Prime Minister Stephen Harper’s statement about the failures of Canada's drug policy is mostly on point. It’s just the last bit he gets wrong: “I think what everyone believes and agrees with, and to be frank myself, is that the current approach is not working, but it is not clear what we should do.” He’s wrong, because we know what we should do: Supervised injection sites; prescription heroin; medical cannabis dispensaries; crack pipe distribution; drug testing kits; Naloxone for reversing opioid overdose.
When you hear that your government is helping addicts shoot up or smoke crack, it's normal to wonder: how can this possibly be good? Until recently, Alberta Health Services did similar work, distributing free, clean crack pipes to Calgary addicts through the Safeworks Harm Reduction Program. But when local media publicized the existence of the pipe arrangement last month, things went sideways.
Louise Gallagher (Director, Public Relations, Volunteer Services, with the Calgary Drop In, Rehab Centre)
21 August 2011
In 2008, Safeworks, an outreach program of Alberta Health Services, began a harm reduction program aimed at mitigating the effects of sharing crack pipes with other addicts. Through the program, users had the opportunity to obtain a clean pipe. It helped cut down on transmittable diseases and it gave outreach workers an opportunity to build relationships and explore safer options with this at-risk population of crack users. It's disheartening that AHS decided last week to let this program go up in smoke because it became controversial.
A decision to stop a clean crack-pipe distribution program has disappointed those working to rehabilitate street addicts. Since 2008, Alberta Health Services had been giving out crack-pipe kits as part of the Safeworks program, an effort to reduce transmittable diseases. The kits contained a glass pipe, mouthpiece and cleaning tool and were handed out in an AHS van. More than 14,500 crack pipes were given out as of June 2011.
Vancouver health officials will distribute new crack pipes to non-injection drug users this fall as part of a pilot project aimed at engaging crack cocaine smokers and reducing the transmission of disease such as hepatitis C, HIV and even respiratory illnesses. The program, part of Vancouver's harm reduction strategy, is expected to start in October and run for six months to a year. The intent is to connect health care workers with crack cocaine smokers to evaluate how many of the drug users are in the city and what equipment they need to lower their risk of catching diseases. A kit with a clean, unused pipe, mouthpiece, filter and condoms will be handed out to the participants.
Andrew Ivsins, Eric Roth, Nadine Nakamura, Mel Krajden, Benedikt Fischer
30 June 2011
Crack use is prevalent amongst street drug users in Canadian cities, and associated with severe drug use, health and social problems. Whilst few targeted interventions are available for crack use, the common use and sharing of hazardous makeshift paraphernalia are a key concern, as these risks may be associated with oral injury and blood-borne virus (BBV) transmission amongst users. Recently, distribution programmes of so-called 'safer crack use kits' (SCUKs) have been initiated in select Canadian cities, primarily to reduce the use of unsafe materials and paraphernalia sharing amongst crack users. This study explored uptake and benefits of, barriers to, and possible improvements to two recently implemented SCUK distribution programme in Victoria, Canada.
Leslie A. Malchy, Vicky Bungay, Joy L. Johnson, Jane Buxton
30 April 2011
Crack smoking has increased in Vancouver despite the harms associated with its use. Many people who smoke crack share their equipment, thereby increasing their risk for infectious disease. This project explored the effects of outreach distribution of "safer crack kits" on smoking practices. While kit distribution made safer use items more accessible, its impact on safer use practice was limited. Our findings highlight the need for targeted distribution of safer use items. Future research should explore the dynamics of unsafe crack smoking practices and ways to leverage safer use messaging.
This fact sheet explains the Safer Crack Use Program of the Public Health Department of Toronto (Canada). In Toronto, a range of community-based, government and institutional agencies deliver harm reduction services. As with other harm reduction measures, there is no evidence that the distribution of safer crack use kits encourages drug use. Only people who are already using crack cocaine participate in the Safer Crack Use Program.
Jean-Paul Grund, Philip Coffin, Marie Jauffret-Roustide, Minke Dijkstra, Dick de Bruin, Peter Blanken
01 April 2010
Harm reduction programmes targeting stimulants like cocaine and (meth)amphetamines in several countries have shown positive results. However, these programmes are limited to Australia and North America. As the effectiveness of pharmacological and psychosocial interventions for stimulant users is limited, interventions to stabilise and minimise the negative consequences of ongoing methamphetamine use are of paramount importance. A wide range of health and social problems associated with stimulant use are largely unaddressed by current services.
This paper examined whether use of crack cocaine has become a risk factor for HIV infection. Smoking of crack cocaine was found to be an independent risk factor for HIV seroconversion among injection drug users. This finding points to the urgent need for evidence-based public health initiatives targeted at people who smoke crack cocaine. Innovative interventions that have the potential to reduce HIV transmission in this population, including the distribution of safer crack kits and medically supervised inhalation rooms, need to be evaluated.
In 2004, a team comprised of researchers and service providers launched the Safer Crack Use, Outreach, Research and Education (SCORE) project in the Downtown Eastside of Vancouver, British Columbia, Canada. The project was aimed at developing a better understanding of the harms associated with crack cocaine smoking and determining the feasibility of introducing specific harm reduction strategies.
A number of public health departments and community organizations in Canada distribute safer crack use kits to people who use crack cocaine. The kits typically include mouthpieces, glass stems and screens, as well as condoms and referral information for other health and support services. This document outlines why such health programs are needed and answers a number of legal questions related to the distribution of safer crack use kits.
In the city of São Paulo, the culture of crack use has undergone considerable changes over these 11 years since it was first described. The sociodemographic profile of the users is practically the same and most use is still compulsive, with significant physical, moral and social impairment among them. Sole use of crack has overwhelmingly been replaced by associations between crack and other drugs, thus characterizing users in the city of São Paulo as multiple drug users.
The aim of this report is to provide key findings related to the SCORE project. It is our hope that the insights that we have gained may be of benefit to others engaged in similar initiatives and to ultimately improve the health of individuals who use crack. The SCORE project (Safer Crack Outreach, Research, and Education) grew out of the vision and hard work of the Safer Crack Use Coalition of Vancouver. Before the SCORE Project was funded, this coalition devoted much energy into raising awareness regarding the insufficient resources aimed at preventing the harms related to crack use.
Lynne Leonard, Emily DeRubeis, Linda Pelude, Emily Medd, Nick Birkett, Joyce Seto
30 April 2007
Among injection drug users (IDUs) in Ottawa, the capital of Canada, prevalence rates of HIV (20.6 percent) and hepatitis C HCV (75.8 percent) are among the highest in Canada. Recent research evidence suggests the potential for HCV and HIV transmission through the multi-person use of crack-smoking implements. On the basis of this scientific evidence, in April 2005, Ottawa's needle exchange programme (NEP) commenced distributing glass stems, rubber mouthpieces, brass screens, chopsticks, lip balm and chewing gum to reduce the harms associated with smoking crack.
Clinical observations and scientific evidence - The use of some drugs in Chile remains silenced in official discourses, making it important to clinically observe the various ways those drugs requiring more attention appear, and which are not seen as a priority in mental health. Specifically, this is the case with cocaine paste, widely used by people living in poverty.
Based on two studies carried out in the cities of Buenos Aires and Montevideo, this report examines the origin, characteristics and impact of the explosive increase in cocaine base paste in urban areas. It also highlights the variety of products consumed in these cities and the substance known as crack that is consumed in Brazilian cities. The Brazilian experience with this consumption could serve as an example and a lesson for the Southern Cone.
An ethnographic study of women and drug use in inner city neighborhoods in Kingston, Jamaica, revealed that cannabis is commonly used in conjunction with crack cocaine to minimize the undesirable effects of crack pipe smoking, specifically paranoia and weight loss.
Eliseu Labigalini Jr, Lucio Ribeiro Rodrigues, Dartiu Xavier Da Silveira
01 October 1999
This study ensued from clinical observations based on spontaneous accounts by crack abusers undergoing their first psychiatric assessment, where they reported using cannabis in an attempt to ease their own withdrawal symptoms.