Distribution of crack kits is good policy
Consider this: The province decides to fund a cheap medical program that could reduce the spread of a serious disease and, along with it, could reduce health care costs significantly.
One would think such a program would be heartily endorsed by anyone who's concerned about spiralling health care costs. Alas, the program concerns drugs - more specifically, crack cocaine, one of the most harmful of the illicit drugs. And that means that many people will reflexively oppose the program regardless of the benefits it may realize.
The pilot project involves distributing crack kits, including pipes, mouthpieces, filters and condoms, to crack cocaine smokers. Although it's not clear how many subjects will be involved, the project is expected to run for six months to a year and to cost between $50,000 and $60,000.
That's a mere pittance compared to the project's potential savings.
Although the evidence is not conclusive on this point, there is reason to believe that the sharing of crack pipes can lead to transmission of a variety of blood-borne diseases, most notably hepatitis C (HCV). Indeed, just a few years ago Benedikt Fischer of the University of Victoria's Centre for Addiction Research studied 51 crack smokers and found HCV on one pipe.
This doesn't prove that HCV is transmitted via shared crack pipes, but given that many crack smokers have burns and open sores on their lips, it's certainly possible.
We know further that both HCV and pipe sharing are epidemic among crack users.
According to data from the ongoing BC Alcohol and Other Drug Monitoring Project, which interviews samples of drug users every six months, 70 per cent of crack smokers in Victoria and 60 per cent in Vancouver reported sharing crack pipes.
It is, therefore, imperative that we do whatever we can to reduce the risk of HCV transmission among crack users, not only to safeguard their health but also to reduce health care costs.
The cost of treating HCV infection is estimated at $30,000 per person per year, and given the number of HCV-infected drug users in Canada, the estimate for treatment over the next 20 years runs into the billions of dollars.
This itself is a crisis, in addition to the epidemic of HCV infection among drug users.
And it means that if the pilot project prevents two people from becoming HCV positive, it will have paid for itself for each year's outlay.
But preventing HCV infection is, of course, not the only to reason to endorse the project. Crack pipe sharing might also lead to HIV transmission and to respiratory illnesses such as pneumonia.
And preventing disease isn't the only reason to endorse the project.
The distribution of crack kits also acts as a form of outreach to deeply marginalized drug users, a point of first contact with the health care system.
As we have seen with Insite, Vancouver's supervised injection site, the project could ultimately result in more users seeking treatment.
Of course, we don't know if the project will have this effect, or even if it will reduce HCV infection. But that is precisely why it needs to be tried and studied. Running such a project is the very epitome of responsible health care policy-making.