DRUG USERS TO RECEIVE CRACK PIPES AS PART OF PILOT PROJECT

Vancouver Health Officials Aim to Reduce Spread of Diseases Such As
Hepatitis C by Giving Clean Equipment to Non-Injection Users

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.

The program, part of Vancouver's harm reduction strategy, is expected
to start in October and run for six months to a year, said Dr. Reka
Gustafson, a medical health officer with Vancouver Coastal Health.

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 such
as hepatitis C, HIV and even respiratory illnesses.

A kit with a clean, unused pipe, mouthpiece, filter and condoms will
be handed out to the participants, Gustafson said. It's not known at
this time how many drug users will take part in the program, which is
estimated to cost between $50,000 and $60,000.

"There's been a shift to crack cocaine smoking and we want to make
sure the services we provide are the services they need ... if we're
providing syringes and what we need are pipes, we're not serving
them," Gustafson said.

"We know there's a demand, and chances are what we're going to be able
to supply won't last very long."

Health officials already provide mouthpieces for crack pipes but not
the pipe itself. This means many drug users are sharing the glass
pipes, which may be old or chipped, and are at risk of contracting a
disease such as hepatitis C from cuts on their mouths, or respiratory
illness or pneumonia from inhaling crumbling filters or the drug
directly into their lungs.

"It's just understanding and knowing the health consequences of crack
cocaine smoking," Gustafson said.

"Mouthpieces alone are not enough. Health consequences don't just come
from the mouthpiece; they come from unsafe pipes."

The pilot project is expected to reach out to the rising number of
crack cocaine smokers. Although specific numbers aren't known, it's
estimated there are up to 15,000 users in Vancouver's Downtown Eastside.

Heroin users can get clean needles from needle-exchange programs or
the city's supervisedinjection site, but new pipes for crack aren't as
easily accessible.

"There's quite a high prevalence of [people] smoking crack but it can
differ from city to city," B.C. medical health officer Dr. Perry
Kendall said.

He said the project should help to reduce transmission rates for
disease, particularly hepatitis C, which continues to be on the rise
in Vancouver. About 60 per cent to 80 per cent of drug users in
Vancouver have the disease or are at risk of getting it, he said,
because it's easily spread through blood or saliva or through sexual
activity.

Kendall said there's a strong belief that hepatitis C and HIV can be
transmitted on the mouthpiece of a pipe. "It's not as clear as with
needlesharing, but it's pretty persuasive," Kendall said. "This pilot
will tell us if we should be doing more."

But as only mouthpieces and push sticks - used to clean the filters -
are supplied, the report said, youth who use non-injection drugs may
not be getting the services they need.

"Safer crack cocaine smoking among those who use this substance needs
to be encouraged, and crack cocaine smokers need to be engaged, by
including crack pipes with available harm reduction supplies and
establishing supervised inhalation sites," the report said.

Across Canada, only a handful of cities, including Calgary and
Winnipeg, hand out crack pipes.