They must think we're on crack
Crack pipe program not proven to reduce HIV, hep C: councillor
Last Updated: Wednesday, August 1, 2007 11:43 AM ET
CBC News
There's not enough evidence that an Ottawa program that provides free crack pipes to drug users has directly resulted in lower rates of HIV and hepatitis C infection, says the Ottawa councillor who initiated the program's cancellation.
"We need to have very solid evidence before council endorses any kind of program that sends that kind of mixed message," said Coun. Rick Chiarelli in an interview Tuesday, adding that residents have complained that it encourages illegal drug use.
- Fully agree so far.
Chiarelli said the program's cancellation came amid requests from advocates for $500,000 to study how effective the program was at reducing the spread of disease, "which means there is no conclusive evidence one way or the other," he said.
- Excellent. On the one hand the supporters of the program claim that there's sufficient evidence to prove that it works, and on the other hand they're asking for half a million bucks to run a study to prove that it works. Which is it, people?
He argued the controversy over the program erodes support for the city's overall strategy to fight drug addiction and accompanying social problems.
Program reduces risk: doctor
Meanwhile, advocates of the program said there is plenty of evidence that distributing free crack pipes reduces the risk of disease transmission, even if transmission rates haven't been measured in relation to the program.
- Oh, wait a second here. Based on a leap of logic we should believe what you want us to believe. Okay then, let's play that game from the other side. The supporters of the program claim that it doesn't provide an easy path for people who might not otherwise start using these drugs in the first place. Sorry, but despite there being no direct analysis, common sense tells us that the easier something is to do, the more likely people thinking about doing it will actually do it. So by a leap of logic, handing out the tools to get started with doing drugs simplifies things, and therefore we can conclude that more people will start using drugs than would otherwise. What's good for the goose is good for the gander, and to deny that we can validly conclude that the program makes it easy for new users to start using, thus increasing the number of new users, is hypocritical.
"We know that when folks share drug paraphernalia, that's when they are at risk of transmitting those diseases," said Dr. Dona Bowers, a family physician at the Somerset West Community Health Centre at a news conference held by a group of community agencies Tuesday.
The 10 agencies were announcing their intention to continue the program until the end of the year using their own funding.
Bowers said the program reduces the sharing of homemade crack pipes, which can cause cuts or burns.
She also cited a University of Ottawa study by epidemiology professor Lynne Leonard that showed the program resulted in drug users switching from riskier injection drug use to smoking crack.
- If I had the choice of switching from a sharp pointy, and probably dirty, object which I would have to jab into my body to a nice clean crack pipe, I certainly would. And it wouldn't have anything to do with wanting to reduce harm to myself. If I really wanted to reduce harm to myself I'd figure out how to break the habit or seek help to do so. A crack pipe sure beats having to find an injection site under your toenail 'cause all the other parts of your body have been used. I wonder if the study even addressed the reasons why people switched. And let's go back to the topic of making it easier for kids to get started. No icky needles, a nice clean kit, geez, doesn't seem so dangerous or icky anymore so let's go for it.
"We know that among the IV drug users in our community, there are enormous rates of disease," she said, adding that a fifth of IV drug users are infected with HIV and more than 75 per cent are infected with hepatitis C.
Finally, she added, the program helps drug users develop a relationship with the health and social workers who distribute the crack pipes.
- Excellent. So let's see some stats on the number of people who are getting cleaned up as a result of the program vs. before the program started. Coming into contact is useless unless it changes behaviour. And while we're at it, maybe we can see some stats on how many new users are being produced vs pre-program. I wonder if there's any relationship between the program and the sudden increase in the drug problem we're seeing downtown?
In January, the city's chief medical officer of health, Dr. David Salisbury, told reporters that that the city's HIV infection rate fell from 39 cases in a year to 12 after the program was introduced in 2005.
- Again, let's see the stats on the number of user pre- and during the program, and on whether there are any real benefits that result from the increased contact with the social workers.
