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No, Biden Is Not Handing Out Crack Pipes. Here’s Why Harm Reduction Activists Do.

Racist right-wing outbursts over “crack pipes” reveal the depth of stigma against lifesaving harm reduction programs.

The uproar over “crack pipes” comes at a critical moment in the overdose crisis.

Over the past week, conservatives spread the patently false claim that President Biden is spending millions of federal dollars on free “crack pipes.”

No, the Biden administration is not giving out “free crack pipes,” as Tucker Carlson claimed on his show Tuesday night, specifically touting the racist rumor that the alleged pipes were being given “to Black people.” Carlson and far right lawmakers are exploiting the harmful and racial stigma that still surrounds crack cocaine to score political points and get attention — and their attacks signal a broader backlash against crucial efforts to contain the drug overdose crisis and protect public health.

Some harm reduction groups do hand out free glass pipes for smoking stimulants, counterfeit painkillers and other drugs, a practice conservatives have recently scrutinized in liberal enclaves such as Portland and Seattle, although it’s nothing new.

For some drug users, smoking is an increasingly popular alternative to injecting drugs with syringes, which can lead to abscesses, HIV and hepatitis C transmission and other health problems. Offering free pipes helps encourage this often-safer practice over syringe use, and also brings medically vulnerable people in contact with a range of services, including medical care, HIV testing and pathways to addiction treatment, according to Jim Duffy, founder of Smoke Works Harm Reduction. The not-for-profit group supplies pipes to syringe exchange programs across the country, which are proven to prevent overdose and the spread of disease.

“Every inroad we can make into different drug-using communities — stimulant users, for example — is another avenue for overdose prevention and medical and recovery services,” Duffy said in an interview.

Syringe exchanges and groups like Smoke Works won’t be receiving federal funding earmarked for pipes anytime soon. Instead, harm reductionists develop their own methods of gathering safety supplies through mutual aid: Smoke Works gathers donations and buys pipes at cheap wholesale prices and passes down further discounts that are shared between harm reduction groups.

The uproar over “crack pipes” comes at a critical moment in the overdose crisis. Stigma, misinformation and conservative pushback have prevented syringe exchanges and other harm reduction programs from receiving federal funding for decades. Meanwhile, the government’s efforts to contain the overdose crisis with prescribing restrictions and law enforcement have failed. As the number of drug-related deaths reached record highs during the pandemic, the Biden administration made tentative moves to support harm reduction while continuing to pour money into “traditional” policies rooted in the “war on drugs.”

February 7 was the deadline for applications to a Health and Human Services (HHS) grant program funded by Congress, which offered $30 million in funding for harm reduction programs. It’s a fraction of the money funneled to drug police, but is still significant: The grant program and the legal reforms behind it are the result of years of protest and activism. The funding will help harm reduction programs provide a list of safety supplies ranging from clean syringes and HIV testing kits to bandages for wounds and naloxone, the opioid antidote that reverses overdoses and saves countless lives.

Most of these supplies are considered necessary for protecting public health and are no longer controversial, but conservatives pounced when they discovered the grant program includes funding for “safe smoking kits/supplies.” Safe smoking kits contain items that make smoking drugs out of glass pipes safer, including screens that act like filters, mouthpieces, alcohol swabs and lip balm.

Conservatives have wrongly accused evidence-based harm reduction programs of promoting drug use for decades, and after a vague initial statement from HHS, the claim that Biden was handing out taxpayer-funded crack pipes went viral with help from Republican lawmakers. The federal grant program prioritizes funding for “underserved communities,” which right-wing outlets interpreted as people of color and suggested that Biden is handing out crack pipes to “promote racial equity,” drawing on racist stereotypes about smoking cocaine.

The White House and HHS made forceful statements clarifying that no federal funding would be used to put pipes in safe smoking kits, but that did little to quell the racist memes about “government crack pipes” on social media. Still, experts and advocates say free pipes are consistent with the best practices of harm reduction, and Biden administration should stand firm against clickbait misinformation and support of evidence-based solutions to the overdose crisis, including all safe smoking supplies.

White Press Secretary Jen Psaki said right-wing news reports about “crack pipes” were not accurate and condemned the apparent political opportunism at a time when an average of one American is dying of a drug overdose every five minutes.

“We don’t have time for political games,” Psaki said on Wednesday.

Psaki pointed to Rep. Tom Cotton, a Republican from Arkansas who promoted the “crack pipes” narrative on Twitter but also co-chairs a bipartisan commission that published a report this week endorsing harm reduction efforts, including naloxone distribution by syringe exchange programs. In the past, Republicans were forced to drop their opposition to syringe exchange programs when confronted with HIV outbreaks among their constituents.

“The president is focused on saving lives through harm reduction programs,” Psaki said. “That’s exactly what we’re talking about here. They work in red states, and they work in blue states. We know they save lives; they help connect people to treatment and recovery.”

The goal of saving lives is also why groups like Smoke Works use cost-sharing models to make free pipes available at syringe exchange programs across the country. When Duffy smoked methamphetamine in the past, he did not consider going to a syringe exchange, which are often associated with people who inject heroin. However, he eventually discovered that syringe exchanges offer a range of other services in a compassionate environment regardless which drugs their clients use.

“I would have loved to find a place when I was an active methamphetamine user where I felt like I was treated like a human being, and lo and behold there is one in most major cities, but most people don’t know about it,” Duffy said. “We have lifesaving services that are inadvertently misbranded … you think you have no reason to walk into a needle exchange if you don’t inject, but the services there can change your life.”

Simply put, free pipes give people a reason to show up to a harm reduction site, and once they do, they can access a whole range of supplies and services that make drug use safer and improve health outcomes, including pathways to recovery from addiction if they wish.

Coverage of the overdose crisis has largely focused on powerful synthetic opioids such as fentanyl that have flooded the illicit drug supply amid a crackdown on drug trafficking and painkiller prescribing, but fatal overdoses involving methamphetamine and combinations of drugs are also increasing, according to federal data. Along with providing clean syringes, harm reduction efforts — including the federal grant program attacked by Republicans — provide fentanyl test strips, which can help opioid users gauge the potency of drugs, and alert cocaine and methamphetamine users to contamination that increases the risk of overdose.

Across the country and especially in the West, some injection heroin users have switched to smoking counterfeit painkillers containing fentanyl. If drug users are switching from syringes to glass pipes, then it makes sense for syringe exchanges to offer glass pipes along with their other services. While they are picking up pipes, people can also receive basic medical care, lifesaving naloxone and referrals to mental health and addiction treatment. Under the HHS grant program, vaccinations for COVID and other diseases will also be available through harm reduction programs.

Duffy was amazed by the “litany of services” when he finally arrived at a syringe exchange, including HIV testing, connections to recovery, medical care and just an “ear to bend for 30 minutes.” By helping harm reduction programs make pipes available, he hopes he’ll help more people who smoke drugs out of glass pipes find their way toward care as well.

“These are people who are otherwise excluded from medical and recovery services,” Duffy said.

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