It's just a pipe - and some vaseline and a few metal screens. But harm reduction workers can't believe their safe crack kits run afoul of the law while the city doles out needles to heroin addicts and prepares for safe injection sites. This curious situation, created by the selective intervention of Toronto police, merely shows that officials do not realize the extent of crack addiction in Toronto, say street workers.
"Everybody who's doing front-line harm reduction work has 10 times as many crack smokers than injection drug users," says Lorie Steer, team leader for Street Health and a member of the Safer Crack Use Coalition (SCUC).
Steer says this unfair favouring of one addiction over another means the SCUC has been forced to seek private funding for the safer crack kits it's distributing to stem the spread of diseases like hepatitis C, which are reaching disturbing proportions.
The exact size of Toronto's crack-smoking population is unknown, but one-third of drug users seeking treatment in Toronto identify crack as a problem. In 1999, the last time a study was done, 31 per cent of street youth said they'd used crack.
It's unsafe crack pipes, like tiny ginseng bottles and pop cans, that act as conduits for diseases. Steer says that many crack users pass blood through sores on their lips, which they often get when using unsafe crack pipes that either overheat or are made from broken glass.
Of 108 crack users surveyed by the SCUC last year, 33 per cent said they were infected with hepatitis C. Most of those infected said they shared crack pipes.
SCUC's safer crack kits include, among other things, a clean glass stem or pipe, Vaseline for lip care and literature on safer use.
Raffi Balian, coordinator of the COUNTERFit Program and a long-time harm reduction worker with crack users, says they are transient, often in and out of hospitals, and that if one of them contracted SARS, public health would be in serious trouble.
But this issue has many layers. Funding a program like the safer crack kit could land Toronto public health in some legal hot water.
Detective Court Booth, a drug enforcement officer, says programs that distribute safer crack kits are clear violations of section 462 of the Criminal Code, which says it's an offence to offer anyone an "instrument for illicit drug use."
The city's needle exchange program managed to dodge the same obstacle in the late 1980s by defining syringes as "devices" that when used for "treatment, mitigation or prevention of a disease" technically become perfectly legal to distribute.
But why, then, has the safer crack pipe program been largely overlooked by Toronto police for the past three years?
"When the initiative commenced, the form that (the pipes) were in appeared to be in contravention of the criminal code," Booth says. "You couldn't distribute the pipes in the original format. Now I've heard there's some assembly required.
"We don't want to frustrate people and keep them from thinking of new ideas," Booth continues. "But we're the police. We're accountable for public safety and making sure laws are enforced."
SCUC goes through about 2,000 glass pipes a month at 25 cents (from private funding) per kit, and Steer estimates they could give out up to five times as many per day. That's easy to believe on the day I drop by Street Health at Dundas and Jarvis, one of 11 agencies now distributing the kits in the city. The cramped reception area is abuzz with activity.
But despite the city's stated commitment to harm reduction, Liz Jansen, regional director of Toronto public health, says: "The studies are very complicated. People have a lot of other behaviours. They may be injecting drugs, using dirty needles or having unsafe sex. What we don't know is whether crack pipes are major vessels of disease."
Janzen's position seems to be at odds with board of health chair and city councillor Joe Mihevc.
"Whether you're a prostitute selling to get crack, we have an obligation to take care of each other. We all know people who've been there and come back, and it's always been a nurturing community that's brought them along," say Mihevc.
Lorraine Barnaby, a harm-reduction educator at the Queen West Community Health Centre and a member of SCUC, says that without the kit, they would never have known about the extent of the problem. "The kit brought users to us. It was then that we realized we had thousands and thousands of drug users that we had no contact with."