Rural crack use No. 1 street-drug problem: study

As crack cocaine use rises in Canada, so too does the urgent need for targeted prevention and treatment programs—especially in smaller communities. 
That’s the conclusion of a new study led by health sciences researcher Benedikt Fischer and published in the journal Drugs: Education, Prevention and Policy.

Fischer’s team documents a recent investigation of the social, health and drug-use characteristics of 148 primary crack users in three mid-sized B.C. communities: Nanaimo, Campbell River and Prince George.
 
Past studies have confirmed that crack users in larger urban settings are more likely than other drug users to face health problems such as HIV, Hepatitis C virus (HCV), sexually transmitted diseases, and mental illness. They’re also prone to extreme poverty, homelessness and illegal income generation.

Fischer’s study focused on crack users in non-urban communities to determine their unique characteristics and how best to target and deliver prevention and treatment programs in rural settings. 

It found that non-urban crack users:

• Were at a “crucially elevated risk” of health problems due to unstable housing, illegal incomes and frequent encounters with the criminal justice system.
• Displayed a “high prevalence” of concurrent physical and mental health problems.
• Used a variety of other legal and illegal psychoactive substances including alcohol, cocaine and opioids.
• Exhibited HIV and HCV rates similar to those observed in primary injection-drug users.

The study calls for “the comprehensive improvement of preventive and treatment intervention services,” to address rural crack use, specifically:

• Improved resources and training for health workers. 
• Improved accessibility to infectious-disease testing in the study locations.
• “Crack kit” distribution programs including prevention and healthcare information.
• Safer crack-inhalation facilities, akin to European facilities.
• More treatment options and research

“In many B.C. communities, crack use is the No. 1 street-drug problem, yet we give it much lower attention than other forms of drug use,” says Fischer.