Hepatitis C: An In-Depth Guide

Safer crack smoking

Smoking drugs can lead to open sores, burns or cuts on the lips and in the mouth, which can transfer blood to a pipe. If the pipe is shared, even a speck of blood carrying hepatitis C can transmit the virus. Sharing includes borrowing, lending, passing on, buying, selling, reusing, receiving or taking any equipment that was used by someone else. Some people do not identify risk with the word “sharing” or when reusing involves a close sexual partner (like a boyfriend or girlfriend). Risk exists, even under these circumstances.

Some harm reduction agencies and public health units have taken the lead in putting together and distributing kits that contain the materials needed to make smoking crack safer. Here is an example: Harm reduction kit - crack

Distribution of safer crack-smoking kits reduces the risk that people will share pipes or use broken ones. It is also an opportunity to connect more drug users with harm reduction programs and other health and social services. Sometimes, these are people who would otherwise never approach a program or agency.

Unfortunately, safer-crack kits that have the materials to make a safer-crack pipe are not available in all communities. People can be encouraged to create their own kit that includes the supplies outlined on this page.

The harm reduction information that follows is offered as a public health service. Its purpose is not to encourage or condone the use or possession of illegal drugs. It is to help people make safer choices in their use of drugs that will reduce the spread of Hep C and HIV.

Pyrex Pipe/Glass Stem

Pipes made of plastic, pop cans or copper add to the dangers of smoking crack by releasing toxic fumes when heated or burned. Thin glass pipes, such as light bulbs or syringes, break easily and can lead to cuts. pipe

Pyrex pipes are safest because they do not break down when heated and do not conduct heat as much as other materials, so burns are less frequent.

Another way to prevent burns on the lips is to hold the flame beside the stem but not directly on it. This produces enough heat to melt the rock but reduces how hot the stem gets. Moving the flame alongside the stem instead of concentrating the flame in one spot will also spread the heat out.

Metal Pipe Screen

Brass screens are safer to use than steel wool or Brillo. In order to prevent the screens from coming loose and presenting a choking hazard when sucked into the throat, five to six screens are rolled  pipe up tightly and pushed into the glass stem with a chopstick, which will make sure they are firmly in place. Replacing these periodically will also prevent choking as they may come loose after being heated.

Steel wool or Brillo screens are not as safe or effective as brass screens because they break down when heated and pieces frequently come loose when the crack vapours are inhaled. These pieces end up on the lips (causing sores and burns) or are sucked into the throat and lungs (where they cause more damage).

Mouthpiece

Attaching a rubber or plastic mouthpiece at the mouth end of the pipe prevents burns. Mouthpieces can differ in length and width to be the best fit for a stem. A person can also make a mouthpiece using rubber bands, tape or an empty cardboard matchbook.

Other Materials for Safer Smoking

  • Lip balm containing vitamin E, to help protect and heal chapped or injured lips.

  • Alcohol swabs and hand wipes for cleaning one’s hands and equipment before using the equipment. This prevents bacteria and germs in the environment from getting into the body.
  • Wooden push sticks (such as chopsticks or kebob sticks) for packing the stems firmly in place in the pipe. Metal pushers (such as a coat hanger or screwdriver) can chip or cause cracks in the glass stem, which can cause oral sores. Plastic pushers (such as a pen or syringe) can melt inside the pipe.
  • Lighters, so every individual can apply consistent heat to his or her own pipe. The lack of one’s own heat source increases the chance that a person will share a pipe with someone else.
  • Chewing gum, to prevent lockjaw and keep the mouth hydrated.

Smoking-related risks

While smoking drugs prevents injection-related risks like vein damage and reduces the chance of getting Hep C, smoking is associated with risks of its own. Smoking drugs can cause respiratory problems, such as shortness of breath, chronic cough, chest pains, asthma, bronchitis and pneumonia. Using brass screens instead of steel wool or Brillo screens and using Pyrex stems instead of pop cans or plastic bottles will help prevent some of this damage.

Sharing pipes can also spread HIV, other sexually transmitted infections and tuberculosis.

Sex and drugs

Drugs like crack and meth may increase sex drive or make a person sexually passive and could lead to people engaging in unprotected sex and sexual activities that increase the risk of spreading hepatitis C between partners. Having open sores on the mouth or lips is a possible way to transmit Hep C during oral sex. Part of planning for crack use means bringing condoms, dental dams and lube along. These items are often included in safer-crack kits that are distributed by some needle exchange programs. Safer-sex education may be appropriate alongside safer drug-use education.

Prepping Before Using

Planning how much to use and setting limits can prevent some of the dangers associated with using or bingeing. Paying rent, buying groceries and paying other bills before buying drugs means budgets will not get out of control. After a binge, people are often very hungry and ready to crash, so encouraging people to have food on hand and a safe place to sleep will make the crash easier. 

Revised 2011.