Reducing widespread pipe sharing and risky sex among crystal methamphetamine smokers in Toronto: do safer smoking kits have a potential role to play?

Abstract

BackgroundCrystal methamphetamine smoking is associated with many negative health consequences, including the potential for transmission of hepatitis. We examined whether or not a kit for crystal methamphetamine smoking might have some potential to reduce the negative health effects of crystal methamphetamine smoking.MethodsFive focus groups were conducted with crystal methamphetamine smokers recruited by community health agencies and youth shelters in Toronto, Canada. Target groups included homeless/street-involved youth, sex workers, men who have sex with men, and youth in the party scene. Participants (n = 32) were asked questions about motivations for crystal methamphetamine use, the process of smoking, health problems experienced, sharing behaviour, risky sexual practices, and the ideal contents of a harm reduction kit.ResultsPipe sharing was widespread among participants and was deemed integral to the social experience of smoking crystal methamphetamine. Heated pipes were unlikely to cause direct injuries, but participants mentioned having dry, cracked lips, which may be a vector for disease transmission. Many reported having sex with multiple partners and being less likely to use condoms while on the drug. Demand for harm reduction kits was mixed.ConclusionsChanging pipe sharing behaviours may be difficult because many participants considered sharing to be integral to the social experience of smoking crystal methamphetamine. Within the context of a broader health promotion and prevention program, pilot testing of safer smoking kits to initiate discussion and education on the risks associated with sharing pipes and unprotected sex for some communities (e.g., homeless/street-involved youth) is worth pursuing.

Co-morbidity of substance use disorder and psychopathology in women who use methamphetamine during pregnancy in the US and New Zealand

“…Oceania is the region with the highest prevalence of amphetamine-type substance (ATS) use, with Australia and New Zealand (NZ) having the highest annual estimates of 2.7% and 2.1%, respectively. One major indication of the health risks of ATS is the increased proportion of women requiring comprehensive health and mental health services in both the US and internationally (Jones et al, 2011; Wechsberg et al, 2010; Wright et al, 2012). …”

Safer smoking kits for methamphetamine consumption

“…Additional items packed in these kits may include educational materials, lip balms, disinfectant wipes and condoms . The availability of these kits may potentially increase the engagement with health‐care services (including harm reduction services) and decrease injuries attributable to hot, damaged and/or makeshift pipes among people who smoke methamphetamine . However, qualitative assessments indicate that pipe‐sharing is an integral component of the social experience of methamphetamine smoking .…”

“…The availability of these kits may potentially increase the engagement with health‐care services (including harm reduction services) and decrease injuries attributable to hot, damaged and/or makeshift pipes among people who smoke methamphetamine . However, qualitative assessments indicate that pipe‐sharing is an integral component of the social experience of methamphetamine smoking . For a small minority of people who smoke methamphetamine, this risk behavior is a consequence of lack of access to unused pipes due to poverty .…”

Integration of Methamphetamine Harm Reduction into Opioid Harm Reduction Services in Iran: Preliminary Results of a Pilot Study

“…Some studies in Iran have found that active drug use is one of the main factors affecting both positive prevention (9) and access and use of the services among people who live with HIV/AIDS (10). Even among noninjecting methamphetamine users, the risk of pipe sharing is high, leading to an increase in the risk of blood born viruses' transmission, mainly hepatitis C transmission (11).…”

“…There are evidences that show methamphetamine harm reduction programs have positive effects on reducing HCV transmission, improving client general health status, and even reducing injection among methamphetamine users (11,12). drugs (PWUD) (13) and its effects on patients who were undergoing opioid substitution therapy (14).…”