By Aris Folley | The Hill | February 23, 2022
Lawmakers are drawing heat over their pushback against a federal grant program meant to reduce harm among drug users with “safe smoking kits,” with advocates decrying the claims that taxpayer money is being spent on “crack pipes.”
The outrage began earlier this month, when right-wing media outlets started reporting the Biden administration was funding “crack pipe” distribution in a bid to advance racial equity — an accusation the White House has repeatedly pushed back on as false.
But as the narrative took hold on social media, lawmakers brought the issue to Capitol Hill.
Sen. Marsha Blackburn (R-Tenn.) temporarily put a hold on a spending bill intended to avert a government shutdown after citing a report on the kits by The Washington Free Beacon.
The objections gained steam when Sen. Marco Rubio (R-Fla.) introduced legislation along with Sen. Joe Manchin (D-W.Va.) that sought to bar federal funds for pipes used for crack cocaine, as well as syringes and needles.
The efforts are being slammed and mocked by advocates who say lawmakers are trying to score political points by opposing funding for what they see as proven methods to reduce harm to people who use drugs, particularly as overdose deaths hit new highs nationwide.
“We are in, literally, a record-breaking overdose epidemic, and for lawmakers to go after harm reduction tools when we need all tools at our disposal to save lives is so irresponsible it’s shocking,” Maritza Perez, the director of the office of national affairs at the Drug Policy Alliance, told The Hill.
The outrage stems from a new program announced months back that seeks to increase access to harm reduction services for drug users as part of a larger effort to combat that epidemic, which has worsened during the ongoing coronavirus pandemic.
In December, the Biden administration unveiled plans for $30 million to be put toward the launch of a “first-ever” harm reduction grant program run by the Substance Abuse and Mental Health Services Administration (SAMHSA), which operates under the Department of Health and Human Services.
Officials said the funding was intended to support harm-reduction services such as the provision of safe smoking kits to reduce health risks to drug users.
While pushing back on reports that the administration is funding distribution of pipes, White House press secretary Jen Psaki said earlier this month that kits being provided through the SAMHSA program could contain items such as alcohol swabs, lip balm and clean syringes.
“I would note that what we’re really talking about here is steps we’re taking as a federal government to really address the opioid epidemic, which is killing tens of thousands, if not more, Americans, every single day, week, month of the year,” Psaki said at the time.
The Centers for Disease Control and Prevention (CDC) released data last week estimating 104,288 overdose deaths in the United States for the 12-month period ending in September — a figure that an agency representative confirmed Tuesday is a new high.
In recent months, the CDC has also reported a rise in deaths from synthetic opioids, consisting “primarily” of fentanyl, as well as psychostimulants such methamphetamine.
Peter Davidson, a professor at the University of California-San Diego with years of research experience in areas including drug intervention, stressed the importance of harm reduction services in an interview, while pointing to fentanyl as “one of the things that’s really driving the overdose death epidemic at the moment.”
“What I would really wish and hope for is that lawmakers from any political party, when they first hear this, would actually go out and find out what the science and the evidence actually says about these things, rather than just having an immediate gut reaction,” Davidson said.
According to the World Health Organization, people who inject drugs are more likely to contract HIV, tuberculosis and viral hepatitis B and C. The WHO, citing 2020 data from the United Nations Office on Drugs and Crime, said that, of the roughly 11 million people who inject drugs across the globe, about 13 percent live with HIV and “39.4 percent have viremic HCV infection.”
A January brief published by the University of Washington’s Addictions, Drug & Alcohol Institute said the distribution of safer smoking drug supplies is effective in helping reduce health risks and infection spread from the sharing of smoking supplies.
According to the CDC, decades of research have shown that comprehensive syringe services programs are also a proven means to helping reduce the transmission of viral hepatitis, HIV and other infections.
Daniel Raymond, director of policy at National Viral Hepatitis Roundtable, said the time devoted on Capitol Hill to the recent uproar could have been better spent educating the public “instead of jumping to stigma and politicized attacks.”
“The drugs that we’re concerned about that are driving overdose rates are different now than they were 10 years ago,” he said, “and we have to continue to adapt and evolve our strategies to keep up with that reality, and make sure that we’re hitting the mark.”
Some advocates also took issue with rhetoric used by lawmakers and conservative media around the outrage.
“First of all, the notion that the government is distributing pipes is racist dog whistling. What we’re talking about are glass pipes, but they use the word ‘crack pipes’ for a specific reason,” Perez said, before evoking the nation’s “war on drugs” and its disproportionate impact on the Black community.
“It’s another reminder that some people are really willing to stigmatize people who use drugs and kind of perpetuate the racist narratives that fuel the war on drugs,” said Jenna Mellor, executive director New Jersey Harm Reduction Coalition.
Rubio and other opponents of the government plans to fund safe smoking kits argue that certain tools, such needles, could exacerbate substance use disorder and that they should not be funded by taxpayer dollars.
But advocates say treatment-first or treatment-only approaches are not always effective.
According to 2019 data provided by SAMHSA, nearly 19 million people aged 12 or older who dealt with an illicit drug use disorder, alcohol use disorder or both went without treatment at a specialty facility. More than 18 million of those “did not feel that they needed treatment,” the office said.
Caitlin O’Neill, founder of the New Jersey Harm Reduction Coalition, told The Hill that “there’s a small group of people for whom abstinence does work.” But, even in that group, she added, return to use “is very normal and very common.”
But advocates say distribution of safer smoking drug supplies has helped serve as a gateway to additional resources for those who use drugs, such as connections to treatment, options for HIV testing, counseling services and food.
“When someone is being handed a safer smoking kit, it’s not just being like [at a] drive thru window, you get it and you walk away and you don’t connect with someone. It’s being handed to you, and you’re usually being asked a question of like, what’s going on? How are you using?” added O’Neill, who said she has also dealt with substance abuse in the past and previously used a harm reduction program.
Rubio’s legislation to bar federal funding for pipes and other drug paraphernalia was blocked by Senate Democrats last week. But the Florida Republican, who is up for reelection this November, has signaled in comments to reporters that the fight is not over.
“We’ll be back on this,” he said days ago after a vote on his bill failed.
The Hill has reached out to Rubio’s office for further information.
Though O’Neill said harm reduction services have seen much funding from “local state funding or private funding,” as well as grassroots fundraising, she expressed concerns about whether the “stigma at a national level like this” over the SAMHSA program could hurt expansion for similar services going forward.
“But it won’t stop our efforts on the ground,” she quickly added. “We’re going to continue to take care of each other because that’s what we do … and if the government doesn’t show up for us, we’re gonna continue to show up for each other.”