Canada: British Columbia Health Officials Welcome Crack Pipe Study and Link to Hepatitis C

A new study affirms the risk that hepatitis C can be transmitted by crack pipe sharing.

"We have some initial evidence that a hepatitis C-infected crack smoker can, under certain circumstances, pass on the virus on to the pipe," said Dr. Benedikt Fischer, the study's leader and the director of the University of Victoria's Center for Addictions Research. "[That's] one of several steps necessary to transmit hepatitis C from one crack smoker to another by way of crack pipe sharing."

In the study, crack pipes were collected shortly after being used by 51 inner city Toronto participants. Testing confirmed that 22 smokers (43.1 percent) were positive for hepatitis C antibodies. Hepatitis C virus was found on one of the pipes whose owner also tested positive.

The study's results, Fischer said, have implications for scientists and public health officials alike. "Primarily, that in order to prevent the spread of hepatitis C in the high-risk population of street drug users, you need to not only focus on injection drug users but also on crack smokers," he said.

Dr. Perry Kendall, British Columbia's provincial health officer, said the study "adds further support for interventions that are aimed at trying to reduce the spread of infectious agents between crack users."

Kendall continued, "For quite some time, we've been concerned about the potential spread of diseases like HIV, hepatitis C, tuberculosis, and even syphilis, using shared crack pipes -- a bit like using shared drug-injection equipment can spread diseases. This study, which actually finds hepatitis C virus on the stems of crack pipes ... adds weight to the fact that this is a feasible way to spread diseases."

Given this new evidence, Kendall said it is particularly frustrating that harm reduction programs distributing crack pipes, stems, and other items designed to prevent disease transmission via crack use have come under fire.

"For some reason, crack pipes have been a lightning rod for people who are opposed to harm reduction initiatives, who haven't been able to unseat established programs, such as needle and syringe exchanges," Kendall said.

The full report, "Hepatitis C Virus Transmission Among Oral Crack Users: Viral Detection on Crack Paraphernalia," was published in the European Journal of Gastroenterology & Hepatology (2008;20(1):29-32).

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