#harmredux

I made a vein care embroidery.

Holy cow! My crack pipe distribution project HarmRedux.Com is almost a year old! I'll have to celebrate in November! I've handed out nearly a thousand crack pipes with other health and hygiene supplies in San Francisco and I just established an Oakland partnership! I'm still going and still growing. It's been predominantly out of my pocket with a growing number of goods donations coming in to me. So far I've been afraid to accept cash donations from the general public. I do have long time fans who have slipped me my startup cash as gifts but those are very specific and private friends. I'm in the early stages of filing for nonprofit status and then I'll feel better soliciting cash from people. I want everything to be legitimate, accountable, and tax deductible. There are a lot of bullshit fundraisers and charities out there. I'm getting statistics and keeping receipts to document a legitimate need and to prove that the money was spent on what it was intended for doing. Most folks want just the pipe and the Brillo for a filter. Even in this case, I still bag the supplies into a kit and add a few extras simply because a pipe all by its lonesome looks 'druggier' than when it's in concert with alcohol pads, Chapstick, burn cream, antibiotic ointment, and vitamins. I really want to add mouthwash and sugarless gum into the mix, too. It helps protect the individual and helps protect me. Just handing out pipes from a bag would get us all harassed by the cops. If I'm going down, I REALLY want the rest of the supplies to be identified as well. I don't want to be arrested with a bag that only has objects classified drug paraphernalia and nothing else. I need the other medical and hygiene supplies to be counted. It's like a fractal of harm reduction: not only are the health and hygiene supplies an important part of harm reduction in and of themselves but they're also a form of harm reduction for me and my project. But also it made me realize that for most of my life I've done harm reduction for the mucous membranes of the genitals. HIV prevention. Sex education. Doula work. In San Francisco you can get STI care pretty fucking easily, all things considered. It's free or cheap because many cities and states realize they have a vested interest in our common health. The mouth, however, spreads most of our illnesses. Pathologize the vagina and anus all you want, we spend more of our lives eating and breathing than we do having sex. (Especially since we breathe during sex---we pass more respiratory illnesses during sex than STI's!!) By and large, dental care is regarded as an extra. It isn't covered by most health insurance and it's really, really hard to get access to low income dental clinics. When someone does get that care, it's usually late in the game, non-preventative care, and very limited in scope. If you're low income you might get an extraction covered but no one will pay for an implant because that's considered a luxury rather than a missing bone. Oral and dental care isn't an extraneous part of health care, IT IS HEALTH CARE. Cities need to have clinics for oral health with a budget comparable to the budget spent on preventing sexually transmitted infections. We have HIV & STI test counsellors all over America, we need something similar for oral care. Much of the infection risk from sharing pipes comes from the damage to the mouth that blisteringly hot pyrex pipes can cause as well as from the dry mouth and lack of sleep from the drug. Routine use inhibits saliva production and being up all night means missing out on the body's natural wash cycle. When dental care is withheld from people, decay adds up and compounds the risk of major infections. When people make ad hoc pipes from what they find on the street there's another risk factor because many of these objects actively cause injury. Now add on the pervasive risk of tuberculosis. We are withholding oral care from people and criminalizing pipe distribution: this is part of why we're seeing wayyyyyyyyyy more Hep C than HIV. We can treat Hep C but the price tag is steep. As the picture above shows, it's about $84,000 for the pills alone. You also need to pay the healthcare team for their labor and the cost of lab work. Each Hep C patient can cost the city roughly $100,000. For a budget of $5,000 I can operate for an entire year because I don't pay myself for my time, just my supplies. If I prevent just one Hep C infection in an entire year, I could still save the city $95,000 if they chose to find my supplies. Fuck, I'm not asking the city to pay for my supplies OR my time. Even if I got an outreach worker's salary for what I did ($40-50k a year) I would still be half the cost of one course of treatment for one person. I'm just hoping I won't get arrested for what I'm doing with my time and with my money. I seriously cannot fucking people that in San Francisco, one of the very birthplaces of the harm reduction movement and one of the first very first cities in America to have needle exchanges, crack pipe distribution is being opposed by our mayor and the Department of Public Health. This is so ridiculous it makes me so angry. Our mayor and DPH are openly proud of the work needle exchange does but act as though pipe distribution is somehow different and dangerous. Needle exchange was illegal when it started and the founders were arrested and harassed for their work. In some places, they still are. But all around the country people are not only rejecting but embracing syringe access because of the documented good it does. The federal ban on syringe access was lifted and even conservative states are opening up needle exchanges. You would think that we would have learned our lesson and applied it to an adjacent program but of course not. It's always history repeating itself. In San Francisco, they still have the baby carriage that needle exchange founders used to peddle supplies in the Tenderloin. I look at that and remember there are two parts to this work, passion and discipline. If you only have discipline you won't take necessary risk and you will become draconian. This is why DPH won't stand up to the mayor. They're very well disciplined and procedural. But passion alone will make you sloppy. My risks have to be calculated and I have to protect myself. Getting arrested might very well be the quickest path to mainstreaming crack pipe distribution but only if I have precise documentation of my work and I'm handing out complimentary gear to emphasize the mission of providing street level healthcare to people. If I go to court with a bag of crack pipes and a background like mine, I will lose. If I go to court with my documentation and other supplies, I've got a really good shot at winning. Such a good shot that I think my risk of arrest is very low because it would be a precedent setting case. If I'm a lone wingnut doing this work unbothered but unendorsed, the city benefits from what I'm doing without having to contribute a dime or take any risks. If I got arrested, it would be a media thing and going to court could risk a ruling of pipes being determined a part of standard harm reduction care like syringes. I'd also probably be able to parlay that into my professional life as well. It's in their best interest to ignore me and hope that others do as well. The harm reduction movement needs to be collectively pushing for pipes. They need to be mainstreamed. We have to drop the stigma. One of my points of discontent with the sex positive movement is how bougie it is. It's predominantly centered around private adult sex education rather than trying to break down barriers and get into shelters and social welfare programs with state reimbursement. It's very neoliberal in that it's directly in bed with private companies, mainly sex toy companies. This has limited the scope and perception of sex positivity and lessened our potential impact. On one hand I wish I could appeal to this body of social media savvy people but on the other hand, I don't think they would actually promote this kind of work. I'm building a base and finding the others doing this work and forging connections with them. The sex positive movement adopted the language of harm reduction but really left its roots out in the cold but is taking tiny little baby steps to integrate drug harm reduction into its message. Most of them do fear drug stigma and don't want to be sullied by connection to heroin, crack cocaine, and meth. I'm not afraid that people will think I use drugs. I'm proud I started this project. I'm glad I'm still with it. And I'm really excited to watch it grow.