Hepatitis C virus transmission among oral crack users: viral detection on crack paraphernalia

Abstract

HCV transmission from an infected host onto paraphernalia as a precondition of HCV host-to-host transmission via shared crack paraphernalia use seems possible, with oral sores and paraphernalia condition constituting possible risk modifiers. Larger-scale studies with crack users are needed to corroborate our findings.

Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies

“…Based on the evidence for distinct injury/morbidity risks associated with crack use (Faruque et al, 1996;Fischer, Powis, Firestone Cruz, Rudzinski, & Rehm, 2008;Haydon & Fischer, 2005;Porter, Bonilla, & Drucker, 1997), 'safer crack use paraphernalia' (SCUP) distribution initiatives have been implemented in select locales as targeted efforts to reduce such risk outcomes. SCUP programs are typically offered as community-based outreach initiatives, distributing simple 'kits' of basic materials (e.g., break-safe glass stems, rubber mouthpieces, metal screens for safer crack pipe assembly; (Haydon & Fischer, 2005;Malchy, Bungay, Johnson, & Buxton, 2011) -plus basic information and health promotion elements -to facilitate safer crack use practices.…”

Social, health and drug use characteristics of primary crack users in three mid-sized communities in British Columbia, Canada

“…These high HCV infection rates among non-injection crack users have given rise to the hypothesis that HCV transmission among crack users might occur through the sharing of HCV-contaminated oral crack-use paraphernalia (Faruque et al, 1996;Roy et al, 2004;Tortu, McMahon, Pouget, & Hamid, 2004). One recent study suggested that on the basis of virological detection of HCV on crack paraphernalia that such transmission between crack users might be plausible (Fischer et al, 2008b). Besides physical health problems, crack users also feature disproportionately elevated levels of mental health problems, for example, antisocial personality disorders, paranoia and depression.…”

A 38-year-old man who uses crack cocaine

“…8 Among this population, using or sharing improper inhalation equipment (whether for financial, social or relational reasons) is a key modifiable behaviour associated with increased transmission of infectious diseases. 9 Harm-reduction programs provide clean inhalation equipment (e.g., glass stems, mouthpieces, push sticks and brass screens) in an effort to reduce the harms associated with using ill-devised paraphernalia and sharing. 8 Initial evaluations have shown associations between programs providing appropriately built crack pipes and reduced sharing, reduced crime and violence to obtain pipes, and reduced sourcing of pipes from the street, as well as transactional sex to obtain pipes.…”