OBJECTIVE:To characterize the situation regarding crack cocaine use in the city of São Paulo, along with the sociodemographic profi le of its users. METHODOLOGICAL PROCEDURES:Qualitative ethnographic study carried out with an intentional sample of crack cocaine users (n=45) and former users (n=17). The participants were recruited by means of the chain sampling method and they underwent a semi-structured interview guided by a questionnaire, in 2004 and 2005. The combination of each question and its respective responses gave rise to specifi c reports that were interpreted individually. ANALYSIS OF THE RESULTS:The predominating profi le of the crack cocaine users was that they were single young men of low socioeconomic class and low schooling level, without formal employment ties. The pattern of use most frequently cited was compulsive, characterized by multiple drug use and carrying out illegal activities in exchange for crack cocaine or money. However, controlled use was also identifi ed. This consisted of non-daily use of crack cocaine mediated by individual factors that were developed intuitively by the user. Controlled use was similar in nature to the strategies adopted by former users to achieve a state of abstinence. CONCLUSIONS:The culture of crack cocaine use has undergone changes regarding the pattern of use. Although most users do so compulsively, the existence of controlled use was observed. This deserves to be investigated in more detail, particularly with regard to the strategies adopted to attain this.

These findings are consistent with results that have been reported for the general Brazilian population. Therefore, these findings should be taken into consideration when developing strategies at the prevention of drug use and the early identification of drug abuse among college students.

Religiosity was found to be a strongly protective factor against drug use among Brazilian university students. However, more studies are needed to identify the mechanisms by which religiosity exerts this protective influence.

OBJECTIVE:To characterize the situation regarding crack cocaine use in the city of São Paulo, along with the sociodemographic profi le of its users. METHODOLOGICAL PROCEDURES:Qualitative ethnographic study carried out with an intentional sample of crack cocaine users (n=45) and former users (n=17). The participants were recruited by means of the chain sampling method and they underwent a semi-structured interview guided by a questionnaire, in 2004 and 2005. The combination of each question and its respective responses gave rise to specifi c reports that were interpreted individually. ANALYSIS OF THE RESULTS:The predominating profi le of the crack cocaine users was that they were single young men of low socioeconomic class and low schooling level, without formal employment ties. The pattern of use most frequently cited was compulsive, characterized by multiple drug use and carrying out illegal activities in exchange for crack cocaine or money. However, controlled use was also identifi ed. This consisted of non-daily use of crack cocaine mediated by individual factors that were developed intuitively by the user. Controlled use was similar in nature to the strategies adopted by former users to achieve a state of abstinence. CONCLUSIONS:The culture of crack cocaine use has undergone changes regarding the pattern of use. Although most users do so compulsively, the existence of controlled use was observed. This deserves to be investigated in more detail, particularly with regard to the strategies adopted to attain this.

ResumoContexto: No Brasil, levantamentos epidemiológicos têm apontado o aumento do uso de crack, possivelmente em razão de mudanças de seu acesso, estratégias de mercado e formas de uso. Objetivo: Identificar tais aspectos da cultura de uso de crack, na cidade de São Paulo, sob a perspectiva do próprio usuário. Métodos: Adotou-se amostra intencional, selecionada por critérios, composta de usuários (n = 45) e ex-usuários de crack (n = 17). Recrutados por meio de informantes-chave e técnica de amostragem em cadeias, cada participante submeteu-se à entrevista semiestruturada. Resultados: Atualmente, conforme os entrevistados, o acesso a crack é simples, facilitado por estratégias de mercado como a entrega em domicílio do crack (crack delivery). As pedras têm sido substituídas pelo farelo, forma mais barata e adulterável da droga. Embora o cachimbo artesanal de alumínio seja a forma de uso mais comum, têm-se identificados o shotgun e o uso combinado de crack a tabaco ou maconha. Conclusões: Embora de caráter preliminar, esse estudo aponta que a qualidade, o mercado e as estratégias de uso de crack têm sofrido mudanças, implicando potenciais riscos à saúde do usuário, sugerindo sua consideração à atualização das políticas públicas e dos programas de intervenção atualmente vigentes. OliveiraLG, Nappo SA / Rev Psiq Clín. 2008;35(6):212-8 Palavras-chave: Cocaína-crack, comportamento, pesquisa qualitativa, antropologia cultural, políticas públicas de saúde. AbstractBackground: In Brazil, survey data have pointed to an increase in crack cocaine lifetime use, possibly due to changes on its accessibility, market strategies and ways of use. Objective: To identify such issues in the crack cocaine culture of use, in São Paulo, according to the user point of view. Methods: An intentional sample was selected, composed by crack users (n = 45) and former users (n = 17). Recruited through key-informants and chain sampling methods, each participant was submitted to an in-depth semi-structured interview. Results: Nowadays, as reported by interviewees, it is quite simple to get crack cocaine, especially through new market strategies as crack cocaine delivery. Rocks have been replaced by "crack powder", the cheapest and easily "changeable" crack cocaine. Although makeshift aluminum pipes are the commonest way of use, others have been identified, among them, "shotgun" and the combined use with tobacco or marijuana. Discussion: Although preliminary in nature, this study points that crack cocaine quality, market strategies and ways of use have changed, implying in potential heath risks to users suggesting its utilization to the health public policies and intervention methods updating.

Brazil is currently experiencing a growing number of newly recorded cases of HIV infection among women, with transmission mainly occurring by sex. This increase may be associated with the development of sexually risky behavior among female crack users who, according to informal reports, prostitute themselves for drugs or for money to be used for buying drugs. Since epidemiologic studies have not yet addressed this phenomenon, the aim of this study was to investigate this in depth using a qualitative ethnographic approach. An intentional sample was utilized, composed of 75 female crack users in S?o Paulo, who were selected by specific criteria using the snowball strategy and key informants. Fourteen different chains of users were investigated, allowing us to include the largest possible number and variety of users. Each participant was submitted to a semi-structured in-depth interview that was guided by a questionnaire. Verbal information was corroborated and extended using participative observation. These 14?45-year-old women, who had little schooling and no job connections, opted to sell their bodies as a strategy to obtain drugs and to satisfy their compulsive use of crack. The subjects engaged in up to nine acts of sexual intercourse per day, in unsafe locations and with multiple partners who were approached in a besieging way and selected using subjective criteria. These crack users generally exchanged sex under craving for ridiculously low prices and left the use of protection up to the client. Because the users used inadequate pipes to smoke crack, it was common for them to have lesions on their lips and mouths. Since they often provided oral sex, they exposed themselves to considerable risk for infection with STDs including HIV, because of the contact of their partners? semen with their open wounds. These women make up an important risk group with respect to the transmission of STDs including AIDS.

ObjectiveAlthough there are many studies on risk factors for drug use, little has been known about the reasons that prevent people away from drug use. The aim of this study was to identify the reasons that would prevent low-income youngsters against psychotropic drug experimentation and use, even when living in a drug dealing environment. Methods A qualitative study was carried out in an intentional sample selected according to a set of criteria. Sixty-two youngsters, aged between 16 and 24 years, from low-income families who have never used psychotropic drugs (32 subjects) or who were heavy drug users (30 subjects) were interviewed. Each interview lasted on average 110 minutes. Results Among non-users, access to information and a protective family structure were identified as major reasons from preventing youngster from drug use. Comprehensive information on the outcomes of drug use and affective bonds between parents and their children, assured by feelings of support and respect, seems to be important in helping them avoid drug use. The importance of these two factors as reasons to keep youngsters away from drugs is emphasized when their lack is mentioned and censured by drug users. ConclusionsThe outlook of those who have never used drugs in their lifetime and their reasons should be considered in the development of drug prevention programs targeting lowincome youngsters.

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