226.700 Euro) from the public authorities, half of this amount from the Ministry of Social Affairs, and the other half from the Municipality of Copenhagen. In 2003, for the first time in the history of the organisation, the DDUU was guaranteed an appropriation for three years.


Yet, because of the illegal character of drugs, drug users’ organisations are placed in a difficult intermediate position. The organisations admit or openly emphasise that their members have an active use of illicit drugs, implicitly acknowledging that they involve in illegal acts of buying and possessing drugs. The organisations thereby run the risk of being condemned and repudiated by the surrounding society as illegal and illegitimate organisations. The DDUU has faced this threat in various occasions. Confronting the risk of being denied a right to exist, the organisation has opted for seeking legitimacy through good behaviour.


Most harmful to the organisation are accusations of illegal drug dealing in its rooms, which were brought up by the tabloid newspaper Ekstrabladet in April 2000. A journalist had visited the organisation for a few days, and the paper claimed to possess cassette recordings which proved that drug dealing took place in the rooms of the organisation.[19]  The story immediately raised a political debate on the conditions of public support and if public means were used to finance drug dealing.[20] Moreover police investigations and financial revisions were started. The DDUU maintained that individual members who use drugs obviously sometimes buy drugs together to get them on a cheaper basis. But even if such arrangements occasionally take place they do not involve the organisation as such, the chairman argued in the newspaper. Neither the police investigations nor the financial revisions of the organisation found any proofs of illegal activities.


In 2004, the DDUU again confronted a problem due to members’ active use of illegal drugs. The chairman was convicted to prison for almost one year for possession of heroine. The group of activists was stopped by the policy, precisely when they had left to go on the yearly summer vacation. The conviction again led to financial revisions and also to an external evaluation of the organisation, yet the organisation succeeded to continue its activities while the chairman was in prison.


The DDUU maintains that the use of drugs is a private matter. The aim of the organisation is not to form a club that provides the infra-structure for taking and using drugs, but to be an interest organisation and a drop in centre for drug users. On the other hand, in some cases the activists in the organisation have to show acts of solidarity with individual drug users. This has happened on occasions, where drug users in methadone treatment have been excluded from the treatment programme suddenly standing on the street with abstinences. In such cases, the activists have ‘passed the hat around’, seeking to help in the specific situation.[21] While this practice indeed illustrates the caring and helpful atmosphere of the DDUU, it can also give rise to myths and bad press.[22]


Another example of how difficult it is for an organisation of drug users to put forward arguments that may be judged as controversial in the public was exposed in a parliamentary debate on a proposal of introducing health or consumption rooms in Denmark.[23] In the debate, MP, Birthe Skaarup from the right wing party Danish People’s Party (Dansk Folkeparti) argued that the idea of health or consumption rooms was supported by a powerful drug-industry (and maybe drug dealers) that had been involved in lobby-activities to increase the amount of drugs sold in Denmark. She argued that the DDUU was one of the organisations which had made positive comments to the proposal prior to the parliamentary debate and that the DDUU had supported an international campaign in favour of liberalising international drug conventions.


Such attempts to de-legitimise the organisation’s raison d’être clearly illustrates that there are limits to the kind of proposals and actions that stigmatised groups can support or involve in without being suspected of having criminal intents. To protect the organisation from suspicion and critique, the organisation seeks to provide an image of itself as a nice, clean and well-functioning organisation with well-functioning activists. The activists do not deny that they take drugs, but on the other hand they are very conscious not to bring forward views that would be too controversial in relation to the current drug policy in Denmark.  The organisation has given priority to seeking legitimacy and providing an image of drug users as basically decent and able citizens instead of following a more disruptive and confrontational strategy.



Balancing the claims: Critical but useful

Politically, the DDUU seeks to advance harm reduction initiatives in a broad sense (including any initiative which could improve the situation of and respect for drug users). To the DDUU it is not so much the drugs which are the problem. The issues of importance are the life conditions of drug users and the ways whereby drug users are treated by society, the police and treatment institutions. The DDUU favours health rooms or consumption rooms, where drug users can inject their drugs under more secure conditions. It also favours treatment or maintenance programmes with heroine. The DDUU claims that allowing these measures in Denmark would reduce the number of drug related deaths and harms significantly. But these proposals are only occasionally raised as clear-cut demands in the public. Some years ago, the organisation organised a public demonstration in favour of heroin maintenance, but it does normally not use a strategy of protests to call attention to its claims.


The organisation rather seeks to behave as ‘good’ and responsible citizens, adhering to a strategy where the activists show a good example (as responsible drug users, who – for example – clean up the used syringes of other drug users). In this way, the activists attempt to provide an alternative image of drug users in the public, seeking to challenge stigmatisation, but also seeking to establish a position from where they may be taken seriously by the authorities. Thus instead of calling attention through interrupting or challenging strategies, the organisation seeks to gain legitimacy as a serious organisation, which can participate in direct negotiations and dialogues with the authorities.


Even if public funding provides the organisation with official legitimacy, public funding also functions as a co-opting mechanism which tends to limit the strategies that are available to the organisation (Jepsen 2004). Too much critique of national policies or specific treatment measures could have a negative impact on the possibilities to gain resources in the future. It could also harm the image of the organisation to the public. The chairman explains:


“We have to be aware of the national conditions, and we have to adapt ourselves to the fact that we have a weak foundation. We are not supported by the population, we have these public funds and our subscriptions….  So we are very conscious to move carefully on the thin ice, if we pass the line, we react immediately and turn around. We are not going to stick our necks out, so we don’t go out and make a lot of noise.”


The DDUU thus seeks to establish and maintain good contacts with the different actors in the field (social workers, civil servants in the Ministries and municipalities, health personnel, doctors, experts, and politicians). The DDUU in this way has succeeded in forming informal alliances with many different actors in the field, gaining influence through networks and personal contacts. One of the ways to establish these contacts is among other things the celebration of the anniversary of the organisation. On this day, a user-friend’s prize is awarded to someone who is working in the field.[24] Most of the relevant actors in the drug field show up on this day, including representatives from the Ministry of Social Affairs.


The organisation also gives priority to carrying out information activities. The DDUU reaches a number of different actors in this way, gaining recognition as reliable actors, who present the views of drug users. From January 2004 to July 2005, 42 formal lectures were given for approx. 735 persons and moreover minor groups of students and other visitors often get information in informal conversations (Hansen, Malmgren et al. 2005). The DDUU is thus able to reach decision-makers, administrative personnel, and also front-line workers (police officers and social workers) whom the drug users often face in their interaction with the authorities.


When the DDUU attempts to call attention to its objectives and its proposals for alternative drug policy measures, the organisation often use symbolic acts. Each year the organisation organises a memorial act to honour and call attention to the drug users who died from drug-related deaths during the year. This ceremony takes place at a memorial site that was established in 2003 with support from the municipality of Copenhagen. In 2004 one cross for each drug user that died was placed in the memorial site. In this way, the DDUU attempts to get attention from the media and to raise debate on the consequences of a control oriented drug policy.


But in spite of the recognition that the DDUU has gained, it remains in a difficult position. The DDUU risks to lose funding and to damage its image as a responsible and serious organisation if it brings forward views that are too controversial or if it involves in activities that would be condemned by the public. The DDUU is in other words, constrained in what can be said and done. As argued by Meyer (2004), even if social movement organisations make choices about how to present themselves and their claims, they do not themselves design the circumstances (Meyer 2004:53).



Achievements and limitations

The traditional way to assess the significance of social movement organisations is to evaluate the political influence of the organisation (Gamson 1975; Giugni, McAdam et al. 1999). I claim, however, that a delimited political focus is insufficient to understand the importance of the DDUU. The significance of the DDUU as an interest organisation in the field just refers to one dimension of DDUU’s work.


First, I will argue that the existence of an organisation of drug users in itself is a remarkable achievement that deserves recognition. The DDUU is driven by people with an active use of opiates or methadone, without interference from professionals or non-users. Running an effective and well-functioning user organisation[25] by principle challenges the stereotyped image of drug users as untrustworthy, self-centred addicts who are unable to have trusted responsibilities. In this way, the DDUU is an existing proof of the organisation’s own claim; that an active use of opiates does not in itself lead to non-social behaviour, and that it is possible to live a decent life as a drug user (Jepsen 2004).


When the organisation appears in the media, it invariably provides an alternative image of drug users. But even if most articles that deal with the organisation are positive, the organisation still has limited possibilities of changing denigrating practices and stereotyped images of drug users. Providing an alternative image is one thing, yet changing practice is a completely different thing.


Through its continued efforts in the field, the DDUU has gained recognition as an entity which should be taken seriously. The authorities recognise DDUU as a legitimate interest organisation, and as such it is facilitated by public means. The chairman explains how they are taken into consideration by the authorities:


“Things that are related to us are circulated to us for consideration. When a new law is being made, we are asked and so on. I will say that being asked provides us with a certain degree of status. Well, perhaps they do not follow our arguments, but sometimes at least we are able to put our fingerprints on the stuff.”


A few years ago, the DDUU also had a seat in the Board of Narcotics, where the chairman could participate in different working groups and bring forward the opinions of the organisation. The board was closed down in 2002, however, and the organisation thus lost an important platform for mediation.


The DDUU has been able to have a say in relation to treatment with methadone. On the one hand, the organisation influenced the formulations that became part of the revisions of the methadone circular. On the other hand, the DDUU has also been able to call attention to – and to achieve changes of – local practices that have been experienced as denigrating and harmful to drug users. Thus the DDUU with support from a lawyer opposed the practice of mixing juice and methadone. The president explains:


They mixed juice and methadone to prevent people from injecting it. When people injected it anyway…. it meant that they got staphylococcus in the heart valves and things like that… We were very determined to get rid of that.


The DDUU achieved to change this practice, and the DDUU has also in other occasions been involved in attempts to question or change specific practices at the treatment institutions.


Yet apart from these achievements as an interest organisation, the DDUU must also be valued for the meaning it has for its members. The organisation serves as a unifying point of a social network of drug users who often lack more stabile life conditions and social relations. Through the work and experiences in the DDUU, the activists gradually gain self-confidence, they gain a position, an identity:


“Well, we seek not just to de-criminalise but also to de-stigmatise [drug use]. We think that this is important, and we experience it right here… You can see around these people who are here now, none of them walk around hiding themselves. They are satisfied with being here and with the work they are doing. They are doing something important, you see… They are not ashamed, because they gradually have realised that we actually have something here to be pleased with, and to be proud of. We made this project thrive.”


Through the activities of the organisation, the drug users become part of a collective, which has the organisation and its activities as their shared point of reference. The organisation provides a space where the activists feel that they can involve in meaningful activities.


Asked directly, if the organisation may be compared to some kind of movement, the chairman replies that it is rather to be seen as a big family. What is entailed in this statement is that the internal life and the close social networks between the activists and members in many ways appear to be more important than mobilising activists in collective action. To many of the activists, the organisation serves as a primary social network. It is the space and context of many of the daily activities and the place where many recreational activities take place.


I gain from this because I’m able to get out of bed in the morning, to do something, instead of just sitting at home without doing anything. So, I’m very happy to come here in the association. Before I started coming, I had a depression for three years, where I just took my methadone but stayed in my bed. For almost three years. And then I started coming here..[…]… And I started to learn to take duties and so on. And then I had something to wake up to, and I was able to get out of that stupid bed.


The activists in the DDUU in many ways care for each other like in a family. If people do not show up, when they are expected to, some of the activists try to make contact to them to ensure that nothing is wrong. In my view, it is very important to emphasise the significance of this internal solidarity. As an interest organisation, the DDUU holds an important role because it has gain a position from which it is able to speak for drug users. As a self-help organisation it serves as a unifying entity, which gives new meaning and content to the lives of many of its members.


The primary strength of the network of activists could – from a social movement perspective – also form a barrier to the organisation, if it ends up as a self-sufficient network that is unable to recruit new activists. This dilemma relates to another problem that is well-known in these types of organisations, namely that it is a relatively small number of activists which carry out most of the work (Hansen, Malmgren et al. 2005). If the organisation is not able to recruit and involve new members and activists, it may be difficult to continue the work with the same kind of energy and results.




The DDUU to a wide degree reflects the developments and the organisation of the treatment system. First, the treatment system provided the space that enabled user organisations to emerge. Second, the DDUU was formed by users of a treatment centre that was closed down, and in many ways it gains its legitimacy from its interaction with the actors of the treatment system. Third, the organisation moreover serves as an alternative offer to drug users, where people can involve in activities without interference from social workers, health workers, etc. It is also noteworthy that the DDUU does not make a lot of efforts to challenge penal policy. It rather focuses on seeking to expand the kind of measures that are accepted as harm reduction initiatives (injection of methadone, treatment with heroine, consumption rooms etc.). In this way the work is directed towards the issues that are currently open for political debate, and where differences between the political parties provide a space for advancing the users’ view.


Stigmatisation of drug users and dependence of public means influence the strategies of the organisation. Bad press which questions the activities that take place in the organisation, illustrates how delicate the position of the organisation is in a society that condemns the use of illicit drugs and drug users. Drug users are almost automatically looked at with suspicion, and consequently an organisation of drug users has to prove that it is trustworthy to a wider degree than other social organisations. The DDUU has succeeded in gaining recognition as a reliable, serious and useful organisation, and following this strategy it has gained influence on policy documents and concrete practices in the treatment system.


The DDUU claims rights for drug users (rights to be treated with respect). An important part of the efforts of the DDUU is manifested in activities, which are meant to prove that drug users basically are like any other citizens. They have skills, resources, and they are able to run an organisation effectively, just like any other interest organisation in the welfare society. More than attempting to challenge the system, they seek to become part of it. Therefore, they take on responsibilities and carry out activities, which are recognised as important and useful by the surrounding society. They inform about drugs, they involve in social work, and they collect used syringes on the streets to improve the image and understanding of drug users and to alleviate stigmatisation.


So, the DDUU is not a radical movement in the sense that it organises a number of protests to call attention to the drug problem or change drug policies. Instead the organisation seeks a position from which it can go into dialogue and negotiations with authorities. It does not exist outside the legitimate institutions, and the success of the organisation in fact depends upon the apparatus of the state (Wieloch 2002: 66). It tends to play down controversial aspects and in this way gain access to the formal channels of interest mediation of the democratic system. At the same time, the DDUU forms an autonomous space and a small community for drug users, who through their engagement are given a status, a position and an identity from the collective activities in the organisation.






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[1] When I refer to drug users in this paper, I basically refer to opiate users. Activists and members of the DDUU are primarily using heroine and methadone, but they may also have a supplementary use of e.g. cocaine, cannabis, alcohol and benzodiazepines.

[2] This study forms part of an ongoing research project which discusses the possible formation of welfare movements among homeless and drug users in Denmark. The research project is supported by the Danish Social Science Research Council (24-02-0277).

[3] The organisation has been visited approximately 20 times, with visits lasting from one to five hours. After these visits, notes were taken, which have formed part of the empirical material for the analysis.

[4] In Århus, interviews were done with activists in Stris (Drug users’ rights in society) [Stofbrugeres rettigheder i samfundet]. Like the DDUU, Stris was formed in 1993 but the organisation never reached the same degree of continuity and stability. In Herning, one interview was conducted with the president of the local user association, which also functions as an open drop-in centre.

[5] Quotes of interviewees were translated into English by the author.

[6] Jepsen (2004b) describes this a blueprint for a Danish version of the War on drugs.

[7] The following description is based on the rules of the association, signed by the chairman 18 September 2004.

[8] The chairman of the DDUU is international director of NAMA.

[9] The importance of meeting drug users with respect instead of control is also emphasised as one of the important aspects of user participation in the article by Vibeke Asmussen in this publication.

[10] These and the following figures are taken from a questionnaire that was answered by 61 users (of a total number of 72) who were registered as visitors/users in the organisation from May to September 2005. The questionnaire formed part of an evaluation of the organisation, which was commissioned by the Ministry of Social Affairs and the Municipality of Copenhagen Hansen, F. K., M. Malmgren, et al. (2005). Brugerforeningen for aktive stofbrugere – en evaluering. København, CASA..

[11] 10 of the 60 persons who answered the question do not form part of a maintenance treatment programme.

[12] According to the DDUU this equals nearly 20,000 used syringes.

[13] With the treatment system, I refer to the different institutions, treatment centres, doctors, social workers, nurses and other actors who take part in providing services, treatment or help to people who use drugs.

[14] Interview with Poul Thyge Petersen. President of the organisation of relatives to drug users that supports harm reduction initiatives. There is also another organisation of relatives to drug users in Denmark, which is much more critical of harm reduction initiatives.

[15] Today, the organisation is called Landsforeningen for human narkobehandling (The national association for human drug-treatment). It works closely together with the DDUU and its office is situated within the premises of the DDUU.

[16] For further discussion of this, see Anker  (2005).

[17] Meaning that they felt like clients. They didn’t think they could manage to run the organisation by themselves.

[18] This is often mentioned in my informal conversations with the activists. It is also noted repeatedly by visitors also from abroad.

[19] Ekstrabladet 3 April, 2000.

[20] Ekstrabladet 4 April, 2000.

[21] Ekstrabladet 4 April, 2000.

[22] As part of this study newspaper articles were searched on the internet site ’infomedia’, which contains newspaper articles from all the newspapers in Denmark. A total of 116 articles were found which had ’The Danish Drug Users’ Union’ included in the text. Of these 116 articles, 10 were very critical or negative in their description of the organisation, indicating that bad press is not a general trend of the media representation. The articles found goes back to May 1996 and up to November 2004. It must be noted that not all newspapers have been represented in the data base in this period.

[23] Proposition B 68 proposed 14 January 2003. The following references are from the parliamentary debate of 28 February, 2003.

[24] This is a good example of the connections between national user organisations and how the action repertoire is copied across national frontiers. The idea appears to have originated from user organisations in The Netherlands (See Tops’ article in this book). It is now also applied by other similar user organisations for example in Sweden.

[25] Jepsen (2004) characterises the organisation as well-functioning and this assesment is supported by interviews with other actors in the field.

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