Get cracking on small-town crack-use solutions: study
Benedikt Fischer, 778.782.5148, bfischer@sfu.ca
Julie Ovenell-Carter, PAMR, 778.782.3210, joc@sfu.ca
As crack use rises in Canada, so does the urgent need for targeted prevention and treatment programs—especially in smaller communities. That’s the conclusion of a new study led by Simon Fraser University health sciences researcher Benedikt Fischer.
In a paper to be published in Drugs: Education, Prevention and Policy next month, Fischer’s team documents a recent investigation of the social, health and drug-use characteristics of 148 primary crack users in three mid-sized B.C. communities: Nanaimo, Campbell River and Prince George.
Past studies have focused on larger urban settings and confirm that crack users are more likely than other drug users to face significant health problems such as HIV, Hepatitis C virus (HCV), sexually transmitted diseases, and mental illness. They also feature a distinct social profile characterized by extreme poverty, homelessness and illegal income generation.
Fischer’s study focused on crack users in non-urban communities to determine their unique characteristics and how best to target and deliver prevention and treatment programs in rural settings.
Among the study’s key findings:
- In addition to their drug habits, participants were compromised by unstable housing, illegal incomes and frequent encounters with the criminal justice system—a combination putting them at a “crucially elevated risk” of health problems
- Participants displayed a “high prevalence” of concurrent physical and mental health problems
- Crack use tended to occur in conjunction with the use of a variety of other legal and illegal “psychoactive substances,” including alcohol, cocaine and opioids
- Participants exhibited HIV and HCV rates similar to rates observed in primary injection-drug users; alarmingly, many users with HCV did not know they were infected
- Subjects assembled their crack-use paraphernalia mostly from high-risk materials such as scrap metal, metal piping or broken glass, leading to oral burns, cuts and other mouth injuries conducive to infectious disease transmission
- Most participants “saw any attempt to quit crack as a futile effort” given the current acute lack of viable treatment options
- Improved resources and training for health workers to address the complex and intertwined health challenges faced by crack users
- Improved accessibility to infectious-disease testing in the study locations
- “Crack kit” distribution programs that include information on prevention and health care
- Safer inhalation facilities for crack users, akin to those found in Europe
- More research into and expansion of treatment options
“We need better and more targeted prevention and treatment for crack use in order to reduce its enormous negative public health impact.”
The study was supported by funds from the B.C. Ministry of Healthy Living and Sports, the Vancouver Island Health Authority and the Canadian Institutes of Health Research.
-30-