Comparing key characteristics of young adult crack users in and out-of-treatment in Rio de Janeiro, Brazil

Abstract

BackgroundCrack use is prevalent among street drug users in Brazilian cities, yet despite recent help system reforms and investments, treatment utilization is low. Other studies have identified a variety of – often inconsistent – factors associated with treatment status among crack or other drug users. This study compared socio-economic, drug use, health and service use characteristics between samples of young adult crack users in- and out-of-treatment in Rio de Janeiro, Brazil.FindingsStreet-involved crack users (n = 81) were recruited by community-based methods, and privately assessed by way of an anonymous interviewer-administered questionnaire as well as biological methods, following informed consent. In-treatment users (n = 30) were recruited from a public service in-patient treatment facility and assessed based on the same protocol. Key indicators of interest were statistically cross-compared. Not-in-treatment users were less likely to: be white, educated, stably housed, to be involved in drug dealing, to report lifetime marijuana and current alcohol use, to report low mental health status and general health or addiction/mental health care; they were more likely to: be involved in begging and utilize social services, compared to the in-treatment sample (statistical significance for differences set at p < .05).ConclusionsIn-treatment and not-in-treatment crack users differed on several key characteristics. Overall, in-treatment users appeared to be more socio-economically integrated and connected to the health system, yet not acutely needier in terms of health or drug problems. Given overall low treatment utilization but high need, efforts are required to facilitate improved treatment access and use for marginalized crack users in Brazil.

Profile and pattern of crack consumption among inpatients in a Brazilian psychiatric hospital

“…Authors of one study conducted in the city of Rio de Janeiro drew attention to low numbers of dependent individuals in treatment, in relation to the great demand for treatment and the urgency of the need for increased access to treatment centers. 41 The present study resembles the previous study 29 and another recent study, 16 both of which were conducted at the HPSP. All three of these studies found characteristics in common in the profiles of crack-dependent inpatients in treatment -young adult polydrug users with low incomes who have made previous attempts to stop and who exhibit high frequency drug abuse.…”

“…One of the differences identified in that study was that the group in treatment had higher socioeconomic levels and heavier usage, while not being in treatment was associated with more housing problems, lighter consumption and being a novice user. 41 There are low numbers of crackdependent individuals in treatment, in contrast to the great demand, revealing difficulty in providing access to treatment centers. 41 The present study was able to demonstrate a heavy pattern of consumption, with negative characteristics, such as a large proportion of polydrug users and escalation from licit to illicit substances, in accordance with the hypothesis.…”

“…41 There are low numbers of crackdependent individuals in treatment, in contrast to the great demand, revealing difficulty in providing access to treatment centers. 41 The present study was able to demonstrate a heavy pattern of consumption, with negative characteristics, such as a large proportion of polydrug users and escalation from licit to illicit substances, in accordance with the hypothesis. Furthermore, the findings validate previous studies about crack-dependent profiles.…”

HIV Testing in Non-Injection Drug Users: Prevalence and Associated Factors

“…The questionnaire was constructed by the researchers and included variables derived from instruments previously validated in vulnerable populations (10,11,24,26,27,30,(32)(33)(34)(35)(36)(37)(38)(39) and other potential factors associated with HIV testing. The interviews were conducted by members of the study team who were professional experts in mental health and had been previously trained.…”

A trajetória de usuários de crack para a situação de rua na perspectiva de familiares

“…al., 2013;CRUZ et al, 2014). Considerando-se as condições clínicas apresentadas por esses usuários, estudos têm reportado altas taxas de contágio por agentes de doenças sexualmente transmissíveis, incluindo o risco aumentado para o contágio pelo vírus HIV, principalmente entre as mulheres OLIVEIRA, 2011;ATKINSON et al, 2010;KOPETZ et al, 2013).…”