Pipe potential

This column generally focuses on our advocacy work – working with people who call or email us around the country to ensure that their drug treatment works for them, and not just for their provider. This stream of work is often confused with Release’s other Advocacy work (capitalised for the purpose of differentiating it from drug treatment advocacy). That is the work Release is more commonly known for – the drug policy reform and broader systems-change which would improve rights’ realisation for people who use drugs and people impacted by drugs laws. This month we’ve chosen to highlight a topic that brings both advocacy and Advocacy closer together – the provision of safer smoking materials, specifically pipes. 

Many well-intentioned drug workers around the country, including our very own in East London, are currently hamstrung by Section 9A of the Misuse of Drugs Act, which prohibits ‘supply etc of articles for administering or preparing controlled drugs’. While exemp­tions exist for some harm reduction supplies such as citric acid, foil, and sterile water, the distribution of items including pipes and tourniquets remains unlawful.

Pipes are important drug use tools for many people using many different drugs, but the widespread distribution of pipes would have the biggest positive impact on people who smoke crack – as they are likely to experience severe respiratory health harms , and report high levels of contact with the criminal legal system and experiences of homelessness. 

Criminalisation and homelessness both act as barriers to accessing support services. On top of that, crack users often stand to gain little from engaging in drug services, given the lack of useful tools on offer. For people uninterested in or put off by group work, the provision of pipes can be an attractive offer, particularly if they’re not presently interested in stopping using.

Release has been fortunate to be partners on the Safe Inhalation Pipe Project (SIPP) study, an academic-community collaborative mixed-methods evaluation of pipe provision in England. Much of what is cited above was learned from SIPP, and through our involvement in SIPP we heard feedback on pipes from people around the country. Many shared how important pipes were to meeting new drug users and building meaningful connections to enable better quality of life for people using crack. The pipes themselves were critical, but not only because they enabled safer smoking for the user. Pipes were a vehicle for drugs workers to learn more about crack and start having meaningful, informed conversations with people who use crack – an engagement tool for workers as much as for users. After more than a decade of declining skills and expertise in the sector, any opportunity for workers to learn new information and harm reduction tactics is greatly welcome. 

It’s not only the drugs sector that stands to gain from the provision of pipes if the law were to change. Given the recent buzz around Andy Burnham’s pledge to end rough sleeping, we would be remiss to neglect mentioning this reform as one that might get us closer to that goal. Burnham has previously been cited as recognising that drugs and homelessness are interrelated matters (albeit not always in a way that favoured progressive drug policy reform). 

Pipe provision should be embraced as a tool towards ending street homelessness. With pipes, outreach workers could be offering an immediately useful and health-saving tool to people, enabling a new working alliance and communicating that people who use crack are no less deserving of rights to housing or health. 

And that working alliance is what brings us back to our usual business: lower case advocacy. Much of our day-to-day work is about strengthening that alliance between workers and people in services, to improve outcomes for the latter. Where we see the best results is often where there is both a willingness to accept that people are the experts of their own needs, and a broad suite of tools available to choose from to meet those needs. There’s only so much good advocacy can achieve when the law itself limits the tools workers are able to offer. The allowance of pipe provision would enable better care for drug users, and could foster improved relationships – leading not only to improved health but to housing, improved quality of life, and the realisation of rights for a group of people long prevented from such.

Fraser Parry is drugs advocacy and support adviser, and Shayla Schlossenberg is head of drugs service, at Release