SAFE CRACK HOUSES NEED MORE STUDY

Re: Jumping To Crack Conclusions, editorial, Oct. 21.

Your editorial about supervised sites for consumption of crack
cocaine raises some important points. Insite, Vancouver's supervised
injection site for intravenous users of opiates (read heroin) has
shown positive results such as a modest decrease in criminal activity
and increased utilization of treatment services in those that use
Insite. Its effect on transmission of hepatitis C and HIV is less
clear, most likely because by the time that someone will use Insite
he is well advanced in the addiction process and infection has
already occurred.

Furthermore, heroin overdoses are easily managed by an antidote which
can be life saving. Therefore there is sound reasoning behind the
provision of a supervised injection site for heroin users.

Supervised self-administration of stimulants such as crack cocaine or
amphetamines may or may not be different. Stimulants tend to be taken
repeatedly until exhaustion and are associated with high-risk
behavior ranging from unprotected sex to violence to psychosis.
Unlike heroin, there is no antidote to an overdose.

Until properly tested, any usefulness of giving addicts a place where
they can use crack cocaine can neither be praised nor denied.

Dr. Charles MacKay, American Board of Addiction Medicine, St. Eustache, Que.