Crack Abuse Research Articles

Exploring the Relationship between Drug Addiction and Quality of Life in Herat, Afghanistan: A Cross-sectional Study.

Addiction is a global public health problem, with over 36 million people suffering from drug-use disorders. Afghanistan, the world's leading opium producer, has high rates of drug use owing to the easy access to drugs in this country. This study aimed to investigate drug users' quality of life in Herat, Afghanistan, and identify the factors affecting it. This cross-sectional study examined health-related quality of life at six rehabilitation camps in Herat, Afghanistan, from March to July 2019, using the short form-36 questionnaire (SF-36). Data collected through interviews were analyzed using SPSS software (version 25). A total of 240 participants from six rehabilitation camps in Herat, Afghanistan participated in this study. The majority of participants (80%) rated their overall health as "good" or "very good". Men had higher average scores for mental health and vitality than women and those aged 30-39 had the highest quality of life. Statistically significant differences were found in bodily pain (P=0.038), vitality (P=0.042), and social functioning (P=0.046) among users of different types of drugs. Opium abusers had the highest scores for the physical and mental components, followed by heroin, methamphetamine, hashish, and crack abusers. This study explored the relationship between drug addiction and quality of life in Herat, Afghanistan. The findings showed that young adults were more vulnerable to drug use and male addicts and opium users had the highest quality of life. This study can inform the development of effective rehabilitation programs but more research is needed for addiction treatment strategies.

Use of solid phase microextraction in tips (SPME-Tips) for analysis of cocaine and biotransformation products in oral fluid by liquid chromatography tandem mass spectrometry (LC-MS/MS)

To develop and validate a method for analyzing cocaine and its metabolites using SPME-Tips and LC-MS/MS. Among the biological matrices used for analytical toxicology, oral fluid has advantages such as simplicity and non-invasive collection, the difficulty of adulteration, the low level of contamination risk and the possibility of recent abuse evaluation. Recently, nearly two million users have used cocaine in the US/Europe. When abused, cocaine is rapidly metabolized, mainly into methylecgonine and benzoylecgonine. Cocaethylene is formed in the concomitant use of cocaine with ethanol, and anhydroecgonine methyl ester (AEME) (in the crack abuse). Currently, in (green) analytical toxicology there is a growing interest in the use of new sample preparation techniques that are fast, efficient, automatable, and ecologically correct. Thus, methods based on microextraction processes have been developed, such as solid phase microextraction (SPME), a miniaturization of solid phase extraction. A variation of SPME technique was recently developed, consisting of a microfiber coated with extractor phase installed in a micropipette tip. In SPME-Tips, the extraction of analytes occurs in a extractor phase, allowing the direct immersion of the tip in biological fluids, causing the analytes to be adsorbed on the fiber and allowing the desorption to be carried out using small volume of more polar and less toxic solvents. The procedure was optimized, studying parameters such as salting-out effect, extraction time, sample agitation speed, elution solvent volume, and constitution. For extraction, SPME-Tips were immersed in 150 μL of oral fluid (collected with Quantisal) and kept under agitation at 500 rpm for 80 min. For the elution, 125 μL of methanolic solution with 0.1% formic acid was used, kept under agitation at 500 rpm for 30 min. The elution content was taken to LC-MS/MS, in which 5 μL were analyzed. The analyses were performed in a Nexera-UHPLC chromatographic system, coupled with a LCMS8060 mass spectrometer. The chromatographic separation was performed with Atlantis-T3 column (150 × 3.0 mm, 3.0 μm), maintained at 40 °C. The mobile phase consisted of ultra-pure water (A) and methanol (B), both containing formic acid (0.1%) and 2 mmol/L ammonium formate. The flow rate was set to 0.4 mL/min, and the elution gradient used started with 10%B for 1 min, followed by a linear increase to 100%B for 2 min and then maintained at 100%B for 2 min and returning to the proportion start in 0.1 min. This condition was maintained for another 3 min, completing a total of 8 min of chromatographic run. With this optimization, the method validation began, as recommended by the AAFS Standard Practices for Method Validation in Forensic Toxicology. For cocaine, benzoylecgonine, and cocaethylene, the correlation coefficient r 2 was greater than 0.98 (50 to 500 ng/mL). Good accuracy and precision results were obtained for low, medium and high QC. In this way, low extraction efficiency was observed to AEME and methylecgonine in C18 SPME-Tips. For the other analytes, the precision and accuracy values were in accordance to the criteria of the method validation guideline. Also, to prove the applicability of the method in real situations, 10 samples of oral fluid collected from individuals who participated in university parties will be analyzed. The samples were already collected and are stored in the Laboratory. A green analytical toxicology method was developed using SPME-Tips for the analysis of cocaine and its metabolites in oral fluid.

Street scars: Suicide ideation and suicide attempt among street-involved adolescents and youth in southern Brazil

ObjectiveTo measure the prevalence of suicidal ideation and attempts as well as suicide attempts' associated factors among street-involved youth in southern Brazil. Participants and settingCross-sectional study was conducted with street-involved adolescents and children from Porto Alegre and Rio Grande, Brazil. MethodsA respondent-driven sampling strategy was used to access this hard-to-reach population quickly and efficiently. Descriptive, bivariate, and multivariate analyses were conducted, with the latter being binary logistic regression. ResultsThe prevalence of suicide attempts was 16.3%, while the frequency of suicidal ideation was 30.9%. Most participants were male, aged between 16 and 18 years, with no ties to school and family. Almost half of the sample had been in a street situation for five years or more, and two-thirds reported spending more than seven hours a day on the streets. Variables independently associated with suicide attempts were aged 19–21 years old, with reduced ties with school and family, having had an experience of sexual abuse, and lifetime use of crack. ConclusionsPublic policies targeting the strengthening ties of street-involved children, adolescents, and youth with school and family might reduce their vulnerability to threats, such as sexual abuse and use of crack, and hence focus on decreasing suicide attempts.

Gestantes e puérperas em uso abusivo de crack: considerações para saúde materno-infantilGestantes e puérperas em uso abusivo de crack: considerações para saúde materno-infantil

O objetivo é identificar o perfil e os estigmas sociais enfrentados pela mulher em período gravídico fazendo uso abusivo de crack e compreender as principais complicações obstétricas devido ao uso abusivo do crack. A metodologia utilizada é a revisão integrativa de literatura com abordagem qualitativa e cunho descritivo realizada em base de dados da LILACS e BDENF, onde os critérios de inclusão foram: artigos em língua portuguesa, disponíveis para leitura, texto completo, com recorte temporal de 07 anos (2014-2020). Os critérios de exclusão descartaram artigos repetidos ou que não se aplicavam a temática. Após aplicação dos critérios foram selecionados 5 artigos para compor o estudo. Resultado: Foram observadas dificuldades em captar essas mulheres aos serviços de saúde. Observa-se certo bloqueio e despreparo dos profissionais para lidar e conduzir à temática. Conclusões: Conclui-se que os estudos que abordam a temática de consumo de crack entre mulheres são raros e pontuais Discutir sobre o crack vai muito além de pontuar os efeitos ou as consequências do consumo abusivo, pois se trata principalmente do impacto social que este consumo propicia. Foi observado que o preconceito e o estigma dos profissionais de saúde frente a mulheres que fazem uso abusivo de crack contribuem para a manutenção do consumo “às escondidas” É importante que os profissionais de saúde de toda rede, e não apenas os da maternidade, estejam preparados pra lidar com o tema, principalmente nas circunstancias da mulher em período gravídico fazendo uso abusivo de crack.

Telephone counseling for young Brazilian cocaine and/or crack users. Who are these users?

ObjectiveTo describe the users’ drug abuse characteristics, problematic behaviors associated with addiction, the motivation of teenagers and young adults to quit cocaine and/or crack abuse, and then compare these characteristics. MethodsA cross‐section study was conducted with 2390 cocaine/crack users (teenagers from 14 to 19 years of age, and young adults from 20 to 24 years of age); 1471 were young adults and 919 were teenagers who had called a phone counseling service between January 2006 and December 2013. Semi‐structured interviews were performed via phone calls. The questionnaires included sociodemographic information; assessment of the characteristics of cocaine/crack abuse; assessment of the problematic behaviors; also, the Contemplation Ladder was used to evaluate the stages of readiness to cease substance abuse. ResultsParticipants reported using cocaine (48.2%), crack and other smoking forms (36.7%) and combined consumption of both drugs (15%). Young adults were more prone to using crack or crack associated with cocaine (OR=1.9; CI 95%=1.05–1.57) and they were exposed to substance abuse for longer than two years (OR=3.45; CI 95%=2.84–4.18), when compared to teenagers. On the other hand, they showed higher readiness to quit. ConclusionData shows important differences in drug abuse characteristics, problematic behaviors and motivation to cease substance abuse between teenager and young adult cocaine and/or crack users. Behaviors displayed by young adults involve greater physical, mental and social health damages. These findings reinforce the importance of public policy to act on prevention and promoting health, to increase protection factors among teenagers and lower risks and losses during adult life.

Heroin-based crack induces hyperalgesia through β-arrestin 2 redistribution and phosphorylation of Erk1/2 and JNK in the periaqueductal gray area

Continuous use of crack induces hyperalgesia which is related to drug tolerance. Despite cumulative evidence based on the growth rate of crack abuse, no serious study has been focused on the mechanisms of crack-induced hyperalgesia. This study aimed to elucidate whether extracellular signal-regulated kinases (Erk1/2)/β-arrestin pathways are involved in the crack-induced hyperalgesia. Fifty adult male Wistar rats were randomly divided into five groups: normal saline (NS), crack (0.9 mg/kg/day), heroin (1 mg/kg/day), crack + barbadin (100 μM), and heroin + barbadin groups, which received their intraperitoneal (i.p) treatments for four weeks. The thermal sensitivity was assessed using the hot-plate test. Moreover, phosphorylation of the Erk1/2 and JNK, as well as expression of protein kinase C-alpha (PKC-α), Mu-receptor (MOR), and β-arrestin 2 were determined in the whole lysate and membrane fraction using immunoblotting assay in the periaqueductal gray (PAG) area. The results demonstrated that chronic administration of crack and heroin significantly decreased hind-paw withdrawal latency compared to the NS group. Furthermore, crack as well as heroin administration increased phosphorylated Erk1/2 and JNK in the PAG. In addition, membrane β-arrestin 2 and PKC-α were significantly increased in the crack and heroin-received groups, while membrane MOR expression was decreased in the PAG. Nevertheless, co-administration of barbadin, an inhibitor of β-arrestin, and crack or heroin reversed all these changes. Our findings may partially confirm the role of β-arrestin 2 and PKC rearrangements, Erk1/2 and JNK phosphorylation in crack-induced hyperalgesia and provide potential therapeutic targets to attenuate crack-induced hyperalgesia.

Insights into the Effects of Crack Abuse on the Human Metabolome Using a NMR Approach.

Approximately 255 million people consume illicit drugs every year, among which 18 million use cocaine. A portion of this drug is represented by crack, but it is difficult to estimate the number of users since most are marginalized. However, there are no recognized efficacious pharmacotherapies for crack-cocaine dependence. Inflammation and infection in cocaine users may be due to behavior adopted in conjunction with drug-related changes in the brain. To understand the metabolic changes associated with the drug abuse disorder and identify biomarkers, we performed a 1H NMR-based metabonomic analysis of 44 crack users' and 44 healthy volunteers' blood serum. The LDA model achieved 98% of accuracy. From the water suppressed 1H NMR spectra analyses, it was observed that the relative concentration of lactate was higher in the crack group, while long chain fatty acid acylated carnitines were decreased, which was associated with their nutritional behavior. Analyses of the aromatic region of CPMG 1H NMR spectra demonstrated histidine and tyrosine levels increased in the blood serum of crack users. The reduction of carnitine and acylcarnitines and the accumulation of histidine in the serum of the crack users suggest that histamine biosynthesis is compromised. The tyrosine level points to altered dopamine concentration.

Telephone counseling for young Brazilian cocaine and/or crack users. Who are these users?

ObjectiveTo describe the users’ drug abuse characteristics, problematic behaviors associated with addiction, the motivation of teenagers and young adults to quit cocaine and/or crack abuse, and then compare these characteristics. MethodsA cross-section study was conducted with 2390 cocaine/crack users (teenagers from 14 to 19 years of age, and young adults from 20 to 24 years of age); 1471 were young adults and 919 were teenagers who had called a phone counseling service between January 2006 and December 2013. Semi-structured interviews were performed via phone calls. The questionnaires included sociodemographic information; assessment of the characteristics of cocaine/crack abuse; assessment of the problematic behaviors; also, the Contemplation Ladder was used to evaluate the stages of readiness to cease substance abuse. ResultsParticipants reported using cocaine (48.2%), crack and other smoking forms (36.7%) and combined consumption of both drugs (15%). Young adults were more prone to using crack or crack associated with cocaine (OR=1.9; CI 95%=1.05–1.57) and they were exposed to substance abuse for longer than two years (OR=3.45; CI 95%=2.84–4.18), when compared to teenagers. On the other hand, they showed higher readiness to quit. ConclusionData shows important differences in drug abuse characteristics, problematic behaviors and motivation to cease substance abuse between teenager and young adult cocaine and/or crack users. Behaviors displayed by young adults involve greater physical, mental and social health damages. These findings reinforce the importance of public policy to act on prevention and promoting health, to increase protection factors among teenagers and lower risks and losses during adult life.

Association between the Intron 8 VNTR Polymorphism of the DAT1 Gene and Crack Cocaine Addiction

Background: This study aims to compare allele and genotype frequencies of a 30-bp variable number of tandem repeats (VNTR) polymorphism of the DAT1 gene, located at intron 8, between adult crack cocaine users and nonaddicted individuals. Due to its involvement in drug addiction, this gene is a good candidate for molecular studies. Methods: A cross-sectional sample of 239 current adult crack abusers or dependents from in- and outpatient clinics and 211 control individuals was collected in Brazil. They were evaluated using ASRS, ASI-6, WAIS-III, and MINI assessments. DNA samples extracted from whole blood were genotyped for the intron 8 VNTR in DAT1. Results: Logistic regression analysis was performed and controlled for gender, age, ethnicity, educational level, and comorbidities of clinical interest (generalized anxiety disorder, suicide risk, major depressive episode, and attention deficit/hyperactivity disorder). This analysis showed that the 6R6R genotype was associated with crack cocaine addiction (OR = 1.844; CI = 1.101–3.089; p = 0.020). Conclusions: Our results are consistent with the role of DAT1 in the neurobiology of drug addiction. Nevertheless, the study of other genes, environmental factors, and their interactions is also important to gain a broader understanding of this condition.

Diógenes e o corpo “fabricador de drogas”: o estatuto do corpo no uso abusivo de crack e nas situações de precariedade e vulnerabilidade social

Este artigo aborda a relação entre os modos de subjetivação resultantes das situações de vulnerabilidade social e o uso abusivo de crack. A partir de um estudo de caso clínico, examinou-se como a ação do crack sobre o corpo pulsional se liga à experiência do sujeito e à sua inscrição no laço social e na realidade sociocultural. Observou-se estreita articulação entre o estatuto do corpo engendrado pelo uso de crack e o lugar conferido ao corpo nas situações de precariedade e exclusão.

Predictors of early relapse among adolescent crack users

ABSTRACTRelapse is associated with a poor prognosis among drug users. Crack cocaine users are more prone to severe dependence because of the intensity of use. Additionally, initiating drug use during adolescence worsens users' prognosis due to the increased rates of impulsivity and other risk behaviors. This study aimed to identify the predictors of early relapse among adolescent crack users discharged from inpatient treatment. A cohort study was conducted with 89 psychiatric inpatients aged 12–17 years from two different hospitals in southern Brazil who met the criteria for crack abuse or dependence. Demographic data, substance use disorders, psychiatric comorbidities, and crack consumption profile were assessed during hospitalization using the Teen Addiction Severity Index, Schedule for Affective Disorders and Schizophrenia for School Age Children—Present and Lifetime, and Crack Consumption Profile. Participants were re-assessed at 1 and 3 months after hospital discharge to determine their crack cocaine use based on self-report, family/caregiver information, and urine tests, whenever possible. There were extremely high rates of relapse (valid percent) in the first and third months, 65.9 and 86.4%, respectively. Statistically significant associations were observed between relapse in the first month and length of cocaine/crack cocaine use, and length of hospital stay. Data at 3 months were not analyzed because of the small number of patients who did not relapse. The high rates and significant associations found in this study suggest that intensive outpatient treatment strategies targeting this population should be developed and implemented to prevent early relapse after detoxification. One of the possible approaches, based on recent studies, might explore motivation as a strategy to reduce the rate of early relapse.

Knowledge , Attitude and Performance towards Crack Abuse Side Effects According to the Students Gender and Kind of Faculty

Knowledge , Attitude and Performance towards Crack Abuse Side Effects According to the Students Gender and Kind of Faculty

The Effect of Matrix Method on Anxiety and Attitude Toward Methamphetamine and Crack Abuse in Males Referring to Addiction Treatment Centers in Tonkabon, Iran

Background Drug abuse is a major problem in the communities and has many harmful effects on human body..Objectives The current study aimed to compare the efficacy of matrix method on anxiety and attitude of male crack abusers referred to addiction treatment centers in Tonkabon, Iran, in 2014..Patients and Methods The current semi -experimental study included 1,000 males referred to addiction treatment centers in Tonkabon with crack abuse history in 2014. Based on Morgan sample volume formula, 278 males with anxiety and higher attitude to drug abuse were randomly selected from 1,000 males referred to addiction treatment centers in Tonkabon. Then, 30 subjects were reselected out of them and equally assigned into two groups of experimental and control, 15 subjects in each group. The experimental group received 24 sessions of 30 - 60 minutes matrix treatment method in group, but the control group received no training. At the end of training period the post-test was carried out. The research findings confirmed the efficacy of matrix method on anxiety and attitude to crack abuse among those referring to the addition treatment center..Results The single covariance analysis of ANCOVA indicated that the value of Eta about 72% of variance of anxiety variable and about 76% of variance of drug abuse variable are taken in to account for variable of group. The intervention was effective in reducing anxiety and attitude to crack in males. Evaluating the adjusted mean showed the effectiveness of matrix method on anxiety and attitude to crack abuse in males..Conclusions The research result showed that matrix method affected the reduction of methamphetamine and attitude to crack abuse in males referred to the addition treatment center..

Predictors of early relapse in adolescent crack users after hospital discharge

Predictors of early relapse in adolescent crack users after hospital discharge

Adesão aos Princípios da Comunidade Terapêutica e Processo de Mudança ao Longo do Tratamento

Comunidades Terapêuticas (CT) são instituições para usuários abusivos de drogas ainda pouco estudadas na realidade brasileira. O presente estudo teve por objetivo investigar a vinculação de internos aos princípios de uma CT e sua relação com o processo de mudança vivenciado ao longo do tratamento. Sete homens dependentes de crack, cocaína e álcool foram avaliados por meio de entrevista semiestruturada, Inventário Multifásico Minnesota de Personalidade (Improved Readability Form) e Teste de Apercepção Temática (TAT), no início e ao final do tratamento. Os resultados sugerem melhor vínculo dos participantes aos princípios da CT em geral ao final da internação. Os internos que se vincularam aos princípios de mudança pessoal apresentaram mudanças mais expressivas do que aqueles que aderiram apenas aos princípios morais e religiosos. Os resultados sugerem que o tratamento na CT promove melhoras no funcionamento psicológico, ainda que em diferentes graus, dependendo do nível de integração dos recursos da personalidade.

A review of Brazilian scientific output on crack--contributions to the political agenda.

scientific literature about crack abuse published in Brazilian journals indexed in SCIELO. systematic review of literature treating findings as a framework for agenda-setting orienting policy decision makers. SCIELO online journals research since 02/06/2013 on tag crack as "key word searched" and in indexes as "research amplitude". An amount of 199 references were identified and their abstracts were analyzed getting to a final group of 59 articles specifically studying crack issues in Brazil. institutional criteria (journal, subject area, and publishing time) and analytical categories created by the authors: "Social Risk", "Treatment", "Use/Abuse", "Profile", "Social Relations", and "Study". crack use impact Brazilian journals since 2011; health field is prominent; articles about "Associated Risk" and "Treatment" prevail; SUS cannot face demand;investment improvement in CAP and harm reduction; therapeutic communities need to match with SUS standards; youngers, black people and poor express users profile; rave style use; repressive policies were not well succeeded; and multidisciplinary approach are necessary.

Severe obstructive pattern mimicking an asthma exacerbation as first presentation of crack smoking: A case report

Crack inhalation is known to cause a wide spectrum of acute and chronic pulmonary complications, along with imaging manifestations and lung function patterns. The diagnosis of these conditions is often delayed or mistaken. Only little information about the management and follow up of these pulmonary complications is available in literature. We present the case of a young patient referred to our clinic for symptoms mimicking an asthma exacerbation, not responsive to inhalant treatment. After investigations and the admission of crack abuse by the patient a final diagnosis of bronchiolitis crack-related was made. The patient was then followed for more than a year showing that lung function tests may be useful both for the diagnosis and follow up of such pulmonary complications.

Crack abuse during pregnancy: maternal, fetal and neonatal complication

Objective: The aim of this study was to assess the effects of crack on pregnancy outcomes.Methods: We studied 88 crack user pregnant women in this study. These women were matched to a drug-free group (n = 90) chosen from the population of the same hospital. Maternal outcomes including preeclampsia, placenta abruption, gestational diabetes and preterm labor, and neonatal complication including low birth weight and low Apgar score in 5 min were compared in crack using and drug-free groups. Data were analyzed by SPSS software. Chi-square test and Student’s t-test and Relative Risks (RRs) were used in this study.Results: The results of our study showed that crack abuse during pregnancy was associated with higher rate of preeclampsia p = 0.003 (RR, 1.731; 95% CI, 1.777–2.545), placental abruption p = 0.001 (RR, 2.439; 95% CI, 1.369–4.343), preterm labor p < 0.000 (RR, 3.249; 95% CI, 2.053–5.141) and low birth weight p < 0.000 (RR, 2.179; 95% CI, 1.462–3.247).Conclusions: Crack abuse had significant influence on pregnancy outcomes. Crack appears to influence the prevalence of low birth weight, preterm labor, preeclampsia and placental abruption.

Frequency of neonatal abstinence syndrome (NAS) and type of the narcotic substance in neonates born from drug addicted mothers

Background: NAS is a combination of signs and symptoms that due to physical and mental dependency, develops in neonates born from drug addicted mothers. The onset of NAS varies in accordance with the type, amount, frequency and duration of substance used. Because of diverse and unclear pattern of substance abuse in Iranian addicted pregnant mothers in comparison with western countries, this multi-center study has been designed to evaluate NAS in neonates born from drug addicted mothers.Methods: A cross sectional study was carried out on newborns of narcotic addicted mothers during the first six months of 2008. The newborn’s status and clinical signs were checked by physical examination and scored by the Finnegan scoring system.Results: In this study 100 neonates born from narcotic addicted mothers were examined; the most used narcotic was crack (36%). 60% of neonates showed signs of NAS. The most prevalent signs of NAS were increased muscle tonicity (60%/7), irritability (59%/6) and increased moro reflex (51%/8). Neonates born from crack abusers, in comparison with other drugs, were significantly at risk of NAS (100% vs.87%, P<0.03).Conclusion: Public education as regards to the negative impact of substance abuse in pregnancy is strongly advised so as to promote health status of the society. It is substantial to encourage women at reproductive age to quit addiction before pregnancy, or even undergoing drug replacement therapy with low risk narcotics in order to completely prevent NAS.Keywords: Addiction, NAS, Pregnancy

Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies

There are an estimated several million crack-cocaine users globally; use is highest in the Americas. Most crack users are socio-economically marginalized (e.g., homeless), and feature elevated risks for morbidity (e.g., blood-borne viruses), mortality and crime/violence involvement, resulting in extensive burdens. No comprehensive reviews of evidence-based prevention and/or treatment interventions specifically for crack use exist. We conducted a comprehensive narrative overview of English-language studies on the efficacy of secondary prevention and treatment interventions for crack (cocaine) abuse/dependence. Literature searches (1990–2014) using pertinent keywords were conducted in main scientific databases. Titles/abstracts were reviewed for relevance, and full studies were included in the review if involving a primary prevention/treatment intervention study comprising a substantive crack user sample. Intervention outcomes considered included drug use, health risks/status (e.g., HIV or sexual risks) and select social outcome indicators. Targeted (e.g., behavioral/community-based) prevention measures show mixed and short-term effects on crack use/HIV risk outcomes. Material (e.g., safer crack use kit distribution) interventions also document modest efficacy in risk reduction; empirical assessments of environmental (e.g., drug consumption facilities) for crack smokers are not available. Diverse psycho-social treatment (including contingency management) interventions for crack abuse/dependence show some positive but also limited/short-term efficacy, yet likely constitute best currently available treatment options. Ancillary treatments show little effects but are understudied. Despite ample studies, pharmaco-therapeutic/immunotherapy treatment agents have not produced convincing evidence; select agents may hold potential combined with personalized approaches and/or psycho-social strategies. No comprehensively effective ‘gold-standard’ prevention/treatment interventions for crack abuse exist; concerted research towards improved interventions is urgently needed.