Council supports distribution of crack pipe kits

Campbell River City council supports the distribution of crack pipe kits to crack addicts, but the decision was not unanimous Tuesday.

Councillors heard a presentation from AIDS Vancouver Island and the Vancouver Island Health Authority (VIHA) seeking city support to expand harm reduction services at the Campbell River AIDS Vancouver Island offices. Dr. Charmaine Enns, Medical Health Officer, said crack cocaine smoking is a neglected public health issue in Canada that needs to be addressed. She said people who smoke crack are extremely vulnerable to the transmission of hepatitis C and B and tuberculosis a well as HIV.

"Crack smokers have a very high prevalence of blisters, cuts and sores on their lips and in their mouths from injury from the equipment they're using to smoke crack," she said. "They burn the linings of their lips and their mouth from hot glass or metal stems.

Blood-borne pathogens are much more easily transmitted from those open sores. A survey done in Central/North Island recently showed that almost 90 per cent of crack smokers in this area share their equipment."

The kits contain hardware for safer crack use such as glass stems, brass filters and rubber mouthpieces as well as other harm prevention materials. The kits are currently distributed in several Canadian cities including Victoria, Vancouver, Toronto, Halifax and Montreal among others. They have been distributed in Courtenay since December 2009 at a current rate of about 150 a month.

"If someone is smoking crack, they will find any way that they can to smoke it," Enns said. "If there is not a readily available stem and the brass screens in the kit, they will make what they can - a pop can, a broken bottle, whatever then need to smoke crack. The brass screens that we supply replace what's commonly used which is (steel wool), which is very unhealthy. It's covered in chemicals.

There's small shards of metal and it's very bad on your lungs."

She said research indicates that safer crack use kits encourage safer behaviours among people who smoke crack. The kits provide a point of contact with social and health care workers.

"Providing education builds an opportunity to build relationships, build trust," she said. "Then they're more likely to come back and access other services. We can give referrals to community resources. If they want to access mental health and addictions, or drug treatment, we can do that and support them through that.

"One of the key parts of harm reduction programs is the relationship. We meet them where they're at. If they're using, there's no judgement, we accept them. They have trust, and if they want to take a break or to get clean, we support them through that process, as many times as they want."

But Coun. Ron Kerr was not in favor of the program.

"My concern is the message it sends to our more vulnerable demographic, the youth," he said. "The perception is that we're condoning drug use by supplying the paraphernalia, rather than prevention. I think this is a far larger population that we're putting at risk.

"I'm talking about perception from (the) teenage population. I did a lot of research online, and I didn't find a lot of evidence one way or the other. What I did find was an awful lot of the police associations that weren't in favor of it, and quotes like 'may not be solving the problem, may be creating and continuing the problem.' There definitely seems to be an alternative view to what you're telling us tonight."

Enns said the crack use kits are an addition to harm reduction strategies already under way in the community "because there's already needle exchange and other harm reduction practices. It's not a new concept."

"I don't want to over simplify it, but we can't intervene in people's lives when they're dead. So we really need to work at doing the best thing for people so they can get well.

"The evidence is very, very strong that harm reduction does not promote drug use or increase drug use. Harm reduction is focused to those who are unable or unwilling to stop drug use. Harm reduction is the bridge to stay connected with people that otherwise would be disconnected, so that they can access treatment and hopefully go on to healthier lives."

Council voted to support the expansion. Kerr's was the lone vote against.