Can Free Crack Pipe Kits—Like Free Heroin Needles—Reduce Disease Transmission?

A group in San Francisco plans to hand out free crack pipes, but the city is not convinced it’ll help reduce the spread of HIV and Hep C

Photo: BEN NELMS/Reuters/Corbis

In Seattle and Vancouver, there are programs that apply the logic of needle exchange programs to crack pipes, Time reports: they give out free smoking kits with the aim of reducing transmission of diseases like HIV and Hepatitis C. And now a group in San Francisco called the Urban Survivors Union is proposing a similar strategy

Crack users, lacking a pipe, often improvise a smoking device from "broken glass, lightbulbs, vials and other tube-shaped things," Time explains. Cuts can easily occur, which risk the spread of bloodborne disease if users are sharing a pipe. Since 2011, Vancouver city has distributed around 7,500 smoking kits each month. Here's Time on Vancouver's program: 

Each kit comes with information about detox and places to seek help as well as heat-resistant glass stems and disinfecting alcohol swabs. The aim was threefold: use demand for the kits to gauge how widespread crack use is; find out if free, safe pipes do in fact lessen the spread of disease; and use the moment of contact with a user as an opportunity to discourage drug abuse.

Though their sample hasn’t been big enough to provide concrete results about the spread of HIV, Vancouver Coastal Health spokesperson Anne-Marie D’Angelo says, they have found the giving out the kits reduces the number of wounds people experience and the amount that people share pipes.

Needle exchange programs, in which drug users can acquire syringes for free or very cheaply, "substantially and cost effectively" reduce the spread of HIV among intravaneous drug users, according to a 2004 study conducted by the World Health Organization. In the U.S., the Centers for Disease Control, the National Institutes of Health and the Association all support this stance. 

In San Francisco, though, city officials aren't convinced the same logic will apply to crack pipes. As a Department of Public Health spokesperson told Time, “Our harm-reduction programs are evidence-based and part of a comprehensive program of care. ‘Let’s start handing out crack pipes’ is way too reductionist and too narrow for the department to take on.”

Urban Survivors Union has been operating under the radar for two months already, mostly on the streets of the infamous Tenderloin neighborhood, The Examiner reports. The pipes, the group reports, cost less than $1 each and were paid for by an anonymous donor. 

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