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vancourier.com, February 07, 2013

Health chief supports safe crack room in city

The chief medical health officer for Vancouver Coastal Health says she supports opening a designated space in the city for people to legally smoke crack cocaine.

But Dr. Patricia Daly said she would only support such a facility if it were opened solely for the purposes of a scientific study to examine its effect on crack smokers.

"We're not saying let's open it now," Daly told the Courier. "We're saying if you're going to do it, you need to do it in the context of a research study."

That approach, she said, was taken with the Insite supervised drug injection site on East Hastings, which opened in September 2003 as a three-year scientific experiment.

Several studies done by various researchers showed Insite reduced needle sharing and the spread of infectious diseases and hooked up users with treatment and housing.

Vancouver Coastal Health operates Insite in conjunction with the PHS Community Services Society. Both operators have said no one has died of an overdose at Insite, despite an average of 600 injections per day.

The 12-booth injection facility, the only legal injection site in North America, has remained open past the expiration date of the study because of numerous successful court challenges by advocates of Insite.

The facility was originally designed with a space for an inhalation room for crack cocaine smokers. The PHS, the Vancouver Area Network of Drug Users and Larry Campbell, when he was mayor from 2002 to 2005, lobbied to have a crack smoking room in Insite.

Despite Daly's interest in such a facility, she said the health agency has not applied to the federal government to get the necessary exemption to conduct a study. Nor has the agency advertised for a research group to conduct a study. The health authority is reviewing an evaluation of a program it launched in December 2011 where 150,000 crack cocaine smoking kits were distributed largely in the Downtown Eastside.

So far, Daly said, the draft report shows evidence of less sharing of crack smoking supplies and a reduction in burns and cuts.

Dr. Thomas Kerr, the director of the urban health research initiative at the B.C. for Excellence in HIV/AIDS, commended the health agency for the program.

But, Kerr said, there's more work to do in a city that has seen a substantial increase in the number of people smoking crack cocaine.

"Anyone who has spent any serious amount of time in the Downtown Eastside notices a significant difference in the use of drugs in public spaces," he said, referring to the number of drug users who use Insite. "So while there used to be people injecting all up and down the alleys and in the streets, you don't see that really anymore to the same extent at all. But what you do see is a lot of people smoking crack."

Kerr said the B.C. Centre would be interested in conducting a scientific study on users of a legal crack smoking room but the research group needs to first have Vancouver Coastal Health get an exemption and provide the space.

"We would certainly do that but it's not our position to initiate the program," he said. "That's, in a way, the role of the health authority and it's something we'd have to do in partnership with them."

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