The Urban Survivors Union Methadone Manifesto is a document written collaboratively by members of the Urban Survivors Union (USU) methadone advocacy and reform team, an organizing team composed of current and former methadone patients and our allies. We have come to a consensus on many policy issues based on our shared scholarship and lived experience. However, we are all different people, from different socioeconomic backgrounds, with differing and evolving ideologies, and these differences may be apparent to any reader who compares and contrasts different sections of the document. This text reflects our collaborative writing process. Furthermore, the Manifesto is a living document which is subject to change and elaboration. We in no way intend the current version of the Manifesto to be a comprehensive statement on all of our methadone policy stances and analyses, and we expect to continue to add to and amend this text long after its release.