The aim of this study was to estimate the prevalence of crack dependence in the three largest Dutch cities (Amsterdam, Rotterdam, The Hague), stratified by gender and age. Three-sample capture-recapture, using data (collected between 2009 and 2011) from low threshold substitution treatment (n = 1,764), user rooms (n = 546), and a respondent-driven sample (n = 549), and applying log-linear modeling (covariates: gender, age, and city), provided a prevalence rate of 0.51% (95% CI: 0.46%-0.60%) for the population aged 15-64 years, with similar estimates for the three cities. Females (23.0% of total estimate) and younger crack users (12.8% aged <35 years) might be underrepresented in drug user treatment services.Keywords capture-recapture, crack dependence, prevalence, gender, respondent-driven sampling, mark-recapture, problem drug usersThe authors thank Petra Houwing for her indispensable assistance in the fieldwork; Wim Van de Brink (AMC), Vincent Hendriks, and Peter Blanken (Parnassia) for their valuable contributions to the project design; Filip Smit (Amsterdam Free University), Marcel Buster (Municipal Health Department, Amsterdam), and Peter Van der Heijden (Utrecht University) for their advice on statistical analysis; and all social and healthcare agencies that have collaborated with this study. 1 Treatment can be briefly and usefully defined as a unique, planned, goal directed, temporally structured, multi-dimensional change process, of necessary quality, appropriateness, and conditions (endogenous and exogenous), which is bounded (culture, place, time, etc.) and can be categorized into professional-based, tradition-based, mutual-help based (AA, NA, etc.), and self-help ("natural recovery") models. There are no unique models or techniques used with substance users -of whatever types and heterogeneities -that aren't also used with non-substance users. Whether or not a treatment technique is indicated or contra-indicated -and its selection underpinnings are theory-based, empirically based, tradition-based, based on "principles of faith," etc. -continues to be a generic and key treatment issue. In the West, with the relatively new ideology of "harm reduction" and the even newer quality of life (QOL) and wellbeing treatment-driven models, there are now a new set of goals in addition to those derived from/associated with the older tradition of abstinence-driven models. Conflict-resolution models may stimulate an additional option for intervention. Each ideological model has its own criteria for success as well as failure. Treatment is implemented in a range of environments, ambulatory as well as within institutions, which can include controlled environments. Treatment includes a spectrum of clinician-caregiver-patient relationships representing various forms of decision-making traditions/models: (1) the hierarchical model, in which the clinician-treatment agent makes the decision(s) and the recipient is compliant and relatively passive; (2) shared decision-making, which facilitates the collaboration between clini...