Background: The spread of cocaine and crack use in Europe poses a challenge to the European health-care systems. The assessment of the extent of the problem as well as the support needs of the users require involving all relevant parties in research and future planning. Correspondence: Christian Haasen, Zentrum fü r Interdisziplinäre Suchtforschung (ZIS), Klinik fü r Psychiatrie and Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Addict Res Theory Downloaded from informahealthcare.com by University of Colorado Libraries on 12/26/14 For personal use only.Method: Within the framework of a European multi-center and multi-modal research project, experts of nine European cities were interviewed according to a standardised structural interview protocol. Results: Cocaine use is considered to be on the increase in Europe. The prevalence rates vary substantially between countries and the problem emerges in different target groups in distinct patterns of use. Although cocaine and crack specific risks can be diagnosed, health risks follow basically the general risks of illicit drug use. Proposals for future planning include the broadening of the existing services and the implementation of evidence-based approaches to the problem. Conclusion: In dealing with the cocaine problem in Europe, a comprehensive public health approach is appropriate. An overall strategy should include preventive, harm reductive as well as rehabilitative measures. Consequently, cross-national guidelines should be established and their implementation as well as evaluation should be monitored.
EinleitungInwieweit sich der Konsum einer Substanz zu einem gesellschaftlichen ¹Problemª entwickelt, hängt von einer Reihe von Faktoren und vor allem von deren Bewertung ab. Dazu zählen Faktoren wie allgemeine Prävalenz, Häufigkeit in der polizeilichen Statistik, gesundheitliche Folgen, aber auch die subjektive Bewertung der Schwierigkeiten im Umgang mit Abhängigen. Der Kokain-und
Schlüsselwörter
Kokain´Crack´Psychische Folgen´Somatische Komplikationen
AbstractThe increase in cocaine and crack use calls for a differentiated assessment of its health consequences. The primary difference in the effect of cocaine and crack lies in the speed of central nervous action. Somatic complications result due to vasoconstriction as well as related to the metabolite cocaethylene when consumed together with alcohol. Since cocaine is frequently not used alone, somatic complications seldom have a monocausal relationship to cocaine. The abuse and addictive potential is related to the action in specific neurotransmitter systems. Craving and development of tolerance are more frequent with crack use. There is a high rate of comorbidity especially with personality and affective disorders. Pharmacological treatment of cocaine addiction has not been shown to be sufficiently effective, while several psychosocial interventions have led to positive results.
Key words Cocaine´Crack´Mental Health´Somatic ComplicationsReview 2 Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.
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