Authorities say crack use has dropped 80 percent in São Paulo's notorious "Crackland" district since the implementation of With Open Arms ("De Braços Abertos"), a government-sponsored drug treatment program initiated in January 2014, reported a municipal government office in São Paulo. But there are reasons to doubt the initiative's reported success.
On a mild winter morning in São Paulo, two dozen people pick up brooms and rubbish bins from a warehouse. They wear blue jumpsuits with a De Braços Abertos (With Open Arms) logo, referring to a controversial new programme for crack cocaine addicts, and set off to sweep streets in the city centre.
São Paulo's Cracolândia has been here for 15 years. Its population hovered around 1,500. The city recently took over a collection of flophouses around Cracolândia – businesses whose clientele had fled along with most regular commerce in the neighbourhood – and set 400 addicts up in long-term accommodation. They also pitched a big tent on the edge of the fluxo, the shifting mattress camp on the streetcorner where addicts squat, hung up the Braços Abertos (Open Arms) banner and deployed an army of social workers
Sao Paulo State expanded its attack on crack cocaine by unveiling a program that will provide about $650 a month in subsidies for the rehabilitation of addicts at private treatment centers. Governor Geraldo Alckmin said 1,350 reals will be earmarked monthly for each crack user who voluntarily enrolls in a rehabilitation program that is expected to get under way in 11 cities. The state will give the money to accredited rehabilitation centers when clients present a "Begin Again" card they receive after enrolling in a program.
With Brazil gripped by a crack epidemic, the authorities have launched a series of controversial initiatives. Since the start of last year, São Paulo has introduced street clearance operations by police, increased funds for rehabilitation centres and, most recently, focused more on judicial intervention and involuntary treatment. Critics argue that the policies are haphazard, shift with the political winds, often violate the rights of the users and may be driven by business demands to clean up a piece of potentially valuable land.
The mayor of Bogota has recently proposed a pilot scheme with crack cocaine addicts to explore the substitution of crack made of cocaine base paste (or bazuco as it is called in Colombia) by marijuana. The substitution treatment plan will include 15 problematic users from the marginalized Bronx area who are already receiving health assistance of the CAMAD operating in that sector of the city. The treatment will last approximately eight months, after which the results will be evaluated.
São Paulo’s Cracolândia was Brazil’s first and is still its biggest. It is home to 2,000 addicts. But most Brazilian cities now have similar districts. Recent studies put the country’s crack-using population at 1m-1.2m, the world’s largest. Some city governments have used strong-arm tactics against the crack epidemic—with little effect other than to fill prisons, which have more than twice as many inmates as a decade ago.
The city of Rio de Janeiro has begun a program of involuntary hospitalization for crack users, one month after Brazil’s biggest city São Paulo began a similar program. Critics say that forcing addicts into rehabilitation treatment is ineffective. “When an addict is interned unwillingly, he can remain abstinent as long as he remains hospitalized,” Psychiatrist Dartiu Xavier da Silveira said. “When he returns to his normal life (and his usual problems), the vast majority of users go back to using the drug as before.”
The government’s campaign to curb crack cocaine use that was launched late last year is failing to deliver on its targets, reports O Globo. As of the start 2013, the program Entitled ‘Crack, É Possível Vencer’, which aims to treat crack addiction through the combined effort of four separate government departments, can only count half of Brazil’s states as members.
With a boom in crack use over the past decade, Brazilian authorities are struggling to stop the drug's spread, sparking a debate over the legality and efficiency of forcibly interning users. Brazil today is the world's largest consumer of both cocaine and its crack derivative, according to the Federal University of Sao Paolo. Adults can't be forced to stay in treatment, and most leave the shelters within three days. But children are kept in treatment against their will or returned to parents if they have a family.
Once crack was introduced about six years ago, Mandela and the surrounding complex of shantytowns became Rio's main outdoor drug market, a "cracolandia," or crackland, where users bought the rocks, smoked and lingered until the next hit. Hordes of addicts lived in cardboard shacks and filthy blankets, scrambling for cash and a fix. Dealers have stopped selling the drug in Mandela and nearby Jacarezinho in a move that traffickers and others say will spread citywide within the next two years. The drug bosses, often born and raised in the very slums they now lord over, say crack destabilizes their communities.
About two decades after the U.S. emerged from the worst of its own crack epidemic, Brazilian authorities are watching the cheap drug spread across this country of 190 million people. They have far fewer resources to deal with it, despite a booming economy that expanded 7.5 percent last year. Walter Maierovitch, a former drug czar, proposes programs that offer adults health services and a safe place to use drugs. "Insisting on programs that demand abstinence doesn't work," he said.
In the city of São Paulo, the culture of crack use has undergone considerable changes over these 11 years since it was first described. The sociodemographic profile of the users is practically the same and most use is still compulsive, with significant physical, moral and social impairment among them. Sole use of crack has overwhelmingly been replaced by associations between crack and other drugs, thus characterizing users in the city of São Paulo as multiple drug users.
In Brazil, the first large crack consumption market appeared at the end of the 1980s in São Paulo and expanded during the 1990s reaching its peak halfway the decade. Crack use spread to other regions in Brazil during the 1990s, in particular to youngsters from low-income population in urban areas. A 2002 survey among young street dwellers in all the state capitals revealed that crack had spread to 22 states.
Based on two studies carried out in the cities of Buenos Aires and Montevideo, this report examines the origin, characteristics and impact of the explosive increase in cocaine base paste in urban areas. It also highlights the variety of products consumed in these cities and the substance known as crack that is consumed in Brazilian cities. The Brazilian experience with this consumption could serve as an example and a lesson for the Southern Cone.
Eliseu Labigalini Jr, Lucio Ribeiro Rodrigues, Dartiu Xavier Da Silveira
01 October 1999
This study ensued from clinical observations based on spontaneous accounts by crack abusers undergoing their first psychiatric assessment, where they reported using cannabis in an attempt to ease their own withdrawal symptoms.