Pubdate: Fri, 13 Jun 2003
Source: Prince George Citizen (CN BC)
Copyright: 2003 Prince George Citizen
Author: Karen Kwan
Related: editorial
Bookmarks: (Cocaine) (Hepatitis) (Needle Exchange)


It's a simple apparatus -- a filtered glass tube about the size of a
peppermint stick, attached to a clear-rubber mouthpiece.

But Linda Keefe hopes that giving out clean crack pipes to drug
addicts will help combat a more complex problem -- the spread of
hepatitis C, a contagious disease that's prevalent among intravenous
drug users. The AIDS prevention and needle exchange program began its
new campaign last Friday, and has already handed out nearly 60 clean
pipes from its Third Avenue office. "We're trying to keep the younger
ones from getting hepatitis C" through sharing pipes with infected
users, said Keefe, program co-ordinator and nurse.

"It's not that we're saying, 'Hey, you should be smoking crack
(cocaine). '(But) you try to reduce harm, disease, and maximize
contact with marginalized groups and build relationships," she said.

It's the same harm-reduction philosophy the program has followed since
the public health unit launched the initiative in 1991. Keefe
acknowledges the exchange program provides a "Band-Aid" remedy, but
said it's just one way to help. "We're not in a position to change
social problems, we're dealing with the results of social realities,"
she said.

She said the latest project came about after health-care workers
noticed an increase in hepatitis C cases and, at the same time, began
hearing about children as young as 12 and 13 smoking crack cocaine.
The news was alarming, Keefe said, since the drug tends to dehydrate
the body and causes malnutrition. "What happens is a breakdown in the
mucous membranes," she said, which paves the way for hepatitis C
transmission through shared pipes. A chronic virus, hepatitis C is
contracted through infected blood or blood matter and can lead to
fatigue, jaundice and liver disease. Along with the risk of disease,
there's also a danger of burn injuries when people use things like pop
cans as makeshift pipes, Keefe added.

When the needle exchange first opened, workers saw a number of young
teenagers who were shooting intravenous drugs, but Keefe said there's
been a shift among that age group to crack and crystal

When clean pipes are handed out, the worker explains how to safely use
the pipe, changing the removable mouthpiece to avoid contamination.
Discussions can also lead to education on things like treatment or
sexually transmitted disease. Keefe said reaching out to young people
is important, because drug use can lead to involvement in the
sex-trade or property crimes to help support addictions. Pipes for the
program are being supplied by an entrepreneur on the Sunshine Coast.

Other communities, such as the Sunshine Coast, Nelson, Parksville,
Whitehorse and Toronto, have also established crack-pipe exchanges,
she said.

Besides providing clean needles and pipes to drug users, the AIDS
prevention and needle exchange program also provides nursing services,
disease and pregnancy testing, contraceptives, community education and
referrals to detox centres and medical help. 
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