CRACK-PIPE PROGRAM SAVES LIVES, MONEY

Re: Crack pipe end run upsets O'Brien, Jan. 14.

The Ontario government has chosen to fund the crack pipe program
cancelled by Ottawa's municipal politicians. Mayor Larry O'Brien
stated that the program provided no benefit to its users. He is wrong.

Ottawa's program was virtually unique.

It was set up, not so much to prevent sharing of crack pipes, but
more to prevent intravenous injection of crack cocaine.

The utility of this hinges upon the fact that those addicted to crack
cocaine will self-administer it in any way possible, through
intravenous injection or inhalation. This is a very powerful addiction.

Let us not be mistaken here. We are not talking about kids trying out
crack because they have a bit of extra money and access to a crack
pipe. This program is oriented towards those who cannot stop taking
the drug. These are people whose lives revolve around cocaine, who
may not have the social circumstances or mental health to stop taking
the drug through rehab or otherwise.

The crack-pipe program reduced the crack cocaine injection rate from
96 per cent to 78 per cent. It reduced the crack pipe sharing rate
from 37 per cent to 12 per cent. The program was too small and too
short lived to yield a statistically significant reduction in
hepatitis C or HIV prevalence, but its 4,000 visits by crack users
did increase access to education, social support, health services and
referrals to other social service and drug treatment services.

The importance of reduction in intravenous injection rates cannot be
overstated. Prevention of a single case of HIV or hepatitis C saves
the system at least $20,000 to $30,000 per year. Moreover, bacterial
infections will be reduced.

This autumn, I cared for a young woman whose disseminated bacterial
infection, caused by intravenous cocaine use, mandated six weeks of
treatment in hospital. This cost our society at least $50,000.

There is no doubt that getting people off drugs is preferable. But
that is not a real possibility for some addicts. The whole point of
harm reduction manoeuvres like the crack pipe program is to accept
the reality that, because of addiction, mental illness or
circumstances, there are individuals who will put themselves in harm's way.

It is not only cost-effective and healthier to offer safer
alternatives like crack pipe programs, needle exchange programs and
even alcohol maintenance programs, it is also compassionate and realistic.

If the thought of such programs offends one's values, that's too bad.
The proof that these programs save lives, reduce illness and save
money is unequivocal.

Perhaps we should direct our energies at redoubling our efforts to
ensure all children are raised in homes free of abuse, with adequate
education and employment opportunities, so that addiction problems do
not develop.

Stephen Kravcik, MD,

Manotick