"A Family of Drug Users"—Meet the New Leader of the Harm Reduction Coalition

Oct 24 2016

“A Family of Drug Users”—Meet the New Leader of the Harm Reduction Coalition

October 24th, 2016

“I’m really comfortable being in the background,” Monique Tula tells me. It’s a bit surprising to hear it from a woman who last month became the executive director of the Harm Reduction Coalition and therefore one of the key leaders of the whole movement.

Then she explains it rather well. “I see myself as the producer-director of a film, working to create a vision.” An early opportunity for her to express this will come in San Diego next week, when 1,200 delegates are expected at HRC’s biennial conference.

It’s still a different style from other harm reduction leaders you can think of—people known for their ability to whip up a crowd. Tula, by contrast, admits she’s relieved I didn’t bring a video camera with me to our interview, as I had threatened.

But perhaps there’s something about her kind of leadership that’s well suited to the nature of harm reduction. “I’m not an academic, I’m not an organizer, I’m not a politician,” she says. But “I’m a really good manager and I listen.”

The inclusiveness that implies is a big point here, because her management style is not the only thing that makes her different. When I put it to her that despite the harm reduction movement’s aims and talking-points around drugs and race, a disproportionate number of its leaders have been white men, she looks at me hard. “Did I give you my notes already?”

Sitting in her modest office at her organization’s Manhattan headquarters—which are, appropriately enough, being refurbished—Tula talks thoughtfully and engagingly as she expands on the theme.

“This movement is growing,” she says. “But it’s threatened by the blight of things like conservatism and racism … In spite of all the perceived gains of the American Civil Rights movement, our country is again faced with re-examining regressive tactics aimed at keeping the divide between white people and black and brown people.”

“This plays out in the way law enforcement is trained to deal with alleged criminals and the way the criminal justice system punishes people who use drugs or sell drugs or are accused of doing either. The reality is that skin color in America predicts who serves time for drug-related crime and whose lives are irreparably damaged as a result. This is what is front and center for me.”

Such disparities should be well known to anyone acquainted with past and present US drug policy. But what she says next may be startling to some.

“I also question whether within the harm reduction community there exists our own brand of institutional racism. Some of us, I think, don’t see a divide. I think some of us see the divide and live it every day.”

It’s a stinging charge against a movement that defines itself by its egalitarianism, and one that indicates Tula’s quietness shouldn’t be mistaken for meekness.

“Engaging in a really meaningful dialogue about racism and institutional racism may be one of the most difficult things that we do,” she continues. “It will be painful. It will make us vulnerable. We may lose people along the way, but I really don’t believe that we can move forward without admitting at least the possibility that institutional racism exists.”

“If we can do that in a way that doesn’t ostracize people, then I really do believe we can be the change that we want to see in the world.”


Monique Tula is 51. She grew up in Los Angeles in a “poverty-stricken environment,” the daughter of a black father and a Jewish mother of Russian-Polish heritage; she identifies as a black woman. And drug issues have been important to her for as long as she can remember.

“I come from a family of drug users,” she tells me, without going into details. “I know that my own perspectives about drug use were informed by what was going on with my family. When I think back to what it was like to be a child in the middle of all that chaos, I really didn’t have a word to describe what my family and I were experiencing. In large part, the harm reduction community has given me that language.”

Yet she was no automatic harm reductionist. In the context of the Reagan and Clinton eras, she explains, “and my own experience of my father’s use and folks who were around me, I felt as if there was a part of me [for which] the ‘tough love’ message resonated. It’s very difficult to practice harm reduction with the people you love the most. From an intellectual standpoint I get it, but when it comes down to my own family’s use, I just wanted them to fucking stop.”

After “a lot of soul-searching,” however, Tula embraced “the idea that drug users can be nice people, just human beings who are struggling with any number of things.” She names lack of access to education and jobs, the impact of previous or concomitant trauma and untreated mental health issues as factors. “I think all of those things really help inform my current views on drug use and why this work is really important to me.”

Moving towards this realization in the mid-’90s, Tula switched coasts at the age of 30, with her then-10-year-old son. Without a college education, she managed to find work as an administrative assistant at a small AIDS service organization in Springfield, Massachusetts. “People there took me under their wing and were very patient and taught me a lot of things,” she recalls. “Eventually, I got trained to become an HIV counselor. I started testing people for HIV; there were quite a few folks then who were still seroconverting.”

From there, she moved to working at a needle exchange program in Northampton, Mass. And soon after, she attended a conference of like-minded advocates and service providers at just the time when Donna Shalala, US secretary of health and human services, announced that the Clinton administration would not support syringe programs.

“People were so viscerally angry,” she recalls. “They were this group of ragtag anarchists who, as tough as they may look on the outside, were some of the kindest, most gentle, opinionated outsiders, practicing outsider politics. It really resonated with me. I fell in love with this community.”

After that, Tula never looked back, taking on greater responsibilities in a number of organizations and earning her Bachelor’s degree, at the age of 43, while continuing to work. (She’s taking her Master’s in Organizational Development right now—while running HRC and being a hands-on grandmother. “Struggling to survive,” she says with a smile. “Struggle is real.”)

In 2012, Tula joined AIDS United, a DC-based grant-making and capacity-building organization. There, she led the implementation of some major grant-making programs focused on helping people living with HIV. She served as vice president of programs before moving to her current role.

AIDS United collaborated with HRC to deliver programs and capacity-building, meaning that Tula was already very familiar with the organization and with her predecessor, Allan Clear.

Clear, who led HRC for the first two decades of its existence, is widely revered in harm reduction circles, and I ask Tula how it feels to step into such shoes.

“It’s sort of huge,” she replies. “There’s only one Allan Clear, and he means a lot of things to a lot of different people. Some people see Allan as kind of the leader of the US movement and a representative at the global level. I think of him as one of the major contributors in the fight to include drug users in the development of policies designed to improve their lives. He’s done this in collaboration with people all around the country and the world. One of the unique things that Allan has is his ability to engage people and, no matter what their views are of drug use, to keep the dialogue going.”

“That said,” she continues, “I think one of the things he and I have in common is a commitment to partnership. No one person can lead an entire movement. No one person can be the sole spokesperson for an entire community. I can’t speak for everyone but I can listen, and then use this platform that I’ve been given to help expose how things like mass criminalization and racism and stigma play out in the lives of drug users.”

“I’m clear that my views on drug use and drug use or health and drug user rights are informed by my own experience, my own biases,” she says. “I come from an imperfect world that’s full of people just struggling to survive. I’ve lost people. I feel compelled to use this platform to continue the legacy that Allan and all the people that he worked with over the past 25 years began. It’s a challenge that I accept.”

Tula is disarmingly modest about the organization’s decision to appoint her. “There may be some people who have a more credentialed pedigree who would be suitable for this role, people who are smarter, who are more politically savvy. [But] I think the board of directors made a very clear statement, unspoken or spoken, that now is the time for a black leader, and a black woman leader at that. If not now, when?”


HRC currently employs a couple of dozen full-time staff, mostly based in New York, with a handful in Oakland, California and one in Boston. Tula herself is now living back in California and will continue to do so—looking to build up the organization’s presence there—while also spending time in New York every month.

I ask her in what other new directions she may lead HRC, and how she envisages it will continue to be a unique player in this field.

“We are sort of on the precipice of re-envisioning that,” she responds. “What it has been, I believe, is that we are the visible sort of megaphone, speaking on behalf of drug users and people working with drug users—we have been, in the US, the most visible national organization focused on drug user health and drug-user rights. That’s not going to go away.”

The other aim, though, “is also to work our way into the inside. I think Daniel Raymond, our director of policy, has just been brilliant at the way he’s done this. Daniel is able to walk into a space filled with politicians and bureaucrats in DC and really command the room. I think that is how the Harm Reduction Coalition has grown—we’re able to speak to those folks while also supporting more grassroots approaches to change policy.”

“The work that we do is sort of two-pronged,” she explains. “There’s policy and there’s ‘capacity-building,’ which is very jargon-y: training folks who are working directly with people and providing technical assistance, focused more at the organizational level. We’ve got to be really up on our game, so that the capacity-building piece and policy piece inform one another—neither of those things can be state-of-the-art if we don’t have close ties to folks on the ground doing the direct service.”

“A lot of my work right now is focused internally,” she concludes, “assessing the house to make sure that we’ve got a really solid foundation to take the movement into the next decade.”

In that context, caution is evident in some of Tula’s responses. For example, when I ask her whether she would support the full legal regulation of all drugs, as opposed to just decriminalization, she thinks hard for some time before deciding not to answer.

Yet she’s more forthcoming when I put another idea to her—one that has periodically featured in The Influence.

“This concept that we’re ‘losing our soul,’ it doesn’t hold a lot of water with me,” she says. “A really wise young woman said to me a long time ago that the goal, whether intentional or unintentional, of any avant-garde movement is to become mainstream—that’s how real change happens. I think that that is utterly true for the harm reduction movement of 25 years ago: Those of us who were raging against the machine with our pick axes and hammers at some point realized that we needed people in the inside, figuring out how to dismantle it.”

“I think that we are beginning to see really positive results of that work. When I hear politicians uttering catchy phrases that we came up with 25 years ago like ‘meeting people where they’re at,’ am I happy? Yeah, absolutely.”

Read more from The Influence:

Women Who Use Drugs Need Gender-Specific Services—My Own Life Proves It

Seven Things We Must Understand About Addiction to Undo the Mistakes of the Past 40 Years

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Tula’s reading of the current political and social situation is essentially an optimistic one, even if that’s tempered by her analysis of the reasons for progress. “I do think that the conversation is shifting, but I think that it’s shifting because of the face of the white opioid user in America. It’s not shifting because black and brown people are using drugs.”

“The kids who are coming from middle-class or affluent families, those families are making an impact in ways that we hadn’t seen before,” she continues. “They can walk into a legislator’s office and immediately resonate with whoever happens to be sitting behind the desk because they look the same.”

She’s definitely not going to reject positive change that is predicated on relative privilege, however: “I think that getting naloxone into the hands of folks who need has really been dependent on the [mainly white, often affluent] moms’ advocacy groups; they’re a huge part in driving awareness about fatal overdoses and how they can be prevented. I’m certainly not going to stand in their way; I’m going to stand alongside them in terms of what they are advocating for. [But] I want make sure that users everywhere, regardless of what they look like, have access to naloxone or other things that they need.”

“We are in an era where drug users are finally beginning to be treated with some dignity and respect and some compassion,” she says. “I want to see the harm reduction movement join forces with some of the major social justice movements of this era, and make sure that our cause is built into their platform and vice versa, so that not one more person is imprisoned by the actual or metaphorical bars caused by mass criminalization and stigmatization of people who use drugs. That’s where I believe the opportunity is.”

Will Godfrey is the editor-in-chief of The Influence. You can follow him on Twitter: @GodfreyWill.

  • James DuMouchel

    Legalize all drugs; have them sold at cost thru pharmacies or gov’t dispensaries. Using the previous years statistics, add a surcharge on each dose to cover the care and medical expenses incurred by each type of drug. Maybe a penny per dose of cannabis, probably fifty cents or so per dose of the hard drugs.

    The violent cartels would be wiped out of the drug business, as they won’t sell for cost. Way fewer overdoses, because strength and purity would be regulated. No more junkie burglaries because the real manufacturing cost of these drugs is only a nickel or a dime per dose. Use will not skyrocket because studies show that addiction rates remained relatively the same over the past 150 years, even though legal punishments for use have varied wildly. Portugal’s experience verifies this.

  • natriley

    This great, why not a follow up interview with Daniel Raymond towards the end of the year or the start of the next session.

  • Tim LaBard

    Killary for Prison. Trump 2016! I’m not mentally insane and don’t suffer from cognitive dissonance and don’t support an evil crooked witch criminal.

  • Dan Bigg

    Monique is the perfect person for positive change in Harm Reduction! She is more than ready to properly lead such a group in constructive but principled directions…In many ways, the position been waiting for her her whole life!