Correlation versus Causation – Harm Reduction

Blog, Healthcare & Welfare, Les Routledge

The Globe has an article profiling attempts in Vancouver to hand out crack pipes to addicts to reduce disease risk.

While I am generally a supporter of harm reduction concepts where public health is at stake, the rationale behind this latest action is weak based on the information presented in the article.  The problem is that the risk presented of HIV cases among crack users could be caused by other behaviors beyond how the drug is consumed.  In particular, the increased rate of HIV among addicts could be caused by unsafe sex practices or sharing needles.

When it comes to needle exchanges, I can see some public health benefit from that action because there is a demonstrated causal path of transmission of blood borne diseases from the practice of sharing needles.  I question if that causal link can be found in the case of crack pipes.

For those among you who wonder why I support harm reduction, to me it is part of the package of moving toward a libertarian model where illicit drug use is decriminalized, taxed and harm managed instead of spending massive funds on futile policing and incarceration efforts that have been proven to have limited outcome effectiveness.  Decriminalization combined with harm reduction to protect public health is an option that should be considered.