Bush-Era Crack Panic Is Back, and Its Going to Get People Killed – The New Republic

For years, advocates have struggled to overhaul societysresponse to drug use, replacing the war on drugs framework with a harm-reduction one. Their case is both empathetic and logical. Using drugs is not amoral failure, but it can be a risk factor for illness and death: Over 100,000people in the United States diedof an opioid overdose last year. Manymore drug users are at serious risk of life-threatening health problems: One study showedthat up to 40 percent of drug users admitted to hospitals have bacterial or fungal infections.Intravenous drug use accounts for some 7 percent of new HIV infections each year, and upto 75 percent of people who use drugs have been exposed to hepatitis C,which asrecently as 2014 was the deadliest infectious disease in the country. (Fulldisclosure: I do communications work for Treatment Action Group, a policy thinktank focused on HIV, tuberculosis, and hepatitis C.)

The HHS grants caricatured as $30 million for crack pipeswill allow community groups to distribute suppliesincluding overdose reversal medication, cleansyringes, and balm to avoid cracked and bleeding lipsthat reduce the harms of drug use in various ways. Contrary to the denialsof liberals, unused glass pipes are another key harm-reduction tool: Glass isless likely than other materials to blister and burn the mouth, thus reducingthe likelihood of infection; its safer not to share pipes (sharing has beenlinked to transmission of both T.B. and hepatitis C) and to smoke drugs insteadof injecting them. (Meaning that pipes are used for many drugs, but singlingout crack specificallyand remaining mum about syringesis an awfullyobvious racist dog-whistle.) That Democrats foreclosed on the possibility offunding sterile pipes for people who need them, as a capitulation to thesensibilities of whomever the CRACK Act panders to, is an act of sheercowardice.

Harm reduction isnt some hypothetical thoughtexperiment on which were rolling the dice. Its track record makes it one ofthe most successful public health shifts of the past several decades. Studiesin boththe U.K. and Canada have shown that people often switch from injectingdrugs to smoking them when provided with safe supplies. Needle-exchangeprograms havereduced rates of HIV transmission by up to two-fifths; one program in NewYork alone estimated that 87 potential infections were averted. By the early2000s, one review had already identified 28 differentstudies concluding that clean syringe distribution decreased HIVtransmission. A study in Washington showedthat safer drug supplies curbed hepatitis infections by 60 percent. Safersmoking kits have also beendemonstrated to reduce riskybehaviors and infections. Safer smoking kits in Canada were correlatedwith a significantdecline in hepatitis C, and the program was considered so effective thatglass pipes have been included in vending machines. The vast majority of harm-reduction programming also offers health services for blood-borne and sexuallytransmitted infections. If I spent hours on this paragraph hyperlinking more andmore studies recommending harm-reduction practices, I still wouldnt run out ofavailable material proving their unalloyed value.

The evidence that harm reduction and facilitating safer druguse saves lives is overwhelming. To return to the status quo of the late 1980sin the face of all this progress is absolute madness, as is the idea that anarchconservative outrage cycle, based on obsolete notions with about as muchcurrency as theConfederate Greyback, could roll back these programs just as theyregaining long-overdue, and hard-won, mainstream acceptance is dismaying. Thatthe Biden administration wont stand wholeheartedly behind these communitygrants is equally enraging. The only problem, in fact, with the $30 millionthat had been previously allocated to these proven harm-reduction programs isthat we should be spending even more.

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Bush-Era Crack Panic Is Back, and Its Going to Get People Killed - The New Republic