Vending MachineI’m sure many of you have seen the recent news articles about Vancouver’s crack pipe vending machines. These polka dot machines have been around for over a year but only now are they being publicized and ill received by the media. Where do these negative feelings come from? Why the fear in harm reduction efforts? Does ideology often trump evidence?

The answer to these questions often comes from the legal implications of distributing “drug paraphernalia.” Is a crack pipe considered drug paraphernalia or medical equipment used for safer inhalation? In the Food and Drugs Act, medical devices are defined as being used for “treatment, mitigation, diagnosis or prevention of a disease or abnormal physical condition” therefore, based on that, a pipe is a medical device. Why then do we deny people required medical equipment?

Enabling users to continue using is another common argument, sometimes followed with “well why not give them the drug too while you’re at it.” The honest truth is people will use their drug of choice whether or not clean and safe equipment is available so why not have safe materials available and mitigate the risks of potentially harmful behavior. Seatbelts are a form of harm reduction and driving is a risky act… do seatbelts then enable unsafe driving? What about life jackets?

By supplying safer inhalation equipment we see a reduction in HIV/HCV transmissions because users are not sharing pipes and avoid dangerous materials used to make improvised pipes. The favorable health implications of smoking vs. injecting are huge and Leonard et al. (2008) “suggest[s] that interventions to facilitate transition away from cocaine injection to smoking crack may lead to eventual injection cessation with its diminution of health-related harms including HIV and HCV transmission” (p. 262). In the same study, 40% of participants had decreased injCrack pipeection behaviors and availability of pipes was listed as one of the top reasons for smoking vs. injecting (Leonard et al., 2008, p. 260). While HIV/HCV risks are associated with pipe sharing, reducing injection behavior and sharing of pipes due to increased availability of inhalation equipment will most definitely reduce blood borne pathogen transmission risks as well.

The harm reduction approach is designed to reduce the harmful consequences associated with risky behavior. My question to you is how do we get to the point where people will listen to empirical data that potentially opposes our moral viewpoints?

Case Manager Katy