ISLAND USERS TO GET FREE CRACK PIPES

New Study Suggests Addicts Who Share Tools Could Spread Hepatitis C
Virus

A controversial crack-pipe distribution program driven out of Nanaimo
earlier this year will be set up across Vancouver Island in the new
year.

The crack pipes, or components like mouthpieces and filters, will be
handed out at needle-exchange sites in Victoria, Nanaimo, Campbell
River and Courtenay, as well as through mobile units in many other
Island communities, said Murray Fyfe, medical health officer for the
Vancouver Island Health Authority.

The program will be funded through the Ministry of Health, as part of
its provincewide harm-reduction strategy, which already includes
needle exchanges. Although pilot distribution programs have been in
place in Victoria and other B.C. cities for up to two years, they were
funded by a variety of organizations on a test basis.

They also were a source of controversy. In Nanaimo, VIHA had to stop
pipe distribution in June after city council and residents raised
concerns and VIHA staff were harassed. At the time, VIHA chief
executive officer Howard Waldner admitted the authority could have
done a better job of communicating the goals of the project -- which
were to mitigate the spread of diseases, including HIV, hepatitis C
and tuberculosis, through the sharing of pipes.

Crack cocaine is a highly addictive, relatively cheap and prevalent
street drug used across Canada. Sold in crystal form, it is heated and
smoked through a pipe -- usually makeshift ones fashioned out of glass
fluorescent-light tubes, metal cans or plastic tubes.

The Island's new distribution program comes on the heels of a study --
called the HCV Transmission Among Oral Crack Users -- released
yesterday that suggests the sharing of crack pipes could transmit the
debilitating hepatitis C virus between users.

The study by the UVic-based Centre for Addictions Research B.C. was
conducted on 51 inner-city crack users in Toronto in 2006. The virus
was detected on one of the 22 crack pipes examined whose owners had
tested positive for the hepatitis C virus antibody.

Lead researcher Benedikt Fischer, director of the illicit drugs,
public health and policy unit at the addictions research centre, said
the study provides biological evidence, lacking until now, that
hepatitis C could be passed from an infected crack user onto a pipe,
likely through mouth sores.

While more rigorous research is needed to confirm the findings, the
study demonstrates the need for targeted prevention programs for these
drug users, who are already "marginalized and sickly," he said.

He can't say whether safer crack-use kits are the answer, but said
they aren't costly and certainly do no harm.

While the rate of HIV/AIDS infection has stabilized across Vancouver
Island, hepatitis C infections are increasing -- in 2005, 74 per cent
of intravenous drug users were infected, up from 68 per cent just two
years earlier. Hepatitis C is the most prevalent viral disease among
street drug users, and is estimated to cost the Canadian health-care
system up to $1 billion a year.

There are an estimated 4,000 injection-drug users on the Island, about
half that number in Victoria. According to a 2005 VIHA study, 69 per
cent of injection-drug users in Victoria also smoked crack cocaine.

Katrina Jensen, executive director of AIDS Vancouver Island, which
hands out crack pipes and mouthpieces in Victoria, and will start new
programs in Port Hardy and Campbell River early in the new year,
welcomed the new research about hepatitis C transmission.

"That's what we need is more evidence, we haven't had the scientific
evidence, it's been more anecdotal until now, that crack smoking is a
risk [for hepatitis C transmission]," she said.

Harm-reduction strategies are a small part of health-care spending
that yield a big return, she added.

Similar crack-pipe distribution programs have been set up in other
Canadian cities, such as Vancouver, Toronto, Ottawa and Winnipeg.