Two new harm reduction articles:
program cut disease: study:
paraphernalia also increased drug use, AIDS
By Chris Cobb, The Ottawa Citizen
Ottawa Citizen ( Canada ), August 18, 2006
- The City of Ottawa 's controversial distribution
of free drug paraphernalia to crack smokers is
improving drug users' dangerous habits and
preventing the spread of disease, says a new study
released to the International AIDS Conference here
The University of
Ottawa study, funded by federal, provincial and
city governments, says the crack-user program is
radically reducing the sharing of drug
paraphernalia, which is the main cause of disease,
but is also increasing the amount of crack
saw an increase in crack smoking," said University
of Ottawa epidemiologist Lynne Leonard,
"and it looked like a negative outcome of the
program. We were rigorous and looking for negative
and positive outcomes. But what we also saw was a
huge, significant decrease in the use of injected
drugs, which is far more risky than smoking."
The study results were released two days after
candidate Terry Kilrea said he'd scrap the city's
needle-exchange and crack-pipe-equipment programs,
as well as pesticide-education programs, in order
to spend an additional $1 million on treatment
Mr. Kilrea said the city shouldn't be enabling
drug use by distributing needles and drug
paraphernalia to addicts.
estimates between 3,300 and 5,000 injection drug
users live in Ottawa and about 80 per cent of them
are crack cocaine smokers. Between 75 and 80 per
cent of injection drug users have hepatitis C and
about 20 per cent are HIV-positive. Crack
is a highly addictive stimulant and costs a
quarter of regular cocaine.
The city program started in April 2005 despite
huge opposition from some members of city council
and from police Chief Vince Bevan.
Chief Bevan said at the time that the program
would encourage drug use: "I am concerned that the
message we are sending is that there's a safer way
to do crack, that it's OK to try crack," he said
shortly before the majority of council gave the
program the go-ahead. "There is no hard evidence,
no empirical studies that support the distribution
of crack pipes."
increase in crack use, Ms. Leonard yesterday said
there is now "significant scientific evidence"
that shows the program is important in reducing
the harms associated with crack smoking.
"It can be easily administered," said Ms. Leonard,
who is the director of an HIV prevention research
team. "If you provide it, people will come and
take advantage of it. Once you've got those people
you can work with them to further reduce harm."
program, unique in North America , provides crack
users with a package that includes pipe stems,
rubber mouth pieces and brass screens to prevent
burns. The kits, which cost $2, but are free to
addicts, also include condoms, lip balm, chewing
gum, a pipe-disposal mechanism and information on
drug use and prevention.
In its first year, the program has provided tens
of thousands of pieces of smoking paraphernalia,
including about 52,000 glass stems, to addicts.
Typically, crack smokers using the hot pipes
develop open sores, cuts and blisters on their
lips and when they share bloody smoking equipment
they also run a high risk of sharing blood-borne
disease. Studies also show crack smokers contract
HIV and Hep C through oral sex.
Before the city program began, more than a third
of the addicts who took part in the study said
they used shared equipment every time they smoke
crack. By April, when the study ended, 13 per cent
said they continued to share.
drug users' sex lives
Kingston Whig-Standard ( Ontario ) August 18, 2006
Rob Tripp Whig-Standard Staff Writer
University researcher has found a strikingly high
rate of risky sexual conduct by injection drug
The finding from a pilot study of 60 users in
Hamilton, Ont., suggests that a long-standing
needle exchange program designed to combat the
spread of infectious disease is undermined by
other conduct of the drug users.
HIV, the virus that causes AIDS, can be
transmitted when injection drug users share dirty
injection drug users also are active in the
commercial sex trade, as prostitutes or in
exchanging sex for drugs.
The use of clean needles by drug users is a
barrier to the transmission of HIV, but if users
continue to have unprotected sex, the disease
still has a path to spread.
Dirty needle sharing and unprotected sex also are
common transmission paths for hepatitis C and
Prof. Ana Johnson-Masotti was quick to point out
her sample of drug users was small and the 97 per
cent figure includes all respondents who engaged
in some unprotected sex, even if they also engaged
in safe sex.
"This is just a preliminary finding just to show
that the interviewing process works," said
Johnson-Masotti, of the department of community
health and epidemiology.
The research is a first step in determining
whether needle exchange, condom distribution and
education campaigns are cost- effective tools in
controlling the spread of infectious diseases.
Johnson-Masotti said it is difficult to get
material and information into the hands of the
drug users, who shun contact with agencies and
"Once we reach them, programs seem very
effective," she said.
Her pilot project, funded by a provincial granting
agency, also involves sampling of drug users in
Waterloo , Ont.
"In the future, we intend to expand the program
across Ontario to include maybe five regions," she
Since 1992, a needle exchange program has operated
in Hamilton from a van that visits different parts
of the city.
Kingston has a needle exchange program that
operates out of a storefront on Montreal Street
near Brock Street .
The Hamilton survey found that 97 per cent of the
respondents injected drugs with clean needles.
The bulk of the survey sample, 78 per cent, was
male. Seventy per cent of the group was over the
age of 40.
Seventy-five per cent of participants reported
injecting 10 or more times in the previous 30
days, mainly using cocaine and crack.
in major Canadian and American cities reveals that
many injection drug users engage in unprotected
sex, although the rates typically range between 60
and 80 per cent of the sexually active
A national study in 2003 that tracked roughly 800
drug users in four Canadian cities, Regina ,
Sudbury , Toronto and Victoria , found that 60 per
cent of male respondents never used a condom while
having intercourse with regular female partners.
Johnson-Masottti's survey of drug users in
Hamilton was conducted using face-to-face
interviews between last October and January.