Bill Overview
Title: PIPES Act
Description: This bill restricts the use of funding made available through the American Rescue Plan Act of 2021 for community-based overdose prevention programs, syringe services programs, and other harm reduction programs. First, the bill prohibits the use of the act's funding to procure or distribute pipes or other paraphernalia that can be used to smoke, inhale, or ingest narcotics. Second, the bill applies to the act's funding the conditions that apply to other funding from the Department of Health and Human Services for syringe services programs and needle exchange programs. The conditions require that programs (1) operate in a jurisdiction experiencing (or at risk for) increased transmission of hepatitis and HIV infections due to injection drug use, (2) use nonfederal funds for the purchase of syringes or needles, and (3) otherwise follow applicable laws.
Sponsors: Sen. Manchin, Joe, III [D-WV]
Target Audience
Population: People potentially affected by changes to funding and conditions for harm reduction programs
Estimated Size: 8000000
- The bill impacts individuals involved in or benefitting from harm reduction programs, including community-based overdose prevention and syringe services programs.
- Harm reduction programs are aimed at reducing the health risks associated with drug use, particularly infectious disease transmission and overdose.
- The legislation could impact the availability of clean syringes or needles, potentially increasing risks of hepatitis and HIV transmission among intravenous drug users.
- The restriction on using federal funds for paraphernalia could limit the tools available to harm reduction programs aimed at preventing drug-related harm.
- The changes in funding conditions might limit the expansion or continuation of these crucial services in jurisdictions heavily affected by drug use.
Reasoning
- We considered a diverse population impacted by the PIPES Act, including those directly and indirectly involved in harm reduction programs.
- We accounted for geographical diversity, covering urban, rural, and suburban areas, where the prevalence and impact of drug use and harm reduction programs differ.
- Economic diversity was considered, as harm reduction programs often serve individuals from various socioeconomic backgrounds.
- To ensure accurate representation, we included different age groups and social demographics prevalent in communities with harm reduction programs.
- We recognized that not all individuals would directly experience changes in wellbeing due to the bill, as some regions may have alternative funding or lower dependency on the affected programs.
Simulated Interviews
unemployed (Baltimore, MD)
Age: 34 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- I rely on these programs to keep myself safe. Limiting resources like clean pipes will increase my risk of infection.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 3 | 4 |
| Year 2 | 2 | 4 |
| Year 3 | 2 | 5 |
| Year 5 | 3 | 5 |
| Year 10 | 3 | 6 |
| Year 20 | 4 | 6 |
harm reduction program coordinator (San Francisco, CA)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- This policy makes our job harder. Without adequate resources, it complicates our goal of reducing harm.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 6 |
| Year 2 | 5 | 6 |
| Year 3 | 4 | 6 |
| Year 5 | 4 | 6 |
| Year 10 | 4 | 6 |
| Year 20 | 5 | 7 |
graphic designer (New York, NY)
Age: 27 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- I don't see how this policy will actually solve the problem of drug use. People will just find other means.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
retired teacher (Mobile, AL)
Age: 62 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 7/20
Statement of Opinion:
- I fear that this policy will only drive drug abuse underground, making my community less safe.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 4 | 5 |
| Year 3 | 4 | 6 |
| Year 5 | 5 | 6 |
| Year 10 | 5 | 6 |
| Year 20 | 6 | 6 |
social worker (Portland, OR)
Age: 39 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 4/20
Statement of Opinion:
- My role becomes more challenging with fewer resources available to minimize risks for my clients.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 6 |
| Year 2 | 5 | 6 |
| Year 3 | 4 | 6 |
| Year 5 | 5 | 6 |
| Year 10 | 5 | 7 |
| Year 20 | 6 | 7 |
healthcare provider (Miami, FL)
Age: 51 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- We need all tools available. Limiting this kind of support is a step backward for public health.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 8 |
| Year 2 | 6 | 8 |
| Year 3 | 6 | 8 |
| Year 5 | 6 | 9 |
| Year 10 | 7 | 9 |
| Year 20 | 8 | 9 |
community advocate (Chicago, IL)
Age: 43 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- I believe these measures hurt people who are trying to help. We have to be compassionate.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 7 |
| Year 2 | 5 | 7 |
| Year 3 | 5 | 8 |
| Year 5 | 6 | 8 |
| Year 10 | 7 | 8 |
| Year 20 | 7 | 9 |
student (Phoenix, AZ)
Age: 30 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- Policies that ignore effective harm reduction don't address the underlying issues of drug use.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 7 |
| Year 2 | 6 | 7 |
| Year 3 | 5 | 7 |
| Year 5 | 6 | 8 |
| Year 10 | 7 | 8 |
| Year 20 | 8 | 9 |
barista (Austin, TX)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 9/20
Statement of Opinion:
- The policy seems short-sighted. People in need will continue using drugs with or without those materials.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 7 |
| Year 3 | 5 | 7 |
| Year 5 | 6 | 7 |
| Year 10 | 7 | 8 |
| Year 20 | 7 | 8 |
retired nurse (Charleston, WV)
Age: 55 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- Without supporting these programs, we risk repeating past mistakes, worsening public health issues.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 5 |
| Year 2 | 4 | 6 |
| Year 3 | 4 | 6 |
| Year 5 | 5 | 6 |
| Year 10 | 6 | 7 |
| Year 20 | 6 | 8 |
Cost Estimates
Year 1: $1000000 (Low: $500000, High: $1500000)
Year 2: $1000000 (Low: $500000, High: $1500000)
Year 3: $1000000 (Low: $500000, High: $1500000)
Year 5: $0 (Low: $-500000, High: $1000000)
Year 10: $0 (Low: $-1000000, High: $1500000)
Year 100: $0 (Low: $-5000000, High: $10000000)
Key Considerations
- Potential consequences on public health outcomes, particularly in jurisdictions with high drug use and disease transmission rates.
- The extent to which state or local governments could offset reduced federal spending with other resources.
- Long-term impacts on health systems if increased disease transmission occurs due to limited harm reduction resources.