Why People Are Still Shooting Drugs They’d Rather Smoke

October 31, 2022

In 2012, Anna* was trying to smoke crack for the first time. Corner stores in South Carolina sold glass pipes, and experienced smokers could fashion something homemade, but a 22-year-old used to injecting black tar heroin didn’t know any of that. They tried putting the crack on top of a bowl of weed, but didn’t get any effect; so they went straight to injecting.

A couple of years later, their veins were in bad shape so they tried smoking their heroin from a dab rig. But they didn’t know that adding the whole bag would be too much for that type of pipe. It bubbled up and coated the whole nail, clogging the rig so much they just threw it away.

“There weren’t any instructions on how to do it,” Anna recalled of these attempts to smoke their drugs. “Dab rigs can totally be used for black tar, but without anyone explaining … so instead, I just ended up [injecting] a lot of speedballs at that time in my life.” 

Smoking drugs—technically vaping, wherein drugs are heated to produce inhalable vapor rather than the combustion process of cigarettes—generally involves fewer risks than injecting them. Yet harm reduction programs provide much less access to pipes than to syringes.

There are a few reasons for this. Sterile syringe access is more critical for reducing transmission of HIV and hepatitis C, which is why drug users mobilized around them during the HIV/AIDS crisis.

During the overdose crisis—which policymakers portray as an “opioid epidemic”—syringes have also been prioritized because they’re more associated with opioids. This is despite the fact that many people inject stimulants, or smoke opioids, and are increasingly likely to overdose after combining stimulants with fentanyl, whether intentionally or not.

“Drug use patterns are shifting. It’s all polysubstance use now.”

“It’s typically cross-contamination. But when it does happen, it leaves people more vulnerable to an overdose,” Ryan McNeil, director of harm reduction research at the Yale Program in Addiction Medicine, told Filter. “You can’t respond to this crisis unless you immediately identify that … drug use patterns are shifting. It’s all polysubstance use now.”

Another reason for the disparity in supply access is that syringes cost pennies; glass pipes cost more.

In some states, authorized syringe service programs (SSP) can legally distribute drug use supplies that are otherwise criminalized as “paraphernalia.” Yet a long-standing rider on annual Health and Human Services (HHS) spending bills continues to ban federal funding for paraphernalia, despite multiple attempts to remove it.

This means that even the programs authorized to distribute syringes and pipes can’t use federal funds to buy them. Rather than use up any non-federal funding, staff or volunteers sometimes pay for pipes out of pocket even though some programs have rules against that. Donations don’t make for reliable supply.

And then there’s the fact that safer smoking kits are usually for smoking crack, and the “War on Drugs” continues, as it has always done, to associate crack with Black people.

 

Racism and Funding

Isaac Jackson, president of the San Francisco chapter of the Urban Survivors Union, has been hearing complaints about “drug paraphernalia” in the city since he moved there 30 years ago.

“I think if anything, being a Black man maybe made it more intense,” he recalled of the vitriol he experienced for once injecting meth in public. “You’re definitely a subclass, or untouchable or something.”

In 2014, the local HIV prevention council went before the Department of Public Health (DPS) and presented data on how pipe distribution reduces blood-borne disease transmission. Jackson witnessed the presentation and was impressed. City officials were not, though there were around a dozen local SSP at the time.

“The [council] recommended that it happen. And the mayor said no,” Jackson told Filter. “Which is a completely political decision. It’s nothing to do with health care.”

Jackson began distributing pipes himself, doing outreach in the city’s Tenderloin district with other USU members. It didn’t take long for DPH to request a meeting, apparently unsure whether it wanted to stop him or work with him. A DPH rep said “something to me that really rubbed me the wrong way. She said like ‘Yeah, we could use this as a way to get to the Black community.’ I was like, wait a minute. People who smoke crack are not all Black. I’m sorry, but you know, that’s really a racist stereotype.”

The bill never explicitly named pipes and syringes as eligible for funding, but there was a chance to interpret it that way.

In March 2021, the American Rescue Plan Act allocated $30 million in federal grants for harm reduction services. One-offs like ARPA are not subject to the same restrictions as the annual spending bills, and the legislation stipulated that, among other things, “safer smoking kits/supplies” were eligible. The language of the bill never specified what those kits would comprise—HHS never named pipes or syringes as eligible for federal funding, but there was a chance for some programs to interpret it that way.

In February 2022, right-wing opponents seized on the idea of “crack pipe” funding and leaned heavily on racist tropes to link it to “crime.” The media frenzy prompted HHS to issue a statement explicitly assuring the public that safer smoking supplies did not include pipes.

Glass pipes with a bulb at one end work better for holding meth; straight pipes, or stems, are the ones commonly used for crack. Many programs distribute both, if they have access to them and participants who’d use them, but the bulbs are generally just handed out piecemeal because using them doesn’t require much besides drugs and a lighter. The straight stems involve a few more components, which is why safer smoking kits are associated with crack.

“The pipes, they’re donated right? Well, nobody’s donating them right now. So I lend mine out.”

There is no standardized safer smoking kit. Each program has its own variation, which itself tends to vary as supplies go in and out of stock. A robust kit will include not just the glass stem but also Chore Boy or something similar, rolled into a filter when pushed into one end of a pipe; something like a chopstick to push things back into place; something like a paperclip for scraping out valuable resin; alcohol pads; lip balm; fentanyl test strips; and, most critically, a smoking guard. 

These mouthpieces are usually rubber or plastic, and reduce risk of blood-borne disease transmission—especially hepatitis C, once stems overheat and inevitably crack. Unlike HIV, the virus that causes hep C doesn’t die right away once outside the human body. If someone with hep C cuts their lip on a pipe, the smallest amount of blood left on the glass can transmit the virus to someone who uses the pipe with a cut lip too, even weeks later.

Pipes are reused and shared because even the programs that can afford them never have sufficient quantities. But also because crack produces a very brief high, which makes smoking it an inherently social activity. People will always share stems, and it’s not necessarily unsafe or undesirable as long as they have the right supplies, like separate mouthpieces.

“The pipes, they’re donated right? Well, nobody’s donating them right now. I lend my stem out, because someone won’t have a stem, and then they have to break me off,” New York City resident Veronica* told Filter, referring to getting a free hit.

Usually the amount packed in for one hit is a $10 “dime,” but an experienced smoker can turn one hit into two. “If they spend $50 on hard, I get a free dub [$20 hit] and I keep the resin. But that’s why you want the Pyrex.”

 

Strong Glass

Thin glass stems, like the Love Rose or the kind designed to look like pens, are somewhat commercially accessible in the US. But they don’t last long, and once they crack there isn’t much to salvage. 

“Back in the day we used to joke about, that’s why they call it crack—because the pipe break after one or two use,” Charles*, a 60-year-old New York City resident, told Filter. “But when we had the strong glass, you could use that—I used to tell people, you can drop it, it bounce right back up.”

These thicker Pyrex stems are more expensive, but preferred by just about everyone. They can last for weeks, and when they eventually do crack the jagged edges are easier to file smooth. Or you can simply fit a mouthpiece over whatever’s left. The Love Roses and other cheaper versions are more likely to be abandoned in favor of smoking out of TV antennas or soda cans or apples, or injecting if that’s easier.

Charles was using Pyrex in the ’80s when freebase came on the scene, before SSP were even authorized. Whenever glass wasn’t available, “we’ll make it out of the little liquor [bottles], the nips. Or, remember the 25-cent juices? Only thing we didn’t have when we started off was the rubber tips.”

 

 

Pipes are often the bridge to harm reduction services for people who wouldn’t have accessed them otherwise because they don’t use syringes. Many people like Charles at some point need treatment for hep C even though they don’t use opioids and have never injected anything, even once.

Points of Distribution, an online harm reduction marketplace, pioneered a buyers club model in 2018 to sell harm reduction supplies full-price to groups that can afford it, and on a sliding scale for everyone else. Boston-based Smoke Works built on that to operate a mutual aid model focused on pipes and other smoking kit components.

Smoke Works’ cofounder, Executive Director Jim Duffy, first saw the gap in stimulant harm reduction while working at Boston SSP AHOPE. “We had 150 people come through every day, and you get to build relationships with them,” Duffy told Filter. “But there were another 100 people outside that had no reason to come in because they don’t inject … I don’t think people realize how robust the ancillary services are behind the term ‘needle exchange’ or ‘syringe service program.'”

By 2021, as overdose reached an all-time high, more people were shifting to smoking.

Straight stems are the least expensive shape of Pyrex pipes. They also have the fringe benefit of being the most versatile for people with the know-how to use them creatively. With a sufficiently hot torch, you can blow a bubble into one end of a stem to make a meth bulb in minutes. You can also use them to inhale the vapor from smoking off tin foil, but the foil is the necessary part.

In the Western US, the onset of the pandemic saw black tar heroin overtaken by fentanyl pressed pills, or “blues.” The Harm Reduction Action Center of Denver recently developed a foil smoking kit because injecting is no longer the most common route of administration among participants. By 2021, as overdose reached an all-time high, more people were shifting to smoking.

On the East Coast, where most dope is powder fentanyl, smoking off foil is less common. Veronica, who smokes crack but prefers injecting for dope, wasn’t surprised to hear people were smoking the blues off foil; she’s smoked pharmaceutical pills that way and knows it works. She wouldn’t mind smoking her dope sometimes if she had the option. She hadn’t heard of “hammer” pipes.

Most “paraphernalia” isn’t designed for drug use. Syringes are manufactured for insulin. Rubber mouthpieces are spark plugs. The best resin scrapers are the metal bristles that break off street sweeper trucks. Pyrex pipes are just glass tubing. But the hammer Pyrex pipe was specifically created for people to smoke black tar heroin, and works for powder dope, too.

“I’d try it,” Veronica said after studying images of the hammer for a minute or two. “Yeah. You can’t smoke [powder] off foil, it’s like throwing money away.”

A few harm reduction programs have trialed hammer pipes, but they’re expensive and hard to find. Points of Distribution sells them, but Smoke Works is currently out of stock. In August, $5,000 of hammer pipe inventory was lost to a Customs and Border Patrol seizure; Duffy and his colleagues so far haven’t been able to recover it.

Many people are in the same situation Anna was a decade ago: shooting drugs they’d rather smoke.

“We’ve run into problems in every direction. At one point we had an issue with a payment processor shutting us down,” Duffy said. Inordinate amounts of paperwork are a given. “It’s kind of part of the fight.”

Without access to affordable Pyrex pipes—for crack, meth and heroin—along with meaningful education around injection alternatives, many people are in the same situation Anna was a decade ago: shooting drugs they’d rather smoke.

“Either I’m going to quit cold turkey or I’m going to kill myself,” they recalled thinking at the time. “Those are my two options. I feel like, had smoking been an actual route of administration that I could have pursued, I could have avoided both of those situations. Which were pretty detrimental in the long term.”

 


 

*Names have been changed to protect privacy at sources’ request.

Kastalia Medrano contributed reporting to this piece.

Photographs courtesy of Kastalia Medrano

R Street Institute supported the production of this article through a restricted grant to The Influence Foundation, which operates FilterFilter‘s Editorial Independence Policy applies.

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Troy Farah

Troy is an independent journalist whose reporting on drug policy and science has appeared in Wired, the Guardian, Undark, Discover Magazine, Vice and more. He co-hosts the drug policy podcast Narcotica. He lives in Southwest California.