At dusk on a windswept street in San Francisco’s Tenderloin district — one of the most notorious open-air drug markets on the west coast — three volunteers handed out crack pipe kits to crack users.
The volunteers, part of the San Francisco based Urban Survivor’s Union, were doing so in accordance with what’s known as harm reduction.
Harm reduction, much like it sounds, aims to reduce the external risks of street drug use — diseases such as AIDS and Hepatitis C, being among the most common, according to Isaac Jackson, the group’s senior organizer.
Crack pipes have long been handed out in Vancouver — which has a vending machine. The only known effort to do so in the US is in Seattle. But, data on how effective such efforts are is hard to come by.
The most common way both diseases spread among crack users — the majority of those the Urban Survivors serve are African-American men and women — is because of broken glass pipes that are used to smoke the drug, Jackson told VICE News. Crack users sharing pipes can cut or burn their lips, and the resulting exchange of blood has a high possibility of transmitting either HIV or Hepatitis C, also known as HVC.
“There are thousands of crack users in the Tenderloin,” a volunteer who identified herself as Carla said. “And, as a former addict myself, I really believe that it [the effort] helps people stay safe.”
The crack pipe program doesn’t enjoy much government support at the moment in the famously accepting city.
As a result of political guidance, the Department of Public Health, which hands out about 2.7 million hypodermic needles to drug users every year, doesn’t support the Urban Survivors either, according to a prepared statement.
On the other hand, District Attorney George Gascón has said it feels drug use is a health problem, not one for the justice system.
Sources within the San Francisco Police Department told VICE News that the crack pipe possession charges are so minor, and the chance of prosecution is so low, that arresting Urban Survivor volunteers just isn’t worth it.
“I wouldn’t touch that with a 10 foot pole,” an officer said.
Across the street from Jackson’s motley group of volunteers, the Glide Memorial Church, which is indirectly contracted by San Francisco to provide syringe access and disposal, was running a program at the same time.
Harm reduction programs such as Glide’s “syringe access” have a demonstrated affect on reducing the percentage of injection drug users carrying HIV and AIDS, according to Tracey Packer Director of Community Health Equity for the Department of Health.
“In San Francisco [which has several programs] HIV prevalence among injection drug users hovers around 10 percent. In other comparable cities [without programs] that number is 30 to 40 percent, and sometimes higher,” she said.
The other net benefit of the syringe access programs is that drug users who make use of them are more likely to dispose of needles safely, and both access other health services and enter treatment, Packer said.
Needles are also available for purchase at drug stores across the city, according to a harm reduction expert familiar with Jackson’s effort. Pipes are available too, but many users simply don’t have the cash for either.
The kits themselves contain a glass pipe, wooden “pushers” to tamp the crack rocks, alcohol swabs for sanitation, and a Brillo pad.
The pad is used for cleaning the pipe and collected the unused crack that remains as residue.
“Smoking crack is really inefficient,” one of the volunteers who identified himself as Dave said, “Some of it [the crack] is going to re-harden and the Brillo is used to push the particles from one end to another.”
The group hands out about 50 kits an evening, Jackson said, and the makes an effort to hit the streets at various locations in the Tenderloin every Tuesday.
The Urban Survivor’s mission more broadly includes its participation in a worldwide movement of drug users who are increasingly demanding a seat at the table when it comes to drug policy. Jackson also hopes to de-stigmatize drug users in general, in part by helping those who use them belong to a nonjudgmental community — in addition to political advocacy.
“Society tends to shun drug users without good reason,” Jackson said, “The crack baby stereotype has totally been disproven.”
The organization is primarily funded through donations and grants from large, well-known foundations. Jackson declined to discuss his backers in detail.
The group plans to roll out its first indoor pipe distribution site later this month.