Examination of Safe Crack Use Kit Distribution from a Public Health Perspective

This paper examines the policy of safer crack use kit (SCUK) distribution within the city of Winnipeg, Canada. Publicly funded, SCUK distribution policy has been a contested topic throughout Canada, despite evidence that crack users represent some of the most marginalized members of society. Using the four pillars approach to drug policy as a guideline, the balance of allocation of resources for harm reduction is critiqued. Harms associated with crack use are broadly categorized as being associated with methods of use or social harms. The effectiveness of the current SCUK policy is examined according to the guiding principles of reduced harms and cost effectiveness. Research supports SCUK distribution based on the merits of increased health contacts and harm reductions. Data indicate the SCUK distribution policy supports efforts to reduce the transmission of communicable disease, notably Hepatitis C. A cost-benefit analysis and assessment of the policy’s effectiveness in reducing harms supports continuation of SCUK. Our conclusion advocates for the expansion of the current policy to emphasize further engagement and greater emphasis on working against associated social harms, but notes the need for further research on the topic. Benefits of peer-based kit distribution are discussed and potential alternatives to the current SCUK policy are explored.