TORONTO - Jesse knows a thing or two about the perils of cheap crack pipes.
They break apart when they get hot, he says, leaving jagged edges that slice open the lips and skin of the drug addicts who survive on the mean streets of Canada's most impoverished neighbourhoods.
An addict himself, Jesse works for the Vancouver Network of Drug Users on the city's impoverished lower east side, handing out heat-resistant crack pipes to drug addicts in an effort to reduce their risk of spreading HIV or hepatitis C.
"People cut their lips, cut their hands -- everything,'' and yet persist in sharing their pipes with other users, said Jesse, who refused to give his last name.
"Some people can baby their pipes and it'll last for a week, but if they're partying -- and it's a glass pipe -- they might burn it up in one night.''
Vancouver is one of several Canadian cities distributing "crack kits'' -- heat-resistant glass pipes, filters, condoms and other accessories to reduce the spread of disease -- including Victoria, Edmonton, Calgary, Winnipeg, Toronto, Guelph, Montreal and, until recently, Ottawa.
Ottawa city council voted last week to axe its program -- something health professionals across the country warn could soon happen in other jurisdictions as councils move away from a harm-reduction philosophy toward a tougher law-and-order approach.
"I am quite fearful and worried that there's going to be less cities launching what is a very good and necessary program,'' said Patricia Bacon, executive director of the Blood Ties Four Directions Centre in Whitehorse.
While Whitehorse's program is healthy and receives some private funding, urban areas hoping to launch crack-kit programs may now face an uphill struggle to get people in their communities on side as a result of Ottawa's example, Bacon said.
The Whitehorse program, launched in December 2005, distributes about 400 crack pipes a month. Last year, Bacon and her crew distributed pipes to 570 different users.
Ottawa scrapped the program -- worth $40,000 a year, $8,000 of which came out of city coffers -- after it became a municipal election issue. Coun. Rick Chiarelli, who brought forward the motion to mothball the program, has said the program was sending the wrong message.
"It's one of the most ironic mixed messages a municipal government could send,'' he said last week. "It's just stupid. It's not the way you spend tax dollars.''
Diane Bailey, program director for the Mainline Needle Exchange in Halifax, said the closure in Ottawa could reflect a trend across the country to programs focused on American-style justice.
"That's even more scary to me,'' she said, noting Halifax's program started in 2005 with outreach workers hitting the streets with suitcases filled with supplies.
Randy White, a former Conservative MP and the president of the Drug Prevention Network of Canada, echoed Bailey's comments, saying politicians are facing mounting pressure from the public to deliver programs that show real results and get addicts off crack.
"They seem to be falling by the wayside faster and faster these days,'' White said of harm-reduction programs.
In June, a crack-kit initiative was cancelled in Nanaimo, B.C., and Winnipeg's program is also about to "hit the bricks,'' said White. Voters want to see programs which help addicts get clean, not those that encourage their habits, he added .
"Inevitably, these programs are not going to continue.''
Dr. Margaret Fast of the Winnipeg Regional Health Authority said the city's crack kits sparked controversy when they first hit the streets three years ago, but have since "been integrated into our program without visible problems.''
A single kit costs about $1.20 and is assembled by outreach workers, she added.
Wendy Muckle, executive director of Ottawa Inner City Health, said the real value of the scrapped program was connecting with users.
She also pointed to recent research proving that handing out crack-smoking materials means less users are injecting drugs, which is a higher risk behavior.
Such programs also offer real economic benefits down the road, she said.
"Hepatitis C treatment is about $40,000,'' she said. Most users don't get treated in a timely manner and end up requiring "untold health dollars'' down the road, she added.
