Vancouver Coastal Health to hand out $50,000 worth of crack pipes health, expected, medical, Health

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Vancouver Coastal Health to hand out $50,000 worth of crack pipes


Vancouver health officials will distribute new crack pipes to the city’s non-injection drug users this fall as part of a pilot project aimed at engaging crack cocaine smokers and reducing the transmission of disease such as hepatitis C.

The program, part of Vancouver’s harm reduction strategy, is expected to start in October and run for six months to a year, said Dr. Reka Gustafson, a medical health officer with Vancouver Coastal Health.

The intent is to connect health care workers with crack cocaine smokers to evaluate how many of the drug users are in the city and what equipment they need to lower their risk of catching diseases such as hepatitis C, HIV and even respiratory illnesses.

A kit with a clean, unused pipe, mouthpiece, filter and condoms will be handed out to the participants, Gustafson said. It’s not known at this time how many drug users will take part in the pilot, which is estimated to cost between $50,000 and $60,000.

“There’s been a shift to crack cocaine smoking and we want to make sure the services we provide are the services they need ... if we’re providing syringes and what we need are pipes, we’re not serving them,” Gustafson said.

“We know there’s a demand and chances are what we’re going to be able to supply won’t last very long.”

Health officials already provide mouthpieces for crack pipes but not the pipe themselves. This means many drug users are sharing the glass pipes, which may be old or chipped, and are at risk of contracting a disease, such as hepatitis C, from cuts on their mouths, or respiratory illness or pneumonia from inhaling crumbling filters or the crack directly into their lungs.

“It’s just understanding and knowing the health consequences of crack cocaine smoking,” Gustafson said.

“Mouth pieces alone are not enough. Health consequences don’t just come from the mouth piece; they come from unsafe pipes.

The pilot project is expected to reach out to the rising number of crack cocaine smokers. Although specific numbers aren’t known, it’s estimated there are up to 15,000 of drug users in Vancouver’s Downtown Eastside.

But while heroin users can get clean needles from needle-exchange programs or the city’s safe-injection site, new pipes aren’t as easily accessible.

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“There’s quite a high prevalence of [people] smoking crack but it can differ from city to city,” B.C. medical health officer Dr. Perry Kendall.

He said the pilot should help to reduce transmission rates for disease, particularly for hepatitis C, which continues to be on the rise in Vancouver. About 60 per cent to 80 per cent of drug users in Vancouver have the disease or at risk of getting it, he said, because it’s easily spread through blood or saliva or through sexual activity.

“There’s good reason that hepatitis C and HIV can be transmitted on the mouth piece of pipes. It’s not as clear as with needle-sharing but it’s pretty persuasive,” Kendall said. “This pilot will tell us if we should be doing more.”

The pilot was initiated partly because of a report by Kendall last spring, which found a rise in crack cocaine smoking has been consistently reported in the Downtown Eastside with increases in requests for crack smoking supplies.

But as only mouth pieces and push sticks — used to clean the filters — are supplied, the report said, youth who use non-injection drugs may not be getting the services they need.

“Safer crack cocaine smoking among those who use this substance needs to be encouraged, and crack cocaine smokers need to be engaged, by including crack pipes with available harm reduction supplies and establishing supervised inhalation sites,” the report said.

Across Canada, only a handful of cities, including Calgary and Winnipeg, hand out crack pipes.


To prevent the spread of disease in the Downtown Eastside, free replacements are available for well-used crack-pipe mouthpieces like this one


man lights up a crack pipe in the Downtown Eastside where counselling programs could be in jeopardy