Fallout from smoking kits continues
Officials reckon with decision after community meeting
Last week, Pat Montague walked a few blocks from her home on Monroe Street in Annapolis to a meet group of public health workers handing out sterile syringes, fentanyl testing strips, condoms and other supplies designed to reduce health risks for people addicted to drugs.
Montague had stopped by a few weeks prior and picked up some Narcan, the opioid overdose reversal drug.
AA Power, a program run by the Anne Arundel Health Department, was passing out supplies as it has done five days a week for the last 18 months in Annapolis and other parts of the county.
A worker asked Montague what she wanted. Did she know they had crack pipes?
April 6 was the first day AA Power offered smoking kits in Annapolis — Pyrex glass stems, copper wool, rubber tips and other supplies used to smoke crack, meth and other drugs. Such kits are part of the range of equipment being handed out in the region by AA Power and other programs to help reduce the spread of diseases like hepatitis C, HIV and COVID-19 among people who use
drugs, some of whom aren’t ready to enter drug treatment.
Montague, a recovering crack user clean for 17 years, was taken aback. She accepted them and when she got home, Montague started shaking as memories of her past came back. She took the pipes, she said, to “get them off the street.”
“Everything I need was right here. I had money. All I had to do was go up the street and buy some crack,” she said. “It was not a good look.”
Thursday, Montague met with members of the Anne Arundel County Health Department, including Health Officer Dr. Nilesh Kalyanaraman and Claudia Jackson, who oversees AA Power, and members of the Caucus of African American Leaders.
The caucus last week swiftly condemned distribution of the pipes. Members pointed to decades of harm and destruction — from addiction to incarceration — brought on the Black community by the introduction of crack in the 1980s and 90s.
Handing out pipes, they said, was too much. County Executive Steuart Pittman said he supports efforts to protect the health of users, but called handing out pipes “a stretch.” Kalyanaraman admitted the department “hadn’t put enough thought” into the kits but said the goal is to reintroduce them after hearing from the community.
“One thing that was pretty is clear is that harm-reduction services ... were all well-appreciated,” Kalyanaraman said. “Our goal is to provide what people need.”
Alderman DaJuan Gay, D-Ward 6, who attended the meeting, said he plans to discuss smoking kits at upcoming town halls. Jacqueline Boone Allsup, president of Anne Arundel County’s chapter of the NAACP, said the meeting ended with the need for more discussion and additional comment from the community.
“We understand the need to keep the community safe but are we promoting the use of drugs?” she said. “We need to be very careful when we are handing these packets out.”
AA Power coordinator Izelle Van Zuylen was at the table that day in Annapolis when Montague took the pipes. She likely spoke with Montague, she said, but the program doesn’t collect people’s names to protect their privacy. Whenever someone requests syringes or pipes AA Power asks for sex, race, date of birth and ZIP code, which helps the program understand where users are.
Jackson and Van Zuylen said they were both surprised that the backlash had forced them to stop distributing the smoking kits. They decided to buy smoking supplies in January after persistent requests from those who visit AA Power tables, Jackson said.
Often, users in some parts of the county would decline syringes and ask for pipes, which they didn’t have.
“We’ve never really experienced backlash while we were at outreach,” Van Zuylen said. “No one’ s ever approached us and said anything negative about what we were distributing.”
Over the last 18 months, AA Power has evolved from handing out basic supplies like condoms and Narcan to a five-day-a-week operation that spans the county.
In Annapolis, the group frequents the Eastport/Harbour House neighborhood, Bay Ridge Gardens, Newtowne 20 and Stanton Center, all largely Black neighborhoods. They set up in Wawa and Royal Farms stores in south county. And in north county, they do outreach in Brooklyn Park and in Glen Burnie at Arundel House of Hope and Days Inn hotel.
Overdose data collected by the city and the county health department determined where to place those permanent locations, and more recent overdose data dictates the placement of twice-a-week pop-up sites, Jackson said.
Boone Allsup questioned why the program doesn’t distribute supplies in predominantly white neighborhoods. Jackson said it’s a matter of limited resources.
“With more resources, we would love to have more access points to access services,” Jackson said. “We try to go to where the need is most.”
Beyond providing clean utensils for safe drug use, the program functions as a way to meet users where they live and to start building a relationship that could eventually lead to treatment. The group also provides literature on mental health and other public health services.
“The idea is to galvanize the community with both current and lived experiences, to educate and engage with the community,” Jackson said. “Our program is built on dignity and respect, and also meeting a person where they are and not defining health for them.”
In June, the program was approved as one of 16 syringe programs in the state certified by the Maryland Department of Health, the only program of its kind in Anne Arundel. By November, the five-member team was handing out syringes at all their sites, which was met with gratitude by some substance users, Van Zuylen said.
The program has helped bridge a “gap in the continuum,” between prevention, treatment and recovery, Jackson said.
“The person who had already begun to use drugs and was in active use but wasn’t ready for treatment and recovery, we had to provide that missing piece,” she said. “We’re able to have face-to-face contact with people who are actively using who may otherwise be untouched by services.”
Other syringe programs in the state already have expanded to distributing glass pipes and sniffing kits with positive effects. SPARC, a Baltimore-based harm reduction center for women, has distributed smoking kits over the last year. It’s been effective in breaking down stigma barriers and connecting with people who are currently using drugs and might not be ready to enter treatment, said Katie Evans, outreach coordinator.
Van Zuylen said she hoped the events of the last week wouldn’t hinder others from approaching AA Power tables in the future if they need help.
“Harm-reduction isn’t new but for a lot of people it is, especially for people in recovery,” she said, “because it appears as though you’re enabling the person, but I learned that it wasn’t that through getting educated. It’s more so just providing more education for the community.”