Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, United Kingdom.
Int J Drug Policy. 2020 Sep;83:102829. doi: 10.1016/j.drugpo.2020.102829. Epub 2020 Jun 22.
Crack cocaine use is rising in the United Kingdom (UK), with smoking the primary form of administration. Provision of safe inhalation equipment for crack cocaine is prohibited under UK law. Pipes used for crack cocaine smoking are often homemade and/or in short supply, exacerbating COVID-19 transmission and respiratory risk. This is of concern, given high prevalence of respiratory health harms such as chronic obstructive pulmonary disease (COPD) among people who smoke illegal drugs. This commentary draws on scoping review and mixed method empirical evidence to argue for provision of safe crack inhalation equipment in the UK, with commensurate legal reform. Review of crack inhalation interventions illustrates the health protective and service engagement benefits of smoking equipment supply. Survey data generated with 455 people who inject drugs in London illustrate high prevalence of current crack use (66%, n=299). Qualitative accounts illustrate perceptions of relative smoking safety - alongside accounts of severe respiratory-related health harms. To date, injecting drug use has been of primary concern in relation to harm reduction initiatives. It is crucial that people who smoke illegal drugs are considered a vulnerable population in regard to COVID 19 transmission and fatality risk, with innovative harm reduction measures scaled up in response.
可卡因吸食在英国（英国）呈上升趋势，主要吸食方式为吸烟。英国法律禁止提供安全的可卡因吸食吸入设备。用于吸食可卡因的烟斗通常是自制的，而且供应不足，这加剧了 COVID-19 的传播和呼吸道风险。考虑到在吸食非法药物的人群中，慢性阻塞性肺病（COPD）等呼吸道健康危害的高患病率，这令人担忧。本评论借鉴了范围审查和混合方法实证证据，主张在英国提供安全的可卡因吸食吸入设备，并进行相应的法律改革。对可卡因吸食干预措施的审查说明了提供吸烟设备的健康保护和服务参与效益。在伦敦对 455 名注射毒品者进行的调查数据显示，目前可卡因使用率很高（66%，n=299）。定性描述说明了相对吸烟安全性的看法-以及严重呼吸道相关健康危害的描述。迄今为止，与减少伤害举措相关的主要关注点一直是注射吸毒。至关重要的是，应将吸食非法药物的人视为 COVID-19 传播和死亡风险的弱势群体，并相应地扩大创新的减少伤害措施。
