Smoking Coca Paste and Crack-Tobacco Must be Treated as Double Addiction

Abstract

Coca Paste (CP) is the form of cocaine used extensively by the smoked route in Andean regions from 1970s. It contains cocaine alkaloid plus many toxic ingredients. It is prepared with coca leaves, suphiric acid, kerosene, and sodium bicarbonate (1). In Peru and elsewhere, it is commonly smoked by mixing with tobacco (pressed into the tobacco rod of a commercial cigarette). Users smoke an average of 20 CP cigarettes (CPCs) daily (2). Reports of CP users in treatment suggest that is easier for many to give up cocaine than smoking conventional cigarettes. In fact, many people who smoked tobacco before becoming users of CP abandoned the CP but not the tobacco. Another form of smokable cocaine, crack, is also commonly smoked mixed with tobacco. Addiction to CP and crackcocaine-laced tobacco meets the criteria for double addiction: cocaine-nicotine. Since the middle of 2000s, we have been treating CPC users for both their cocaine and tobacco addictions. More than 50 patients were treated for both addictions and followed for at least 1 year. The tobacco-directed treatment included either transdermal nicotine (TN) or the combination of TN and bupropion (3). The cocaine-directed treatment included pharmacological approach with antidepressants, carbamazapine, valproic acid, methylphenidate, or oral cocaine alkaloid contained in coca tea or coca powder in capsules, as agonist therapy (4). Of course, behavioral guidance is offered for managing both addictions. Our experience suggests that the double pharmacotherapy appeared to give better results in

Consumo de basuco: aspectos relevantes para su tratamiento

“…Una de las combinaciones más frecuentes es el consumo del basuco con tabaco. Se ha sugerido que este tipo de casos requieren un enfoque combinado para su tratamiento, dado que se trata de dos adicciones con mecanismos diferentes, que incluso pueden potenciarse (40).…”