By Rachel Dares
A controversial move to hand out clean pipes to crack cocaine users in Ottawa is helping reduce the spread of hepatitis C and HIV, according to a University of Ottawa report.
The initiative is already showing marked success, according to the study’s preliminary findings released in August to the International AIDS Conference held in Toronto.
Two years ago the City of Ottawa expanded its needle exchange program to include the distribution of crack paraphernalia. Kits containing pipe stems, filters, rubber mouthpieces, lip balm and condoms are distributed by outreach workers and health centres throughout Ottawa, says Wendy Muckle, a member of an Ottawa harm reduction committee. The intent is to connect people to the health care system and reduce the spread of disease.
At the AIDS conference, Lynne Leonard, a University of Ottawa epidemiologist, announced some noticeable trends resulting from the safe-crack-use program.
“The most exciting finding, perhaps, is the impact on sharing crack smoking equipment,” said Leonard at a press conference following her presentation. “(There is) real evidence of increasing behaviour change.”
Fewer people are sharing crack pipes and many are switching from injection drug use to smoking crack, which poses less risk for the spread of disease.
As many as 550 participants were recruited from areas throughout Ottawa. The study involved habitual injection drug users who had reported smoking crack in the previous six months.
In an interview, Leonard confirmed the preliminary findings, but refused to comment further until the report is made publicly available.
At the start of the program, 37 per cent of respondents who reported sharing pipes said they did so every time they smoked. A year later, this number had dropped to 13 per cent.
After just one month of handing out crack kits in Ottawa, four out of five respondents had already accessed the new service.
“This is a clear demonstration of the need. These resources were provided and there was immediate high and sustained uptake,” said Leonard at the press conference.
A Lisgar Street organization called Oasis has handed out clean pipes for about a year, says Hannah Cowen, a nurse at the centre. She says she has seen the success of the initiative in the Centretown area.
“People who are smoking crack often have burns or cracks on their lips. When sharing a pipe to pass it around – if one of those people has HIV or hepatitis C – the blood could get on the pipe and go to the next person and get in their bloodstream,” says Cowen. “There are risks associated with the basic behaviour of smoking crack, but we want to reduce those risks as much as we possibly can.”
Oasis currently has 1,300 active clients who receive a range of services including clean crack pipes, counselling and HIV testing, says Cowen.
The safe-crack-use program also connects people to the health-care system, she says. When drug users enter a health centre to access the clean-pipe program, they are exposed to other health and social services available to them, says Peter Williams, a project consultant at the Centre for Addiction and Mental Health.
“There are many success stories with people being able to get back into work and go back to school and get their kids back from children’s aid,” he says.
When the clean-pipe program got underway in April 2005, Ottawa was experiencing some of the highest disease rates in Canada. According to Leonard, 20 per cent of injection drug users were HIV positive and 75 per cent had hepatitis C.
Ottawa police chief Vince Bevan opposed the program, saying it would encourage drug use. Bevan did not return a request for comment on the report’s findings.
“I assume he wasn’t familiar with the evidence around this,” says Muckle. “It seems very weird to me.”
According to Cowen, there has been no indication of an increase in drug use as a result of the initiative.
“When I first heard about harm reduction, I had that same idea that it would encourage people to use drugs, but it does not,” she says.
Costing roughly $2,500 per year, the crack program is well worth the expense and is a step in the right direction for the city, says Williams.
“How can you value someone’s life?” he says. “If a few people get healthy or get healthier, I think it’s hard to put a price tag on that.”