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.
Highlights
Crack use is prevalent and entails extensive health and social problems in Brazil
In-treatment and not-in-treatment crack users differed on several key characteristics
The street sample: included fewer white people; had lower education; was more likely to be unstably housed and to be involved in begging – but less likely to be involved in drug dealing – than the treatment sample (Table 1)
Summary
Crack use is prevalent and entails extensive health and social problems in Brazil. There may be up to 1 million crack users in Brazil [1,2]; most are young, poor, socioeconomically marginalized and crime-involved [3]. While care (including treatment) services for substance use problems have been expanded in Brazil in recent years, their utilization – by crack users – appears rather limited [8,9]. It is unclear whether these patterns are mainly determined by limitations in service availability, or access barriers between services and the (marginalized) user populations [9]. 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
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call