Study: High-risk group willing to use crack smoking facility
published on June 2, 2005
(Vancouver) – A medically supervised smoking facility (SSF) for crack users shows potential for public health and community benefits, and underlines the need for a scientific evaluation of a pilot site in Vancouver, says a new study published by the B.C. Centre for Excellence in HIV/AIDS.
Past Centre research has shown that smoking heroin, crystal methamphetamine, crack and/or cocaine is associated with considerable health risks, including increased risk for transmission of diseases such as hepatitis C (HCV).
The Centre study, published in the June issue of the International Journal of Urban Health, evaluated the willingness of illicit drug smokers enrolled in the Vancouver Injection Drug Users Study to use an SSF. Among 443 eligible respondents, 124 (28%) expressed willingness to attend an SSF. Those willing to attend an SSF were most likely to be female sex-trade workers in the Downtown Eastside. These participants were also more likely to be heavy crack users and individuals who share crack pipes.
Centre research has shown that involvement in the sex trade is independently associated with HIV/HCV risk behaviour, says Thomas Kerr, one of the study’s senior authors. Recently, it has been suggested that a potential key source of blood-borne disease transmission – especially HCV infection among non-injection drug users – is shared, non-injection drug-use implements such as crack pipes, says Kerr.
“Although a scientific evaluation of a supervised smoking facility is mandatory to fully measure its impact, the research data from this study suggests there is potential for community and health benefits if such a site were made available,” says Kerr.
The paper notes a pilot SSF would be a favourable complement to Vancouver’s existing pilot supervised injection site, known as Insite. An SSF would require the same Health Canada exemption as Insite.
In Vancouver, the Centre’s scientific evaluation of the city’s pilot supervised injection site has indicated major successes in terms of high-service uptake and improved public order within the target community. The Centre study contends an SSF may address additional public order and public health concerns stemming from drug users smoking crack cocaine and crystal methamphetamine.
In several European settings, supervised smoking facilities have been established in addition to supervised injection facilities. Preliminary reports suggest these facilities have improved public order and led to increased contact between drug users and health and social services.