“Anybody want a crack pipe with their fourth booster? Biden will hook you up.”
“Biden crime policy: Crack pipes for all. What could go wrong?”
Starting on Tuesday evening, with little warning, Republicans — including Pennsylvania gubernatorial candidate and former Philadelphia-area U.S. Attorney Bill McSwain and Sen. Ted Cruz of Texas — freaked out over a misrepresentation of a Biden policy that was announced months ago.
Last year, as part of the American Rescue Plan, the Biden administration announced an unprecedented $30 million in grants for community organizations working to reduce the harm of drug use. These activities include the distribution of naloxone (the opioid overdose antidote), syringes, fentanyl testing strips, and smoking kits — a critical investment as America is losing 100,000 people to overdoses per year.
Also potentially included in those smoking kits: clean pipes to allow for safer smoking of drugs such as crack, meth, or fentanyl.
Right-wing media outlets went into overdrive, declaring that the Biden administration is sending $30 million worth of crack pipes to communities of color. “Uncle Sam to hand out crack pipes,” a Fox News banner read.
Within 24 hours, Joe Biden’s top health officials did an about-face on the policy, claiming pipes were never meant to be included — and thus amplified one of the most pervasive, racist, and stigmatizing notions about drug use: that crack is uniquely dangerous, as are the people who use it.
And implied that not all people who use drugs are equally worth saving.
Republicans melted down over the potential inclusion of smoking pipes for one obvious reason: racism.
For about a decade, the majority of people who died from overdoses were white, and the discussion around drug policy has centered on prescription opioids. White middle-class people in addiction have been framed as victims of pharmaceutical companies that got them “hooked.” The narrative about Black people who used drugs during the crack crisis of the 1980s and ’90s was very different, implying that their drug use was a criminal and moral failure.
As more people who looked like them died of overdoses, Republicans and Democrats found themselves advocating for a “kinder, gentler” war on drugs, a stark departure from the racist coverage in the ’80s and ’90s that framed Black people who use drugs as a menace to society.
And some things did change. America still responds to drugs in a punitive way, but there has been progress on harm reduction. Distribution of naloxone is now mostly uncontroversial. Syringe services programs still face tremendous barriers despite decades of proven efficacy — in Pennsylvania, for example, they are still technically illegal — but the opposition was largely quiet, and not part of a culture war.
But right-leaning culture warriors brought all the ugliness of the ’80s and ’90s back to the front this week. Those hoping to spark a scandal knew what they were doing when they mentioned crack: They were directly drawing their audience back to the racist rhetoric of the crack crisis. For example:
“Crack’s destructive sprint across America,” a New York Times headline from 1989 read.
“Crack means power, and death, to soldiers in street wars,” the paper of record declared in 1994.
In a 1986 front-page article, The Inquirer explained to readers that people who use crack “will deplete their savings, steal from their families, sell their bodies, rob, burglarize — even kill.”
This sensationalist coverage created a pervasive narrative: Crack is scary. Crack brings crime. Crack is synonymous with gun violence. And most important for this racist propaganda, in the popular imagination, crack is used by Black people. And it worked. Within an already punitive system, crack brought with it even harsher sentences.
But these punitive tactics don’t work. All over the country, the number of Black people dying of overdose is increasing — in part because the potent synthetic opioid fentanyl is making its way into pressed pills and stimulants such as crack. Despite the difficulty of obtaining reliable statistics on illicit drug use activity, it is well-documented that Black people who use drugs are more likely to use crack than powder cocaine and are less likely to inject than white people.
And crack isn’t uniquely harmful. In fact, according to an analysis of drug harms published in The Lancet, alcohol is more harmful than crack — especially when considering harm to others. Plus, if crack is so harmful, that’s all the more reason to target harm reduction around its use. The only reason not to? Because the people harmed by illicit crack use are mostly not white.
Caving in 24 hours
The Biden administration never specifically planned on sending crack pipes to anyone. The $30 million in harm-reduction grants, administered by the Department of Health and Human Services, could have been used, for, among other things, smoking kits that potentially include crack pipes — and that was a wise move. Allowing grant recipients to decide what best reduces harm in the communities they serve has the potential to save lives, despite Republican shrieks to the contrary.
Lost in the outcry is this important fact: Distributing clean pipes works.
Used or broken pipes can lead to cuts and burns in the mouth, and increase the risk of contracting infections like HIV. According to a study about the distribution of crack pipes in Vancouver, Canada, “the expansion of crack pipe distribution services has likely served to reduce health problems from smoking crack.”
But in a cowardly capitulation to baseless, inflammatory Republican tweets, the Biden administration caved.
On Wednesday afternoon, HHS Secretary Xavier Becerra and Office of National Drug Control and Policy Director Rahul Gupta issued a statement stating: “No federal funding will be used directly or through subsequent reimbursement of grantees to put pipes in safe smoking kits.” Press secretary Jen Psaki reminded reporters that these grants are part of the administration’s effort to address the “opioid epidemic.”
The implicit message: We’re not here to help the 20,000 people a year who died with cocaine, including crack, in their system.
By excluding pipes from its harm-reduction funding, the Biden administration piled on the stigmatization of crack and Black people who use it. It confirmed the racist image that Republicans tried to evoke — that among all the harm-reduction tools, crack pipes are one step too far. And Black people who use crack are too dangerous to society, so keeping them safer isn’t worth it.
The United States is failing to meet the overdose crisis. A person dies in America of an overdose every five minutes — and more and more of the people dying are Black.
Distribution of safer equipment to use drugs with — including unused needles and pipes — is the low-hanging fruit. To actually reverse the overdose death trend, the United States needs to take bigger and bolder actions. The Biden administration needs to finally lend its support to supervised consumption sites to give a path to cities like Philly to save lives. It needs to be up for the fight, because the lives of people who use drugs — all of them — are worth fighting for. That will require withstanding more than 24 hours of angry Fox News segments and tweets.