Smoked cocaine in socially-depressed areas

Journal of Epidemiology and Community Health, 1998

STUDY OBJECTIVE: To describe the prevalence and patterns of use of crack and cocaine hydrochloride among heroin users in Spain. To explore if the expansion of heroin smoking is accompanied by a similar phenomenon for cocaine. DESIGN: Cross sectional study in 1995. Face to face interviews using a structured questionnaire. SETTING: Three cities with different prevalences of heroin use by

European addiction research, 2004

An increase in the use of cocaine and crack in several parts of Europe has raised the question whether this trend is similar to that of the USA in the 1980s. However, research in the field of cocaine use in Europe has been only sporadic. Therefore, a European multi-centre and multi-modal project was designed to study specific aspects of cocaine and crack use in Europe, in order to develop guidelines for public health strategies. Data on prevalence rates were analysed for the general population and for specific subgroups. Despite large differences between countries in the prevalence of cocaine use in the general population, most countries show an increase in the last few years. The highest rate with a lifetime prevalence of 5.2% was found for the United Kingdom, although with a plateau effect around the year 2000. With regard to specific subgroups, three groups seem to show a higher prevalence than the general population: (1) youth, especially in the party scene; (2) socially margina...

The American Journal on Addictions, 1997

The authors collected data by structured interview from a convenience sample of 228 physically healthy, largely (82%) treatment-seeking, cocaine smokers with minimal histories of other smoked (other than tobacco and marijuana) or injection drug use. The vast majority of subjects also smoked either marijuana only (17.5%), tobacco only (17%), or both (61%), with onset of such smoking almost always (97%) preceding the initiation of regular cocaine smoking. There were few significant differences in sociodemographic or cocaine use characteristics among the subgroups of subjects smoking either cocaine only or cocaine and marijuana and/or tobacco. More than one-third of marijuana smokers quit (45%) or decreased (38%) their use after starting regular cocaine smoking, whereas only 5% of tobacco smokers did so. These findings suggest that marijuana smoking is more influenced by regular cocaine smoking than is tobacco smoking.

British Journal of Psychiatry, 1994

We contacted and interviewed 150 cocaine users in south London community settings. Most were taking cocaine regularly, but not daily, and in substantial doses. Three main routes of administration were used: smoking (40%), intranasal (32%), and injecting (24%). Injectors reported having used cocaine more frequently, in higher doses and for longer periods of time. Despite their frequent and extensive use of cocaine, the overall level of dependence was low for the great majority of the sample. Two-thirds (66%) of the full sample (and two-thirds (65%) of the crack smokers) reported only minor signs of dependence during the year prior to interview. Route of drug administration was related to severity of dependence. Cocaine taken by injection was associated with the highest levels of dependence; intranasal use was associated with the lowest levels, and crack smoking was intermediate between the two. There had been substantial changes in the initial route by which cocaine was used, with a ...

Addiction, 2014

Aim To determine predictors of changes in amount of cocaine use among regular users outside treatment services. Design Longitudinal study-we estimated the proportion of subjects who increased or decreased cocaine use and assessed possible predictors related to these changes among a street-recruited cohort of young regular cocaine users (RCU). Setting Three Spanish cities: Barcelona, Madrid and Seville Participants A total of 720 RCU aged 18-30 years not regularly using heroin were recruited in the community during 2004-06 (Itinere Project). Follow-up interviews (n = 501) were carried out at 12-24 months. Measurements The average amount of cocaine used weekly was calculated taking into account the number of days of use and the usual quantity (g/day). A multinomial logistic regression approach was used to investigate the association between changes in amount of cocaine use (i.e. difference exceeded 33.3% of baseline level) after 12-24 months, and baseline socio-demographic characteristics, nightlife, patterns of cocaine use and use of alcohol and other psychoactive drugs. Findings Cocaine use baseline average level was 2.14 g/week [95% confidence interval (CI) = 2.02-2.42]. It decreased in 71.5% of subjects and increased in 14.1%. In multinomial analysis, negative associations were found between decreasing cocaine use and high levels of alcohol consumption and using an increasing number of psychoactive drugs. Moreover, low education level, having used cocaine frequently in houses and reporting cocaine binges were associated with increasing cocaine use. Conclusions A street-recruited cohort of cocaine users in Spain showed a significant reduction in cocaine use over a period of 12-24 months. High consumption of alcohol and increasing use of other psychoactive drugs decreased the probability of reducing cocaine use.

European Addiction Research, 2004

Jornal Brasileiro de Psiquiatria, 2022

Objective: São Paulo‘s Crackland is the biggest and oldest open drug use scene in Brazil, yet little is known about the profile of crack cocaine treatment-seeking individuals living in this region. The aim of this crossectional study was to describe the demographics and clinical characteristics of treatment-seeking crack users living in the Crackland region. Methods: A sample of nighty eight individuals were screened for DSM-V substance use disorders, including substance use, impulsiveness, and psychiatric symptoms. Recent crack cocaine use was also tested using biologic specimens. Results: Results indicated severe social vulnerability, as participants experienced high rates of homelessness (46.9%), unstable housing (50%), unemployment (60.4%) and early school drop-out (27.5%). The average age of crack use onset was 20 years (SD = 6.9) and the mean duration of continuous crack use was 15 years (SD = 9.7). Most participants presented with concomitant mental health disorders, particul...

Drug and Alcohol Review, 2004

This study aimed to examine the physical and psychological harms of cocaine use and investigate the role of injecting versus noninjecting routes of administration in the severity of such harms. Two hundred and twelve cocaine users from inner-city and southwestern Sydney were administered a structured interview containing sections on demographics, drug treatment history, drug use history, cocaine use patterns, cocaine dependence and physical and psychological problems associated with cocaine use. Serious physical and psychological symptoms were prevalent among both injecting and non-injecting cocaine users. The prevalence and extent of symptoms was greater among injecting cocaine users, however route of administration did not prove to be a significant independent predictor of harm when other factors, such as frequency of use and level of dependence, were taken into account. While the level of physical and psychological harm was greater among cocaine injectors, it would appear that factors engendered by injecting, such as more frequent use and higher levels of dependence, result in higher levels of harm, rather than the route of administration per se. Physical and psychological problems were also reported among infrequent users, suggesting that cocaine can cause harm irrespective of frequency or method of use. Harm reduction initiatives should be targeted towards all cocaine users, not just those who seek treatment for dependence or present with acute medical complications. [Kaye S, Darke S. Injecting and non-injecting cocaine use in Sydney, Australia: physical and psychological morbidity. Drug Alcohol Rev 2004;23:391 -398]

International Journal of Drug Policy, 1999

This paper presents an update on the progress and barriers to harm reduction for cocaine users, with proposed new directions, since the overview of Erickson [Erickson Patricia G. Prospects of harm reduction for psychostimulants. In: Nick Heather et al., editors. Psychoactive Drugs and Harm Reduction: From Faith to Science. London: Whurr, 1993, pp. 184–210.]. Though not without challenges, various approaches for opiate use, ecstasy and cannabis—even alcohol and tobacco—have all advanced significantly throughout the 1990s [Erickson Patricia G, Riley Diane, Cheung Yuet W, O’Hare Pat, editors. Harm Reduction: A New Direction for Drug Policies and Programs. Toronto: University of Toronto Press, 1997.]. Compared to these drugs, initiatives for cocaine have been relatively few and far between. We use Zinberg’s organizational framework of drug, set and setting to summarize the available literature on the various expressions of harm reduction around cocaine. It is argued that it is the interaction of these components—that is the social context of use—rather than any one pharmacological feature that shapes the nature of cocaine problems. In particular, there is promise for harm reducing approaches to cocaine in a focus on the social environmental setting of cocaine use and access, applying the concept of community social capital.

Cuadernos de Economía, 2015

In this paper, we examine the socioeconomic factors that determine cocaine consumption in adults aged over 18 years in Spain. For data from household alcohol and drug surveys for the period 2007-2012 (EDADES 2007, 2009, 2011), we used, first, a decision tree to identify the main predictors of cocaine use and high-risk profiles of cocaine consumers and, next, a multinomial logistic regression model to explain cocaine consumption in terms of sex, age, marital status, employment status, education level, income, household size and perceived health status. The results indicate that the main predictors of cocaine use are marital status, sex, employment status, age, education level and household size. The main cocaine user propensity profile is a young single man with a low level of education and unemployed, who should, therefore, be the main target of campaigns for preventing illicit drug use.

Revista da Associação Médica Brasileira (English Edition), 2013

r e v a s s o c m e d b r a s . 2 0 1 3;5 9(4):360-367 Revista da ASSOCIAÇÃO MÉDICA BRASILEIRA w w w . r a m b . o r g . b r Anxiety Brazil Questionnaires a b s t r a c t Objective: The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. Methods: The study investigated two groups of volunteers of equal size (n = 50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ).

Psychologica, 2016

The present study aimed to analyse the psychopathological functioning of crack-cocaine users compared to the general population. It is a quantitative cross-sectional study. A sample of 971 adults, aged from 18 to 59 years, was divided in two groups: crack-cocaine users and general population, selected by convenience sampling. Results: Statistical analysis, using Pearson’s chi-square test, showed a significant association between crack-cocaine users and a greater severity in internalizing and externalizing symptoms. Binary logistic regression analysis using the conditional stepwise backward method showed a severity model for the use of crack-cocaine adjusted to the gender, age, schooling, and anxiety/depression symptoms variables. Conclusions: Based on the results, the comorbidities associated with crack-cocaine use should be investigated to ensure an appropriate treatment for these users.

Trends in Psychiatry and Psychotherapy, 2019

Objective To explore and describe sociodemographic characteristics, crack consumption patterns, and psychiatric comorbidities of female crack users receiving treatment at therapeutic communities. Methods This was a cross-sectional, descriptive, quantitative study. Forty-six women who abstained from crack use were assessed using a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and a profile of crack use questionnaire. Descriptive statistical analyses were conducted. Results Participants had a mean age of 31.02 years (standard deviation [SD] = 7.73), most were single (76.1%), white (67.4%) and had complete or incomplete elementary education (43.5%). Before treatment, 65.2% of the women reported using crack every day; 46.3% smoked between 10 to 30 crack rocks per week. Mean treatment time was 63.56 days (SD = 75.85), with a mean of 80.41 days of abstinence (SD = 74.52) and 3.37 previous t...

International Journal for Innovation Education and Research

The objective of this study was to investigate, through the speeches of crack cocaine users, the reasons that lead them to combine crack cocaine with alcohol and the consequences of this combination, in Brazil. The lack of public policies and effective treatments has led crack cocaine users in Brazil to seek alternatives to cope with problems related to drug addiction. One adopted alternative is the consumption of crack cocaine together with other psychotropic drug. This study used the principles and instruments of qualitative research. A purposeful sample was constructed using key informants and gatekeepers whose sample size (N = 30) was defined by the theoretical saturation point. The study participants were subjected to in-depth interviews, and the responses were subjected to content analysis for the identification of thematic units. Alcohol use played many roles, including increasing the courage of drug users to go to the point of sale for psychotropic drugs, reducing thirst, an...

International Journal of Drug Policy, 2009

Background: In recent years the use of powder cocaine among socially integrated adolescents and young adults has normalised. It is no longer an extraordinary drug to use in trendy/innovative as well as mainstreams clubs. Not much research has been done on motivations for and settings in which this cocaine use takes place. Methods: To gain insight in normalisation and trends in cocaine use, we used quantitative data from the National Prevalence Study on Substance Use (NPS) 1997, 2001 and 2005. To gain insight in social settings and motivations (initiation and continuation), and in the combined use of cocaine with alcohol and/or other drugs, we analysed mostly qualitative data from in-depth interviews with 55 adolescents and young adults who used cocaine in the past year. Results: The NPS studies show a rising trend in lifetime cocaine use, a fall in incidence, and a fall in continuation rates. From the interviews we learn that cocaine has further normalised. Cocaine is -and stays -attractive because of the ritual of snorting (the route of administration). Initiation is often planned. Effects play a role in the continuation of use, not in initiation. Motivations for use are divided into three categories: physical, mental and social. Cocaine is used in nightlife and home settings, together with friends, and it is often combined with alcohol (on the same occasion), because of feeling mentally clear and being able to drink more. Conclusion: About 5% of adolescents have used cocaine at least once in their lives. They feel it can be used in every setting, since it leaves a user in control. While acknowledging the negative side effects, young users try to regulate their cocaine use in order to regulate these effects. Although high frequent use is an exception in our sample, we cannot foretell how many might develop a pattern of problematic use.