Pubdate: Sat, 24 Oct 2009
Source: National Post (Canada)
Copyright: 2009 Canwest Publishing Inc.
Author: Dr. Charles MacKay


Re: Jumping To Crack Conclusions, editorial, Oct. 21.

Your editorial about supervised sites for consumption of crack 
cocaine raises some important points. Insite, Vancouver's supervised 
injection site for intravenous users of opiates (read heroin) has 
shown positive results such as a modest decrease in criminal activity 
and increased utilization of treatment services in those that use 
Insite. Its effect on transmission of hepatitis C and HIV is less 
clear, most likely because by the time that someone will use Insite 
he is well advanced in the addiction process and infection has 
already occurred.

Furthermore, heroin overdoses are easily managed by an antidote which 
can be life saving. Therefore there is sound reasoning behind the 
provision of a supervised injection site for heroin users.

Supervised self-administration of stimulants such as crack cocaine or 
amphetamines may or may not be different. Stimulants tend to be taken 
repeatedly until exhaustion and are associated with high-risk 
behavior ranging from unprotected sex to violence to psychosis. 
Unlike heroin, there is no antidote to an overdose.

Until properly tested, any usefulness of giving addicts a place where 
they can use crack cocaine can neither be praised nor denied.

Dr. Charles MacKay, American Board of Addiction Medicine, St. Eustache, Que.
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