Conservative figures have launched an online furor this week, claiming that the government planned to spend $30 million on pipes for smoking crack cocaine.
“It’s really disappointing that Republicans are trying to win political points by putting lives at risk and creating misinformation about harm reduction,” said Jamie Favaro, executive director of NEXT Distro, one of the groups that applied for the grants. If given the funds, NEXT Distro would spend funds to distribute the overdose-reversing drug naloxone and clean syringes in Georgia, Louisiana and Nevada.
Amid mounting outrage fueled in part by Fox News and other conservative outlets, here’s what to know about the federal grant:
What is the grant for?
In a first-of-its-kind federal grant to be distributed by the Substance Abuse and Mental Health Services Administration, a branch of HHS, dozens of organizations across the country would be able to spend the money over three years on a preapproved list of resources, including referrals to treatment, infectious-disease testing kits, condoms, and vaccinations for hepatitis A and B.
Also on the list: “safe smoking kits.” Typically, such kits include a rubber mouthpiece to prevent cuts and burns, brass screens to filter contaminants and disinfectant wipes, according to Harm Reduction International.
Favaro, whose program does not distribute the “safe smoking kits” approved by HHS, said groups that provide kits typically don’t include a glass pipe as it is expensive relative to providing the rubber mouthpiece. Clean glass pipes are intended to curb sharing pipes and spreading oral infections or injecting with needles, a riskier method of doing drugs.
Keith Humphreys, an addiction researcher at Stanford University School of Medicine, said researchers haven’t found that providing glass pipes works as intended, in part because of the difficulty of tracking infectious diseases spreading among drug users. But addiction, like other health problems, requires solutions beyond cures to reduce suffering, he said.
“Obviously, we would like everybody who is addicted to never use drugs again, but if we can’t have that, we should be grateful to at least reduce use or reduce the damage of use to that person or to the people around them,” he said.
On Wednesday, the White House and HHS denied the funds would be spent on the pipes. HHS did not answer a question from The Washington Post about whether the kits could include glass stems.
“HHS and ONDCP are focused on using our resources smartly to reduce harm and save lives. Accordingly, no federal funding will be used directly or through subsequent reimbursement of grantees to put pipes in safe smoking kits,” HHS Secretary Xavier Becerra and Office of National Drug Control Policy Director Rahul Gupta said in a statement. “The goal of harm reduction is to save lives.”
White House press secretary Jen Psaki also on Wednesday dismissed a report as “inaccurate” from the conservative outlet Washington Free Beacon that an HHS spokesperson said the White House would be distributing crack pipes.
“We wanted to put out information to make that clear,” Psaki said. “The safe smoking kit may contain alcohol swabs, lip balm, other materials to promote hygiene and reduce the transmission of diseases like HIV and hepatitis.”
The funding is “a historic moment” in drug policy as most harm reduction programs have been otherwise ineligible for federal funding in years past, according to Sheila Vakharia, an expert at the Drug Policy Alliance.
These groups, often at the front line in communities hit hardest by the latest waves of the overdose epidemic, directly service people who use drugs, deploying “the law of attraction” to get people otherwise marginalized or unable to access health-care resources, such as information about treatment, Vakharia said, a necessity when people who use drugs are often stigmatized.
“Harm reduction as a practice and as a philosophy is all about helping people make informed and safer decisions,” Vakharia said. “It’s about saying, ‘This is a place where we accept you for who you are and here are the tools for you to help stay safe while you’re smoking, and in addition, we’ve got condoms, and we can teach you about identifying someone overdosing, and here’s naloxone.’ ”
What’s the controversy?
“Biden crime policy: Crack pipes for all. What could go wrong?” Sen. Ted Cruz (R-Tex.) tweeted.
Republican lawmakers and online talking heads painted an absurd image of government-issued crack pipes being mailed to each American like coronavirus tests, alleging that language that said the money would be awarded to underserved communities meant the federal government would target Black people.
“The Biden administration is going to be sending crack pipes and meth pipes, targeting minority communities,” Sen. Marco Rubio (R-Fla.) said in a video message. “I know that sounds insane, I know that sounds too crazy to be true.”
In reality, the investment in harm reduction is a drop in the bucket of federal spending, unworthy of a “massive cultural war blowup,” Humphreys said.
“Even if the pipes do no good at all I don’t think we should get our knickers in a twist over this,” Humphreys wrote in an email.
Republicans did not take issue with just the grant’s potential uses, but also the administration’s response to the controversy they’ve raised.
“Once again, ‘misinformation’ just means true facts that make Democrats look bad,” Sen. Tom Cotton (R-Ark.) tweeted.
After the White House’s response, Rubio announced he would introduce legislation to prohibit the federal funds from going toward “crack pipes or similar drug paraphernalia.” His spokesman later clarified that the proposed bill would be “narrowly focused on crack pipes.”
Sen. Marsha Blackburn (R-Tenn.) threatened to block a stopgap measure to keep the federal government funded until March 11 if she did not receive assurance from the Biden administration that no funds would be allotted for the distribution of crack pipes.
Blackburn faced criticism in her last election for taking money from the pharmaceutical makers and distributors blamed for fueling the opioid epidemic, after a Washington Post investigation found a law she sponsored tied the hands of the Drug Enforcement Administration in its efforts to keep addictive painkillers out of the black market.
Why is this coming up now?
Frustrations aired by Blackburn and others are only the latest fury aimed at drug policy evolving amid the increasingly deadly drug crisis. More than 100,000 people died of overdoses in the 12 months between April 2020 and April 2021, a milestone in a decades-long health crisis.
Mike Pence, as governor of Indiana, oversaw in 2015 the worst HIV outbreak in the state’s history, which critics blamed in part on Pence’s opposition to authorizing a needle exchange program.
For those in the harm reduction world, this rhetoric isn’t new, but it’s coming at a terrible time when overdoses are soaring.
“It doesn’t surprise me someone ran with those talking points,” said Jennifer Plumb, the founder and medical director of Utah Naloxone. Her group, which applied for the grant, would supply clean needles and the overdose antidote throughout her state. Despite hesitancy around harm reduction, Plumb said she’s seen firsthand how effective it is at mitigating the worst repercussions of the drug crisis.
More than 7,000 overdoses have been reversed in over six years with the naloxone her group distributes, Plumb said. When naysayers have criticized her group’s work, Plumb has invited them to speak to drug users.
“I suppose some folks aren’t interested in the reasonableness,” she said. “They are more interested in the fiery flash points of inciting faux rage where there doesn’t need to be any rage. This is a realm that needs compassion and awareness.”