Pubdate: Thu, 18 Jun 2009 Source: Nanaimo News Bulletin (CN BC) Copyright: 2009, BC Newspaper Group Contact: http://www.nanaimobulletin.com/ Details: http://www.mapinc.org/media/948 Author: G. Youngman Referenced: http://www.mapinc.org/drugnews/v09/n631/a11.html CRACK-PIPE PROGRAM SAVES LIVES To the Editor, Re: City sitting on crack kit project, June 16. This program is about harm reduction which not only affects users but those associated with the users who may contract the named diseases. Drug use is illegal but it is out there whether this program exists or not. At least with this program, there is some mitigation of the affects of drug use. City officials seem to be looking for a 100-per cent guarantee of program effectiveness, which can never be attained. Council has been bogged down for some time because councillors seem afraid of 'being wrong'. This is just one of the many tools in the harm reduction toolbox, which can be used. It is now time to look at all avenues and that council makes a decision and stays committed. I do not agree with drug use and the police are obligated to enforce the laws, but it is highly naive to think that enforcement can eliminate the problem. There are many lost souls out there and this program just tries to minimize further human suffering. Individuals who are addicted to crack cocaine will self-administer it in any way possible, through intravenous injection or inhalation. This is a very powerful addiction. Let us not be mistaken. We are not talking about kids trying out crack because they have a bit of extra money and access to a crack pipe. This program is oriented toward those who cannot stop taking the drug. These are people whose lives revolve around cocaine, who may not have the social circumstances or mental health to stop taking the drug through rehab or otherwise. The crack-pipe program reduced the crack cocaine injection rate from 96 per cent to 78 per cent. It reduced the crack pipe sharing rate from 37 per cent to 12 per cent. The program was too small and too short lived to yield a statistically significant reduction in hepatitis C or HIV prevalence, but its 4,000 visits by crack users did increase access to education, social support, health services and referrals to other social service and drug treatment services. The importance of reduction in intravenous injection rates cannot be overstated. Prevention of a single case of HIV or hepatitis C saves the system at least $20,000 to $30,000 per year. Moreover, bacterial infections will be reduced. Research has shown significant reduction in these rates of transmissions and costs. There is no doubt that getting people off drugs is preferable. But that is not a real possibility for some addicts. The whole point of harm reduction manoeuvres like the crack pipe program is to accept the reality that, because of addiction, mental illness or circumstances, there are individuals who will put themselves in harm's way. It is not only cost-effective and healthier to offer safer alternatives like crack pipe programs, needle exchange programs and even alcohol maintenance programs, it is also compassionate and realistic. If the thought of such programs offends one's values, that's too bad. The proof that these programs save lives, reduce illness and save money is unequivocal. Perhaps we should direct our energies at redoubling our efforts to ensure all children are raised in homes free of abuse, with adequate education and employment opportunities, so that addiction problems do not develop. G. Youngman consultant, HIV/AIDS issues Nanaimo - --- MAP posted-by: Jay Bergstrom