Abstract
ABSTRACT Objective The objective of the present study was to evaluate 88 adolescent crack users referred to hospitalization and to follow them up after discharge to investigate relapse and factors associated with treatment. Methods Cohort (30 and 90 days after discharge) from a psychiatric hospital and a rehab clinic for treatment for chemical dependency in Porto Alegre between 2011 and 2012. Instruments: Semi-structured interview, conducted to evaluate the sociodemographic profile of the sample and describe the pattern of psychoactive substance use; Crack Use Relapse Scale/CURS; Questionnaire Tracking Users to Crack/QTUC; K-SADS-PL. Results In the first follow-up period (30 days after discharge), 65.9% of participants had relapsed. In the second follow-up period (90 days after discharge), 86.4% of participants had relapsed. Conclusion This is one of the first studies that show the extremely high prevalence of early relapse in adolescent crack users after discharge, questioning the cost/benefit of inpatient treatment for this population. Moreover, these results corroborate studies which suggested, young psychostimulants users might need tailored intensive outpatient treatment with contingency management and other behavioral strategies, in order to increase compliance and reduce drug or crime relapse, but this specific therapeutic modality is still scarce and must be developed in Brazil.
Highlights
Crack use has spread extensively in Brazil starting at an early age
All of them were adolescents who had been hospitalized for treatment of crack use (Table 1)
We believe that 21 days of hospitalization are not enough to avoid early relapses after discharge because high relapse rates are an important outcome of the history of these patients showing very poor adherence to treatment[5], even though outpatient treatment has been indicated
Summary
Crack users are young people of all social classes. This happens because the drug can be purchased, and exposure usually occurs after alcohol and/or tobacco use[1]. In spite of the significant number of adolescent crack user, there are very few studies of this sample. A study found that, in the Brazilian capital cities, 0.11% of the 0.81% regular users of crack and/or similar drugs were children and adolescents and 0.70% of users were older than 18 years old. About 28 (56%) children and adolescents who use crack and/or similar drugs live in the capital cities of the Northeast region. In the capital cities of the South and North regions, about 3 children and adolescents use crack and/or similar drugs[2]
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