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.
Brazil will soon have a special police task force targeting crack-cocaine. Meanwhile, the Brazilian state of Minas Gerais proposes its own drug fighting alternatives to address crack on the domestic front. Crack is a risk factor in urban violence, contributing to homicides and robberies in Brazilian cities. However, it is not the chemistry involved in crack, but the crack market that is increasing the crime and violence. How can rising crack use effectively be addressed, other than through mere suppression?
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.”
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 Sole use of crack has overwhelmingly been replaced by associations between crack and other drugs, thus characterizing users in the city of São Paulo as multiple drug users.
An ethnographic study of women and drug use in inner city neighborhoods in Kingston, Jamaica, revealed that cannabis is commonly used in conjunction with crack cocaine to minimize the undesirable effects of crack pipe smoking, specifically paranoia and weight loss.
When you hear that your government is helping addicts shoot up or smoke crack, it's normal to wonder: how can this possibly be good? Until recently, Alberta Health Services did similar work, distributing free, clean crack pipes to Calgary addicts through the Safeworks Harm Reduction Program. But when local media publicized the existence of the pipe arrangement last month, things went sideways.
Drug users in France will soon have a state-sanctioned place where they can use heroin, crack and other intravenous drugs, after the government approved a pilot site in Paris. The City Council had already voted to allow a secure injection site to be opened in the city, a controversial measure, which social workers say should help to reduce the number of drug users in the streets.
Insite’s operators have twice applied for a federal health exemption to allow crack cocaine smokers to use the room – the request was rejected in 2006, ignored in 2009. Proponents say the room would allow health officials to reach a fast-growing segment of drug users, a group prone to viruses because of dirty crack pipes. Critics say scientific evidence for the benefits of supervised inhalation rooms is scant.
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.
If moral entrepreneurs and interest groups manage to whip up enough fear and anxiety, they can create a full-blown moral panic, the widespread sense that the moral condition of society is deteriorating at a rapid pace, which can be conveniently used to distract from underlying, status quo-threatening social problems and exert social control over the working class or other rebellious sectors of society.
Brighton is set to be the first British city to offer official "drug consumption rooms" where addicts can use heroin, crack and cocaine under supervision without fear of prosecution. The city's public health leaders will "give serious consideration" to the plan in order to save lives. A report published from an independent drugs commission led by the crime author Peter James and Mike Trace, a former UK deputy drugs tsar, is expected to say that drug consumption rooms "significantly reduce overdose death rates" and do not encourage further use.
BBC Mundo reports that Bogotá is planning a system of "controlled consumption centers," where addicts could be weaned off more hard-core drugs, such as heroin or crack (bazuco), and slowly introduced to pot. Because of its continued prevalence, as well as its toxicity, bazuco will be one of the drugs targeted by Mayor Gustavo Petro's planned treatment centers. The treatment centers are part of a larger movement in Colombia to classify drug addiction as an issue of public health rather than crime.
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.
Marcus Day of the Caribbean Drug and Alcohol Research Institute believes the time has come for regional governments to legalise marijuana to counteract the spread of HIV. "We encourage the crack smokers that we work with to substitute their crack for cannabis and to smoke cannabis instead. Even though it's probably not the best thing, it's much better than crack smoking."
Daniel Vaillant (PS), a suggéré de réfléchir à la création d’une salle de consommation de crack, une fois que la «salle de shoot» de la gare du Nord aura été mise en place. «Je pense qu’il faut d’abord mettre sur pied la salle de consommation à moindre risque du côté de la gare du Nord. Mais il conviendrait de réfléchir avec les praticiens à l’ouverture d’une salle pour les consommateurs de crack, sous forme expérimentale», a déclaré l’ancien ministre de l’Intérieur à l’AFP.
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.
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.
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.
The cocaine base, or “pasta”, may be seen as a type of South American crack. Its obligatory method of administration is smoking. A primary condition of the “pasta” smoker is compulsive drug-search behavior and addiction to cocaine base destroys emotional and mental balance. Socio-economic maladjustment is the norm amongst “pasta” addicts. Since 1984 I have recommended the chewing of the coca leaf, between 100 to 200 grams of coca leaf per week for the treatment of cocaine dependence.