CITY TO GIVE AWAY CRACK-PIPE KITS

Harm-Reduction Approach Aims To Cut Incidence Of Hepatitis And Other Diseases

Courtenay has become the first municipality on Vancouver Island to
wholeheartedly throw its support behind distribution of free crack-pipe kits.

Council voted unanimously this week to support distribution of
mouthpieces and pushsticks in the Comox Valley to combat the spread
of hepatitis C and B, tuberculosis and other diseases.

"The problem is bigger than most of us care to realize," said Mayor
Greg Phelps in an interview.

"By distributing these mouthpieces, we are hopeful it will lead to
some reduction in diseases."

While he acknowledges helping addicts in the so-called
"harm-reduction" approach is controversial, he said that point of
view, taken to its logical conclusion, would mean not providing
health care to people who don't use seat-belts.

In July, Victoria council agreed to a similar program on a temporary
basis, after a request from the Vancouver Island Health Authority.
The Victoria pilot project will include an assessment of community
support for the harm-reduction program.

But Nanaimo council turned down a similar request, saying the program
needed more assessment and the right location had yet to be found for
crack users to pick up supplies.

Other municipalities are being approached, but Courtenay was
proactive and asked VIHA for a presentation, said North Island
medical health officer Dr. Charmaine Enns.

In addition to controlling the spread of diseases, distribution of
the pieces of plastic tubing and flattened sticks -- provided by the
B.C. Centre for Disease Control -- is intended to link crack users
with other services, Enns said.

"We know crack users don't access harm-reduction strategies because
we don't have anything to offer," she said.

About 70 per cent of street drug users are crack smokers who will use
everything from broken glass to discarded pieces of metal to smoke the drug.

The resulting cuts, blisters and sores on the lips and inside the
mouth, added to frequent sharing of equipment, result in easy
transfer of blood-borne infections such as hepatitis, Enns said.

Reducing that spread not only protects public health, it's cost
effective, she said.

"One case of hep C costs the health care system between $125,000 and
$250,000. The crack kit costs pennies, so it is a pretty good return
on investment."

The distribution program will be run by the Courtenay branch of AIDS
Vancouver Island. Sarah Sullivan, a counsellor and harm-reduction
worker, said the Comox Valley, like other mid-sized communities on
Vancouver Island, has a sizable crack-using population.

"It is becoming an epidemic all over the place because it's available
and cheap. We are quite close to Campbell River where there is a lot
of crack use .... This will allow us to do some education on safer crack use."

Crack users are not only likely to have untreated mouth cuts and
sores, they are also more likely to have unprotected oral sex, as the
drug increases sexual urges while reducing awareness of safe sex.
Some also sell sex for drug money, increasing infection risks, Sullivan said.

A larger crack kit, including condoms, lip balm, educational material
and a brass screen, would be useful, she said.

The kits will be distributed through the needle exchange, which has
been in the same location in Courtenay for nine years, Sullivan said.