Free Crack Pipes Are Good, Actually.

Several months ago, the Department of Health and Human Services announced a new federal grant for local drug abuse harm reduction programs that distribute naloxone, clean needles, and safer smoking kits — you know, to keep people from overdosing or contracting a serious and irreversible illness like HIV or hepatitis.

This week, following a ridiculous article in the Washington Free Beacon about the program, the Right went absolutely bananas over a rumor that the Biden administration was giving out free "crack pipes" to addicts as part of these "safer smoking kits" being distributed. I put "crack pipes" in quotes because the very same pipes used to smoke crack are also used to smoke fentanyl, crystal meth, and other drugs. The reason the Right seized on the "crack pipe" narrative, ignoring the other drugs these pipes are used for, is obvious and obviously racist.

And not only were they mad about the mere existence of a supposed "crack pipe distribution" program, they were even more outraged that the programs that would get priority for the grants would be those serving currently underserved communities — including Black and LGBTQ communities. All "The food is terrible — and such small portions!" jokes aside, this obviously makes more logistical sense than giving those grants to programs in communities that are already taken care of in this way, but any excuse to poke the white grievance bear.

In response, on Wednesday, HHS Secretary Xavier Becerra made it clear that the harm reduction grant program would "not be used to pay or reimburse for pipes in safe smoking kits."

White House Press Secretary Jen Psaki firmly denied that the Biden administration would be taking your tax dollars to pay for fancy new crack pipes.

Asked by a reporter if the pipes were never included to begin with or were removed after public outcry, Psaki said, “They were never a part of the kit, it was inaccurate reporting, and we wanted to put out information to make that clear.”

When asked what was actually in the kits, she said they “may contain alcohol swabs, lip balm, other materials to promote hygiene and reduce the transmission of diseases like HIV and hepatitis.”

It's actually too bad that the kits do not include pipes, because we know for a fact that pipe sharing vastly increases the spread of HIV and hepatitis. While we traditionally associate HIV and Hepatitis C with needle sharing, it's also a problem among those who share glass pipes. Smoking crack cocaine and other drugs causes sores on the lips and inside the mouth, so when lack of access to sterile pipes leads to people sharing them, this leads to infectious diseases being spread. The lack of pipes also leads people to DIY their own equipment from Brillo pads and glass stems — which one can probably imagine is not spectacularly safe either — and cause their own health/exploding problems.

We also know that the crack pipe distribution program in Vancouver led to significantly declining rates in the spread of these diseases among those who use glass pipes, and that it is probably a lot more effective than lip balm. Those who are actually doing the work understand what is needed, and the best plan, really, was to allow grant recipients to determine what ought to go in those kits.

Unfortunately, this is apparently one of those situations where we have to let the "common sense" of idiots override the understanding of actual experts.

People very much want to believe that the best way to help addicts is to let them hit "rock bottom," the magical point at which they are supposed to see the light and be able to turn their lives around. It is a very satisfying solution, and one frequently advocated for by those who have never actually known or cared about someone with a substance abuse problem.

But practically every expert on earth — yes, including the people on Intervention — will tell you that there is no such thing as "rock bottom" and that early intervention is ideal. Also if there were such a thing as rock bottom, it is highly unlikely that it would come from fear of getting hepatitis from an unsanitary pipe. That would be the reason we have clean needle programs, the reason some places have crack pipe distribution programs, to begin with.

The truth is the further people fall, the harder it is for them to get back up. There is always another rock bottom, particularly when someone is not in their right mind and has a severe physical addiction to something. And if they die, they definitely can't get back up. Trying to let people hit "rock bottom" frequently means turning a fixable situation into an unfixable situation, and harm reduction is about preventing those unfixable situations.

Oh, and for the more jaded among us? Not spending money on clean needle programs and pipe distribution programs means spending much more money on treating people with HIV and HCV. Research shows that for every dollar spent on clean needle programs, communities get about a $7 return on their investment.

For God knows how many decades, America has been dealing with drug addiction in a way that coddles the "common sense" sensibilities of those who truly do not know what the hell they are talking about. It hasn't worked. Like, it really, really hasn't worked. We have over 100,000 overdose deaths a year — and the opioid overdose deaths alone cost us $1 trillion a year. There have been over a million overdose deaths since 1999. If being assholes about addiction worked as well as some people think it does, this would not be our current situation.

Hopefully, someday, enough people will decide that they care more about doing what works than doing what doesn't work but would provide a deeply satisfying narrative if it did.

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Robyn Pennacchia

Robyn Pennacchia is a brilliant, fabulously talented and visually stunning angel of a human being, who shrugged off what she is pretty sure would have been a Tony Award-winning career in musical theater in order to write about stuff on the internet. Follow her on Twitter at @RobynElyse


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