Saline
Email correspondence, June 3rd 2013
Subject: Safer Smoking Kits: Where to order supplies and how to make them
Hello IDUHA,
In several site visits programs were interested in adding Safer Smoking Kits and Safer Smoking items to the supplies already provided. This email will explain what is in a Safer Smoking Kit, where you can order supplies and how to deliver educational messages regarding smoking crack cocaine.
What is usually in a safer smoking kit:
Rubber Stem Tip
Chore Boy
BZK Towelettes
Alcohol Pads
Bandaids
Sugar-Free Gum
Condoms/Lube
Pamphlet (Safer smoking tips, harm reduction tips, information on your program and where to go for help- don’t leave this out!)
Kits can be packaged using 4X6 Plastic Reclosable bags from amfAR
Where to obtain supplies:
Your organization will need to purchase Rubber Stem Tips (spark plug covers), Chore Boy and Gum for this kit.
Rubber Stem Tips and Chore Boy can be purchased at Safety Works.
Total Access Group is another harm reduction supplier however they’re currently not carrying stem tips due to a supplier issue.
Gum can be purchased at Costco or online retailers such as Staples.
***Do you have questions about other supplies like Vitamin C for injecting crack? Let me know!***
Gum Tips:
Make sure to purchase gum that comes in foil push-pouches (rather than a paper cover). Foil pouches can be cut easily and will last much longer than paper covered gum which can become wet and easily ruined.
It can be helpful for outreach workers to carry a stash of gum in addition to Safer Smoking Kits, some individuals will take the entire kit for the gum, if staff are concerned this is an occurrence, an easy remedy for wasted supplies is offering a few pieces of gum solo. Same goes for Chore Boy actually!
What could go in your educational pamphlet:
Generally a one-pager trifold doubled down works/fits best, one side English and one side Spanish (or other second language specific to community).
Information about “Who gave you this kit?” include brief agency mission, free services available, hours and location of services. i.e., “We offer free syringe exchange services, safer smoking supplies and safer sex supplies. In addition to these services we also provide referrals for any services you may be interested in. This includes but is not limited to drug treatment, support and counseling, healthcare, shelter, legal or other services you may need. You can obtain more of these kits, supplies and learn about our program by coming into the office or speaking to one of our staff or volunteers during outreach hours…”
It may be helpful to include one-two sentences on what harm reduction is, i.e., “We are a harm reduction program, which means that we don’t make judgments on your personal choices but will help you stay safer and minimize the risk that those choices may have on your body, mind and spirit.”
Money and Safety Tips, i.e.,
Try to stay in a safe setting with people you trust.
Use crack from a source you trust: smoke only a little bit first if you’re not sure about its purity.
When you want to say no to using more, say no.
Keep pace with yourself instead of others- decide for yourself whether you want to use more
Avoid areas and people that you smoke with when you’re trying not to get high
Hide drugs and pipes when you’re not using them.
Consider learning more about drug treatment or mental health services if you feel they may help you gain stability.
Pay rent and buy necessities (like food!) before crack.
Ask a non-drug using friend to hold your money.
Make a commitment- When the money you have for getting high is gone, stop using.
Touch flame to stem briefly and move the flame along the stem to make a small amount of crack last longer.
Drink lots of water to stay hydrated.
What’s in the kit?
Rubber stem tip- Used at the end of a crack pipe. A hot stem can burn and crack lips which can cause bleeding. Coming in contact with even small amounts of blood can put you at risk for HIV & HCV. It’s best to use your own rubber stem tip.
Chore Boy- Used inside the crack pipe. Copper Chore Boy is much better than fine steel wool that can release carcinogens and also become brittle and become easily inhaled.
Gum- Used to help preserve tooth enamel as smoking crack reduces saliva production and may lead to tooth decay. Sugar-free gum containing Xylitol will help keep saliva production up and prevent your teeth from decay.
Alcohol Pad- If you have to share a pipe, these can be used to clean off teh pipe to prevent possible bacterial transmission.
Bandage- Used to protect and cover any sores, cuts and burns. If you have a cut or burn that is not healing and appears infected, seek medical attention.
Condoms- Used for oral/vaginal/anal sexual activity to prevent exchange of sexual fluids. Non-lubricated and flavored may be preferred for oral sex. Use a new condom each sexual act.
Lubricant- Used with or without condoms to minimize friction during sexual activity and therefore minimize the chances of getting small tears in the vaginal and rectal cavity that can make STI/HIV/HCV transmission more likely.
How does providing these supplies relate to my work/contracts?
Making harm reduction supplies available to people who smoke crack is a no-brainier. Harm Reduction program engagement with individuals and communities that smoke crack-cocaine is essential, research has found that crack-cocaine is a risk factor for HIV infection among IDUs –Crack Cocaine link to HIV Transmission Article Unfortunately, many supplies listed above are not free and agencies will need to purchase them.
Providing education the Hepatitis C transmission risks of sharing a stem easily fit into the IDUHA Hepatitis C educational deliverable. More about HCV transmission via crack pipes here and attached.
Other notes:
Are you are interested in letting VOCAL do a focus group on crack and cocaine harm reduction with the aim of improving existing interventions and developing new ones (they’ll provide the metro cards!)? Contact Mike Duncan for more info or to arrange a date. mjsduncan@gmail.com
Some programs have provided ointment or lip balm (like Burt’s Bees) in their crack kits to prevent lips from becoming dry/chapped.
Check out other resources on safer smoking- from our friends in Canada and North Carolina.
The People’s Harm Reduction Alliance in Seattle is the only SEP in the US that I know of that is public about providing stems.
The NYC conversation has been around providing supplies that people can be explicitly arrested for (not protected under public health law). If programs want to have a larger discussion about pipe distribution please email me off list.
This can be the beginning of a conversation! Want to talk more? Please email me off list.
In solidarity,
jamie
(Attached)Quick Assessment Guide for HCV Risk Factors
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