Abstract
BackgroundCrack pipe sharing can increase health risks among people who use drugs, yet the reasons for sharing these pipes have not been well described. Therefore, we sought to identify the prevalence and correlates of crack pipe sharing among a community-recruited sample of people who use illicit drugs in Vancouver, a setting where crack pipes are provided at low or no cost.FindingsData for this study were derived from two prospective cohorts of people who use drugs: the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS). Multivariate logistic regression was used to identify factors independently associated with crack pipe sharing. Among 503 crack users, 238 (47.3%) participants reported having shared a crack pipe in the previous six months. Having acquired a mouthpiece in the last six months (adjusted odds ratio [AOR] = 1.91; 95% confidence interval [CI]: 1.31 - 2.79) and difficulty finding new pipes (AOR = 2.19; 95%CI: 1.42 - 3.37) were positively associated with pipe sharing. Binge drug use (AOR = 1.39; 95%CI: 0.96 - 2.02) was marginally associated with sharing pipes.DiscussionThere was a high prevalence of crack pipe sharing in a setting where crack pipes are distributed at low or no cost. Difficulty accessing crack pipes was independently and positively associated with this behavior. These findings suggest that additional efforts are needed to discourage crack pipe sharing as well as increase access to crack pipes.
Highlights
Crack cocaine use continues to be associated with various health-related harms
Difficulty accessing crack pipes was independently and positively associated with this behavior. These findings suggest that additional efforts are needed to discourage crack pipe sharing as well as increase access to crack pipes
Sores, and cuts on the lips and gums are common among people who smoke crack [1], and crack use has been associated with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection [2,3]
Summary
Crack cocaine use continues to be associated with various health-related harms. Increasing access to crack pipes may reduce the frequency of injecting and by extension, blood-borne disease transmission among this population [8]. Crack pipe sharing can increase health risks among people who use drugs, yet the reasons for sharing these pipes have not been well described. Crack cocaine smoking has been associated with the acquisition of HIV infection among people who inject drugs (IDU) in the city [2]. Crack smoking paraphernalia, including Pyrex pipes, plastic mouthpieces and wooden push sticks, are provided through the BC Centre for Disease Control (BCCDC). A mouthpiece made of clear vinyl tubing is used as an attachment for crack pipes as a means of reducing risks for blood-borne disease transmission and other harms [16]. Local stores sell crack pipes in areas where crack smokers live or congregate
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