Evaluating crack pipe distribution in Canada: A systems change case study

Abstract

Over the last two decades, the incidence/prevalence rates of Hepatitis C virus have increased; this has resulted in the development of novel approaches to disease control, with many of these strategies taking a harm reduction approach. In Canada, one response has been crack pipe distribution (CPD). This article presents the results of a case study that compares CPD implementation in two Canadian cities: Ottawa and Toronto. The consequent analysis uses a systems perspective and thus, the implementation of CPD is examined within the larger context of social change that is necessary for public health services to transform their underlying philosophy from abstinence-based to harm reduction.

• Crack pipes
• harm reduction hepatitis C
• sustainability
• systems change