Backgrounder: Shared Crack Pipes May Spread Hepatitis C Virus

Crack or “freebase” cocaine is cocaine that has been dissolved and then boiled in a mixture of water and ammonia or baking soda until it forms lumps or rocks.

The study—“HCV virus transmission among oral crack users: viral detection on crack paraphernalia”—by the University of Victoria’s Centre for Addictions Research (CARBC) is important in that the population of crack users in Canadian cities has been growing in the past years. There are many health risks among crack smokers that are related directly to drug use practices. For example, many crack smokers continue to use glass pipes after they are cracked or broken, and/or use metal implements leading to cuts or burns in the oral cavity. These mouth injuries may be pathways for infectious disease transmission—especially HCV—in crack smokers. HCV is by far the most prevalent viral disease among street drug users. Its consequences cost Canadians an estimated $500 million to $1 billion each year.

“HCV prevention efforts to date principally target injection drug users through, for example, needle exchange programs. We urgently need larger-scale studies to verify the possibility of HCV being transmitted between crack users by way of crack pipe sharing, and to cause HCV infection in the new host. At the same time, we need to consider adequate efforts to improve HCV prevention for crack smokers,” says study leader Dr. Benedikt Fischer, director of CARBC’s Illicit Drugs, Public Health and Policy Unit and a UVic sociology and medical sciences professor.

Virology and addiction experts from the Centre for Addiction and Mental Health in Toronto—Canada’s leading addiction and mental health teaching hospital—and the University of Toronto collaborated on this Canadian Institutes of Health Research-funded study. It has been published in the European Journal of Gastroenterology & Hepatology, Vol. 20, No. 01 (January 2008).

The Canadian Institutes of Health Research (CIHR) is the Government of Canada’s agency for health research. CIHR’s mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 institutes, CIHR ( provides leadership and support to more than 11,000 health researchers and trainees across Canada.

The University of Victoria’s Centre for Addictions Research (CARBC) ( is a partnership between UVic and the University of British Columbia, Simon Fraser University, the University of Northern British Columbia, and Thompson Rivers University. Its mission is to facilitate research and knowledge exchange on substance use, harm reduction and addiction.

For a fact sheet on crack visit

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Keywords: addiction, drugs, hepatitis, viruses, health

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