The big purple truck that delivers health supplies to drug users in Chicago’s suburbs carries more than 100 items — everything from syringes and condoms to snacks and winter coats.
But there’s one other thing the harm reduction group Live4Lali hands out that suddenly has become the subject of a Washington, D.C., firestorm — a slender glass tube used to smoke crack cocaine and other drugs.
It’s the key part of so-called safe smoking kits that are handed out in the hope of cutting down on disease transmission and injuries among people who smoke drugs. For years it was an innocuous part of the arsenal, but last week it came under scrutiny after a conservative news outlet published a story with a provocative headline: “Biden Admin to Fund Crack Pipe Distribution to Advance ‘Racial Equity.’”
The story concerned a $29 million federal grant for harm reduction groups that will allow them to buy supplies, including safe smoking kits (the “racial equity” part refers to a requirement that groups specify how they intend to reach “underserved communities”).
But after the story’s publication, federal officials all the way up to President Joe Biden’s White House press secretary, Jen Psaki, hastened to say the pipes themselves “were never a part of the kit” the grant would pay for.
That hasn’t stopped some from making political hay out of the episode, dubbing the items “Biden’s crack pipes.” Sen. Marco Rubio, a Florida Republican, has introduced legislation that would prohibit federal funds from going toward such purchases, and some Republican operatives have promised that crack pipes will be an issue in the coming midterm elections.
“In 100 years America went from a chicken in every pot to a crack pipe in every house,” GOP consultant Ryan Girdusky told the New York Post.
The Substance Abuse and Mental Health Services Administration, which is administering the grant, did not respond to the Tribune’s request for comment.
Laura Fry, Live4Lali’s executive director, said the dust-up was much ado about very little: Her group, like others, has numerous funding sources, public and private, and at 40 cents apiece, the glass tubes are among the least expensive things it purchases.
But she nonetheless found it disheartening.
“It’s just more bias and stigmatizing rhetoric for our friends who use drugs,” she said. “People who use substances do not deserve any less respect than you and I do when trying to treat our disorders and diseases. That is really what we fight — the stigma and the shame.”
Many harm reduction groups got their start distributing clean syringes to heroin users, intending to curb the transmission of HIV and other blood-borne diseases. Over time they added other products to the mix, including plastic straws, for heroin users who prefer to snort their drugs, and safe smoking kits.
Erica Ernst of the Chicago Recovery Alliance says its kits, which it buys using funds from the Chicago Department of Public Health, include two glass tubes suitable for smoking crack, an alcohol pad to clean them, a bit of copper mesh that acts as a filter and heat retainer, a chopstick to push the drugs and filter into the pipe, and a rubber spark plug cover that serves as a mouthpiece.
She said people who smoke crack or meth can burn their lips and leave blood — and potentially viruses — on their pipes. Sharing the devices heightens the chance of spreading disease, she said.
Researchers have linked crack pipes with the transmission of hepatitis C and tuberculosis. One recent study out of England even warned that “the sharing of pipes poses an acute COVID-19 transmission risk, given the infectivity of the virus.”
Drug users who obtain their own pipes often end up with substandard products, Ernst said, such as thin glass tubes, sold at gas stations or convenience stores, that are known as “roses” for the small artificial flowers they contain.
“They tend to shatter or explode,” she said. “Giving someone a safe Pyrex equivalent can lead to less injury.”
Crack use often accompanies opioid use, so a harm reduction organization can address many issues at once, or even end up guiding a user into treatment. Ernst said the important thing is to connect with vulnerable people and help them make positive changes, no matter how small.
Both the Chicago Recovery Alliance and Live4Lali sought the grant that kicked off the controversy, but with only 25 awards promised, just a fraction of nation’s harm reduction groups will end up with any money.
The alliance won’t be one of them: Ernst said the online portal wasn’t working when the group tried to send in its application and technical assistance didn’t arrive in time.
If Live4Lali succeeds, Fry said the federal prohibition against spending the money on pipes would have no practical effect; the group hands out only 20 or so smoking kits a week.
Besides, there are plenty of other things the organization needs.
“We give out 50 pounds of fresh fruit a week,” Fry said. “That is a hot item — much hotter than a smoking utensil.”
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