CRACK KITS PART OF VIHA DRIVE

Council members received crack pipes as part of a harm reduction
presentation by the Vancouver Island Health Authority on Monday afternoon.

"Harm reduction does not promote drug use."

That was the message delivered by VIHA medical health officer Dr.
Lorna Medd, despite some skepticism from councillors.

Addiction is not simply about making an unwise choice," Medd said.
"Addiction is about people trying to self-manage their pain."

Medd outlined a number of measures being undertaken to reduce the
spread of disease related to street drug use, with the most
controversial being the crack kits VIHA plans to distribute in the
community.

Currently, about 5% of street drug users are HIV positive, with annual
health costs per person as high as $200,000, Medd said.

"If we are focussed, we may be able to prevent that number from
rising, through harm reduction," she said.

Even worse, 72% of drug users carry the hepatitis C virus, as a result
of sharing needles and crack pipes. VIHA already distributes syringes,
vials, condoms and lubricant in order to prevent the spread of disease
related to intravenous drug use and drug-related prostitution. Medd
said the rise in crack use has made the new kits a priority.

"In 1996, crack accounted for about 5% of illicit drug use. Now, it's
up between 45 and 50%," Medd said.

VIHA maintains a methadone program to help intravenous drug users
transition away from heroin. But that program has slipped in priority
due to the shift to crack cocaine.

"For crack, there is no treatment - there is no methadone," she
said.

The kits contain a glass pipe, a brass filter to screen out
impurities, a wooden push stick (actually half of a disposable
chopstick set) and a flexible mouthpiece.

Medd said the kits can prevent the transmission of
disease.

But perhaps more importantly, she said, they provide a window for
marginalized drug users to initiate a relationship with the health
care system, and, possibly, seek treatment.

"It's not about forcing people into abstinence, although it's
certainly in that direction," Medd said. "But the goal is ultimately
to prevent users from doing further harm to themselves."

Examining her sample kit, Coun. Cindy Solda questioned how the kits
actually help.

"Do people re-use them? Do they recycle them?" she asked Gordon Cote,
executive director of NARSF, the Nanaimo-based agency that runs the
needle exchange program.

"The one thing we're hoping to do is reduce sharing," Cote said. "What
we've discovered is that 38% of drug users have reported sharing crack
pipes or needles."

Councillors Hira Chopra and Ike Patterson both questioned the data,
admittedly sketchy, according to Medd, on the question of whether harm
reduction actually facilitates drug use.

"What we know is that the people who are accessing harm reduction are
already in that life," Medd said, adding that one of the hopes is to
reduce the risk to those on the periphery of the drug culture.

"I know that safe sex measures have been a great benefit in reducing
the spread of disease, but I'm still a little skeptical about this
program," Solda said following the meeting.