‘Crack pipes’ aren’t the problem — stigmatizing harm reduction is

I spend most of my days in back alleys, under highways and in empty lots looking for people that need my support. I’m a harm reduction outreach worker and everyday me and my team distribute sterile syringes, Naloxone, hygiene kits — and yes, “crack pipes” to people who use drugs in New York City. 

We do this because we want to keep people healthy, safe and most importantly — alive.

Most people know that sharing syringes can cause disease transmission, but that risk is present when pipes are shared too. When people smoke from glass pipes they sometimes burn or cut their lips — allowing hepatitis C or HIV transmission to occur. By providing people with sterile supplies, they do not have to take that risk.

I know that safer use supplies keep people safe, that’s why I was so disgusted to see misdirected outrage in response to the federal government finally providing funding to harm reduction programs. Despite the misleading headlines, our communities aren’t facing a problem around the distribution of so-called “crack pipes,” or as we call them, stems or straights. The real problem is the historical lack of investment in public health solutions that connect people to support and care. 

And it’s no coincidence that funding of “crack pipes” is what’s fueling all this debate — that rhetoric is a dog whistle to the anti-Black Reagan-era politics that led us to the record number of overdose deaths we see today.

We cannot continue to stigmatize harm reduction. Not only do people get less help it also makes politicians skittish and causes much-needed life-saving resources to dry up.

We can already see it happening. In the short time between the Department of Health and Human Services’ announcement of $30 million dedicated to harm reduction strategies and the outrage that ensued, the federal government has now removed smoking pipes from the list of public health tools getting funded.

This is a knee-jerk reaction and one that misses the point of harm reduction completely. 

When I was homeless and using drugs in the street, it was a harm reduction worker that inspired me to turn my life around. I saw outreach workers every week to get safer use supplies — and after building a trusting relationship I accepted an invitation to get out of the cold. Soon, I was a regular at the drop-in space and eventually enrolled in a job training program. Today, I have a full-time job as an outreach worker, my own apartment and a life I am proud of. 

None of that would be possible without that first interaction where I was offered safer use supplies — this is the real value of harm reduction. 

But if my story isn’t proof enough, the research speaks for itself. 

According to the Center for Disease Control (CDC), harm reduction programs like the one I work for are safe, effective and play a vital role in reducing HIV and hepatitis C transmission. Research shows that new users of harm reduction programs are five times more likely to enter drug treatment and about three times more likely to stop using drugs than those who don’t use the programs. 

As the United States grapples with the worst overdose crisis it’s ever seen, with over 100,000 people lost to preventable overdose in just one year, and Black and Latino rates of overdose surging — we must stop with moralizing and racist misinformation. To scapegoat public health tools as the problem is the opposite of what’s needed right now. 

The federal government must not cave to this false narrative, and instead, do everything it can to expand resources to support lifesaving proven harm reduction programs across the country. We are running out of time; lives depend on it.

Jeffery Foster is a harm reduction outreach worker at VOCAL-NY.