“Being a sex worker or a junkie doesn’t taint your maternal instincts,” Lily tells me. “I am a mother and I love my daughter just as much as someone who doesn’t work in the sex trades or have issues with opiates. I feel like the real problem lies with both drugs and sex work being criminalized. This is what makes it harder for us to be who we are, and then be mothers and partners and everything else that is expected of us.”The viewpoint that sex work and opioid use are inherently degrading, their practitioners amoral members of society, is baseless. It is the criminalization of our lives that forces us against a wall — the high cost of scheduled drugs, the vulnerability of working in an illicit trade, and the danger of arrest.Countless women — your sister on Paxil, your mother on Xanax — are physically dependent on a substance, but most of them don’t consequently have to raise hundreds of dollars a week. Many people work in trades which are loathed — from professional gamblers to parking-meter readers — but not all of them have to worry daily about arrest and violence.Nor do they have to worry about a nightmare combination of the two: rape by cop. This was something Oklahoma City police officer Daniel Holtzclaw’s victims, 12 poor Black women, some of whom were drug-using sex workers, had to suffer without resolution — until his attack of a woman with no criminal record made their reports credible. And most people don’t have to worry about detoxing in jail, possibly dying from withdrawal complications as prison guards look on — like Florida mother April Brogan after she was picked up in a prostitution sting in Daytona Beach last spring.“The criminalization of drugs and the criminalization of sex work combine to affect me in that I’m extremely anxious most of the time,” Rose says, “due to [always] either being about to work or about to score.”When every moment of our daily business , from earning that living to getting well, is fraught with fear and danger, the wonder is not what desperate creatures drug-using sex workers are. The wonder is how we so often manage to transcend that desperation, living fuller lives than anyone imagines.Lily is a celebrated local writer and Chloe Rose tirelessly supports her friends. The two other women I interviewed for this piece are an accomplished community organizer and a grad student who is a rising star in her department. All four of them are not only sex workers who use drugs, but also survivors of impoverished childhoods and underage survival sex work — and still they manage to flourish. Yet despite what we manage to do, the issue always seems to be how far we’ve fallen.At the end of Requiem for a Dream, Marion clutches an ounce-bag of heroin as she falls asleep on her couch, a bag she earned providing entertainment at an orgy. It’s clear that she hasn’t bathed. Her sweaty hair is plastered across her scalp, and the book notes that she can still smell the men on her lips. She is happy because she no longer has to rely on her boyfriend or anyone else, and dope is in easy reach: “I can always feel like this.”But the Greek tragedy format of the tale implies that this is her undoing, with the narrative equating her fate to being lobotomized or having a limb amputated. Being a junkie is bad enough; being a junkiewhore is a debasement that cannot be borne.In fact, even many of my fellow sex workers think this way. Drugs have long been a dicey topic for sex-worker activists. In Feel Me , Leslie Bull writes:“Throughout the feminist sex worker anthologies I read, I felt downplayed, ignored, erased, and portrayed as one small minority of desperate victims, downtrodden and useful as a pawn for sex-negative enemies… I am never heard from or described with any complexity or mobility. I am talked about in terms of AIDS prevention, murder statistics, scarcity, and pity.”Not enough has changed since Bull outlined the problem thusly in 2002. At best, sex worker organizations with middle-to-upper-class members do street outreach, passing out literature, needles, condoms, and other harm-reduction materials, but they do not view hard-drug-using street sex workers as fellow movement participants.At worst, in interview after interview , privileged sex workers insist to media representatives that they do not do drugs — they are not one of those. They believe they are combating harmful stereotypes about sex workers, but what these statements really achieve is the exclusion from the movement of many of their colleagues.“I think drug-using sex workers disrupt other sex-worker activists’ ideas around a sanitized image…a ‘clean’ image that is best put forward, in their mind, to the public when fighting for our rights,” says Marisa, a prominent 37-year-old East Coast sex-worker activist who is also a closeted heroin user. “We should not continue to allow our movement to be sanitized for the sake of respectability politics. Not feeling safe to disclose our use prevents us from participating fully in activism as our authentic selves. It makes us feel alienated and alone in a movement that should be welcoming and warm.”“Sex-worker activists say things like, ‘I came from a good home and I’m college-educated and I don’t use drugs’ to make us more relatable and less scary,” Lily says. “They think it doesn’t look good for their cause, so they pretend we don’t exist and push our narratives as far away as possible from the mainstream… It’s infuriating when the ‘happy hooker’ narrative tries to silence our narratives, which are equally as important and complex and beautiful.”I encountered this strong bias against drug use within the sex-worker activist community when I began writing a column called “ Ask Ms Harm Reduction ,” answering questions like, “My heroin-using friend is pregnant — how do I help her?” Or, “How can I stay safe while taking E at the club?” and “How can I manage risks when doing drugs with clients?”I mostly got a positive reaction, but was also berated by a few sex-worker activists. One New England escort and organizer commented , “why [do] you insist on portraying sex workers as addicts…no doubt these types of articles will be used at trafficking conferences to demand that we stay criminalized.”