Brazil will soon have a special police task force targeting crack-cocaine. Meanwhile, the Brazilian state of Minas Gerais proposes its own drug fighting alternatives to address crack on the domestic front. Crack is a risk factor in urban violence, contributing to homicides and robberies in Brazilian cities. However, it is not the chemistry involved in crack, but the crack market that is increasing the crime and violence. How can rising crack use effectively be addressed, other than through mere suppression?
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.
Drug users in France will soon have a state-sanctioned place where they can use heroin, crack and other intravenous drugs, after the government approved a pilot site in Paris. The City Council had already voted to allow a secure injection site to be opened in the city, a controversial measure, which social workers say should help to reduce the number of drug users in the streets.
About two decades after the U.S. emerged from the worst of its own crack epidemic, Brazilian authorities are watching the cheap drug spread across this country of 190 million people. They have far fewer resources to deal with it, despite a booming economy that expanded 7.5 percent last year. Walter Maierovitch, a former drug czar, proposes programs that offer adults health services and a safe place to use drugs. "Insisting on programs that demand abstinence doesn't work," he said.
Once crack was introduced about six years ago, Mandela and the surrounding complex of shantytowns became Rio's main outdoor drug market, a "cracolandia," or crackland, where users bought the rocks, smoked and lingered until the next hit. Hordes of addicts lived in cardboard shacks and filthy blankets, scrambling for cash and a fix. Dealers have stopped selling the drug in Mandela and nearby Jacarezinho in a move that traffickers and others say will spread citywide within the next two years. The drug bosses, often born and raised in the very slums they now lord over, say crack destabilizes their communities.
Insite’s operators have twice applied for a federal health exemption to allow crack cocaine smokers to use the room – the request was rejected in 2006, ignored in 2009. Proponents say the room would allow health officials to reach a fast-growing segment of drug users, a group prone to viruses because of dirty crack pipes. Critics say scientific evidence for the benefits of supervised inhalation rooms is scant.
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.
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.
For three years, the Vancouver Area Network of Drug Users’ (VANDU) operated an unsanctioned, peer-run “safer smoking room” for crack users in a small ventilated washroom in its Downtown Eastside facility. It protected crack users from violence, connected them with health care services, kept them away from public spaces and prevented the spread of disease from pipe-sharing, according to the authors of a recently-published study titled “We need somewhere to smoke crack.”
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.
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.