Powder Cocaine Use Research Articles

CONCURRENT USE OF ALCOHOL AND COCAINE: DIFFERENCES IN PATTERNS OF USE AND PROBLEMS AMONG USERS OF CRACK COCAINE AND COCAINE POWDER

To investigate differences in alcohol and drug consumption behaviours and related problems among users of cocaine powder versus crack cocaine. The sample of concurrent users of alcohol and cocaine (n = 102) was recruited from clinical and community (non-clinical) settings in London. Those recruited in the community were contacted by means of snowball sampling methods. Data were collected by means of face-to-face structured interviews. Heavy drinking was common. There were differences in alcohol consumption between users of cocaine powder and crack cocaine. Cocaine powder users reported more frequent heavy drinking than crack users. Heavy drinking often involved drinking excessive amounts over prolonged periods. Crack cocaine users reported more serious problems associated with cocaine, other illicit drugs, psychological and physical health problems, and acquisitive crime. Frequent heavy drinking represents a serious risk to the health of many cocaine users. The differences in alcohol consumption patterns confirm the importance of distinguishing between use of cocaine powder and crack cocaine. Few of the sample had received treatment for cocaine or alcohol problems. Healthcare professionals working in primary care or accident and emergency settings may need to be trained to detect, assess, and respond to concurrent alcohol and cocaine problems.

Concurrent crack and powder cocaine users from Sao Paulo: Do they represent a different group?

BackgroundCocaine abuse is a serious and socially damaging illegal drug problem. Different routes of administration are associated with a specific progression of use, different degrees of abuse liability, propensity for dependence and treatment response. There have been relatively few studies comparing different cocaine users groups and no studies into the characterization of the group of individuals reporting concurrent use of powder cocaine and crack cocaine.MethodsSix hundred and ninety-nine cocaine users were assessed during the period August 1997 to October 1998 in one outpatient and six inpatient clinics located in the São Paulo, Brazil. Patients were interviewed using a structured questionnaire schedule in Portuguese, designed specifically for the Brazilian population. The statistical analyses were performed using either ANOVA or a chi-squared test and focusing on their preferred form of use/route of administration and other variables.ResultsFor 83% of the variables tested in this study, the Dual Users subgroup (using both powder and crack cocaine) demonstrated statistical differences from the single drug user subgroups. Those differences include the initiation of cocaine, the abuse of other illicit drugs, and rates of criminal history.ConclusionThese data suggest cocaine-dependent individuals who report use of both powder and crack cocaine are an at least partially, distinct subgroup. However, further studies will be necessary to confirm this and to determine if they also show a different treatment response.

Cocaine Use in Europe – A Multi-Centre Study: Patterns of Use in Different Groups

Aim: The study investigates patterns of cocaine powder and crack cocaine use of different groups in nine European cities. Design, Setting, Participants: Multi-centre cross-sectional study conducted in Barcelona, Budapest, Dublin, Hamburg, London, Paris, Rome, Vienna, and Zurich. Data were collected by structured face-to-face interviews. The sample comprises 1,855 cocaine users out of three subgroups: 632 cocaine users in addiction treatment, mainly maintenance treatment; 615 socially marginalized cocaine users not in treatment, and 608 socially integrated cocaine users not in treatment. Measurements: Use of cocaine powder, crack cocaine and other substances in the last 30 days, routes of administration, and lifetime use of cocaine powder and crack cocaine. Findings: The marginalized group showed the highest intensity of cocaine use, the highest intensity of heroin use and of multiple substance use. 95% of the integrated group snorted cocaine powder, while in the two other groups, injecting was quite prevalent, but with huge differences between the cities. 96% of all participants had used at least one other substance in addition to cocaine in the last 30 days. Conclusions: The use of cocaine powder and crack cocaine varies widely between different groups and between cities. Nonetheless, multiple substance use is the predominating pattern of cocaine use, and the different routes of administration have to be taken into account.

Projecting and Monitoring the Life Course of the Marijuana/Blunts Generation

Since the 1990s, marijuana has been the drug of choice among American youths, especially those that tend to sustain arrests. Previous birth cohorts had greater use of crack, powder cocaine, or heroin. This paper summarizes prior research that strongly suggests drug eras tend to follow a regular course. These insights then serve as the basis for projecting trends in marijuana use both for the general population nationwide and for Manhattan arrestees. To the extent that current trends persist, the prospects for the "Marijuana/Blunts Generation" (born 1970 and later) may be relatively good. These young persons may successfully avoid "hard drugs" as well as the attendant health, social, and legal problems for their entire life, but they may experience higher levels of smoking-related ailments. The conclusion presents issues for continued drug surveillance and ethnographic research to more accurately understand the Marijuana/Blunts Era and to provide an indicator of future changes as they occur.

A TASTE FOR PUNISHMENT: Black and White Americans' Views on the Death Penalty and the War on Drugs

It is commonly accepted that Black and White Americans hold divergent views about the criminal justice system. Furthermore, many accept the view that U.S. public opinion is unflinchingly punitive where issues of criminal justice policy are concerned, with this punitiveness among White Americans deriving to a significant degree from anti-Black prejudice. Using a series of survey-based experiments and large, nationally representative samples of White and African American respondents, we subject the questions of Black-White polarization, unyielding punitiveness, and the influence of racial prejudice to close scrutiny. Our results, first, confirm large Black-White differences in opinion with Blacks consistently less punitive than Whites. These differences are substantially a result of beliefs about the extent of racial bias in the criminal justice system. Second, the framing experiments suggest that responses to the death penalty are very different than responses to drug-related crimes like crack or powder cocaine use, with the former exhibiting far less malleability than the latter. Third, racial prejudice is a consistently large influence on White public opinion and a weaker, but sometimes important influence among Blacks as well. Implications for discourse on race and crime are also discussed.

Regional variation in HIV prevalence and risk behaviours in Ontario injection drug users (IDU).

To measure HIV prevalence, risk behaviours, and further service needs in needle exchange programs throughout Ontario, and to conduct regional comparisons. Injection drug users (IDU) recruited through the efforts of needle exchange programme (NEP) staff in 9 Ontario cities during 1997-98 completed questionnaires about their drug use and behaviours and provided saliva and/or dried blood samples for anonymous unlinked HIV testing. Demographic and drug use characteristics of participants showed great regional variation. HIV prevalence by region ranged from 1.4% to 14.7%. In addition to region, HIV positivity was associated with injecting for more than 5 years, use of (powder) cocaine, use of crack, binge injection (10 or more times per day at least once in the previous 6 months), and being a longer-term NEP user. Sharing of injection equipment, and especially of other drug injection materials such as water and cookers, remain important issues, although much of the sharing reported is with only one other person. Unmet demand for methadone treatment was identified despite changes in regulation of methadone provision designed to make it more accessible. This study suggested significant further HIV prevention needs among IDU throughout Ontario. There is also evidence of potential to provide additional services such as methadone at NEPs if the required resources are invested. NEPs that have succeeded in gaining the trust of high-risk IDU offer a means to provide access to needed services.

Research Briefing: Sizing the Market for Powder Cocaine – is a New Approach Needed?

Abstract: This article discusses approaches to assessing the size of the illicit market for powder cocaine, and the inherent difficulties of this issue. It describes recent attempts to investigate more accurate measures of the prevalence and extent of use than have been available to date. A new approach is suggested in which estimates are derived separately ‐ using separate methodologies for different groups of powder cocaine users, and then summed. The review offers some suggestions that future researchers in the area of sizing the drugs market might consider. It suggests that prevalence and consumption estimates for non‐problem users can be improved by re‐weighting the British Crime Survey for characteristics associated with powder cocaine use. Indirect estimates of the number of problem users derived from arrestee and treatment data should be compared.

The relationship among psychological distress, employment, and drug use over time in a sample of female welfare recipients

AbstractIn this study we examined the relationship over time among work experience, psychological distress, and illegal substance use in a sample of 534 women receiving Temporary Assistance for Needy Families. Study participants were interviewed at intake and at 4‐month intervals for a period of 2 years. Each interview recorded the number of hours worked in the previous 4 months and the use of powder cocaine, crack cocaine, heroin, or methamphetamines during the same period. To measure the extent of psychological distress, participants were also administered the personal adjustment problems subscales of the Multidimensional Addictions and Personality Profile (MAPP) at intake and at 1‐year intervals. A path model was analyzed to assess the temporal effects of employment, drug use, and emotional and psychological distress. Results suggest a cycle in which employment at one time period can reduce the likelihood of drug use in the following period, which, in turn, can lead to improvement in distress. This improvement can lead to an increase in the number of hours worked and further improvement in distress levels. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 223–234, 2003.

Does the calendar method enhance drug use reporting among Portland arrestees?

While a plethora of research has ascertained that respondents under‐report their recent use of illicit drugs, few studies have attempted to improve the validity of self‐reported drug use. The Arrestee Drug Abuse Monitoring (ADAM) Program is a federally funded drug use surveillance system that has been collecting data from arrestees since 1987. In 2000, the ADAM Program fielded a new data collection instrument that uses a calendar method to enhance the reporting of personal drug use. To date, however, no research has assessed the degree to which this calendar method has improved drug use reporting among ADAM arrestees. To address this limitation, urinalysis results and 30‐day self‐report measures for marijuana, crack cocaine, powder cocaine, and heroin use collected in Portland in 1999 are compared to identical drug use measures collected in 2000. In addition, kappa statistics for marijuana, crack cocaine, powder cocaine, and heroin use are generated for each of the two time frames. Results indicate that, despite virtually identical drug‐positive rates within the two samples of arrestees, the introduction of the calendar method in 2000 had no significant effect on the reporting of recent marijuana, crack cocaine, powder cocaine, and heroin use. Implications for the ADAM Program and survey methodology are discussed.

ASSESSING THE EFFICACY OF THE CALENDAR METHOD WITH OKLAHOMA CITY ARRESTEES

ABSTRACT While a plethora of research has ascertained that respondents underreport their recent use of illicit drugs, few studies have attempted to improve the validity of self-reported drug use. The Arrestee Drug Abuse Monitoring (ADAM) Program is a federally funded drug use surveillance system that has been collecting data from arrestees since 1987. In 2000, the ADAM Program fielded a new data collection instrument that uses a calendar method to enhance the reporting of personal drug use. To date, however, no research has assessed the degree to which this calendar method has improved drug use reporting among ADAM arrestees. To address this limitation, urinalysis results and 30-day self-report measures for marijuana, crack cocaine, powder cocaine, and heroin use collected in Oklahoma City in 1999 are compared to identical drug use measures collected in 2000. In addition, kappa statistics for marijuana, crack cocaine, powder cocaine, and heroin use are generated for each of the two time frames. Results indicate that, despite virtually identical drug-positive rates within the two samples of arrestees, the introduction of the calendar method in 2000 had no significant effect on the reporting of recent marijuana, crack cocaine, powder cocaine, and heroin use. Implications for the ADAM Program and survey methodology are discussed.

Exploring the Relationship Between Race and the Use of Cocaine

In 1986, Congress passed the Anti-Drug Abuse Act, legislation that provided harsh new penalties for violations involving crackcocaine. Penalties for powdercocaine offenses, however, were not altered proportionally. This legislation has been denounced on the premise that it unfairly targets minority offenders who are presumed to use crack cocaine more than its powder counterpart. To date, however, only a small body of scholarly research has examined the relationship between race and the preference for crack versus powder cocaine, and no studies have examined this nexus over time. In the present study, a temporal exploration is undertaken with a sample of 6,732 adult Houston arrestees surveyed through the Drug Use Forecasting (DUF) Program between 1990 and 1994. Logistic regression identified that the two most powerful predictors of self-reported three-day powdercocaine use were being white and ever having injected drugs illegally. The two most powerful predictors of self-reported three-day crackcocaine use were being black and ever having injected drugs illegally. While being white was a strong predictor of three-day powdercocaine use each year between 1990 and 1994, the association between being black and having recently used crackcocaine diminished considerably over time. Legal implications are assessed in light of the current findings.

Drug use functions predict cocaine‐related problems in young people

AbstractOver the last decade, concern about young people and stimulant drugs has primarily focused on the use of amphetamines and ecstasy. In the United Kingdom, this concern has recently expanded to include the use of cocaine hydrochloride (powder cocaine). This study examined patterns of illicit substance use, with a particular focus on cocaine consumption, among a sample of 364 young drug users aged between 16 and 22 years. The sample was recruited using snowballing methods and respondents were interviewed in informal settings by peer interviewers. Over half the sample reported lifetime use of powder cocaine and just over 40% of these had used crack cocaine. A seven‐item scale was used to measure cocaine‐related problems. The three most common problems endorsed by the cocaine users were impaired control, ‘prioritizing spending money on cocaine over other things’ and being pre‐occupied with using. In a multiple regression analysis, 50% of the variance in cocaine‐related problem scores was predicted by the perceived functions for cocaine use, the number of times of lifetime cocaine use and the total number of days of recent stimulant use. Use of cocaine to alleviate depressed state or negative mood was the most powerful predictor of cocaine problems. The inclusion of a functional appraisal component could be usefully incorporated in further research studies and in service assessment protocols for young people.

Sequences of Powder Cocaine and Crack Use Among Arrestees in Los Angeles County

The epidemic of cocaine abuse has led to numerous studies on the substance. While extent of use, characteristics of users, patterns of use, and consequences of dependence are well documented for both powder cocaine and crack, few studies have dealt with the sequence or progression of use between the two forms of cocaine. This paper draws on arrestee data collected from county jails in Los Angeles, California. It identifies four sequences of powder cocaine and crack use and examines each sequence in terms of user characteristics, history of use, dependence, contact with the criminal justice system, and concomitant use of other drugs. Findings not only confirm some already established observations, but also offer new knowledge on powder cocaine and crack abuse. For instance, (a) whereas powder cocaine–initiated users are more likely to progress to crack than to restrict their use to powder cocaine only, crack-initiated users tend more often to use crack only than to progress to powder cocaine; and (b) powder cocaine and crack, when used interchangeably, can interact and reinforce each other, resulting in a higher level of use and dependence on both forms of the substance. This paper contributes to the understanding of powder cocaine and crack use among criminal offenders, in particular, and across the adult population, in general. It also sheds light on prevention, treatment, and social control policies of both cocaine abuse and overall illicit drug use.

Patterns and Predictors of Cocaine and Crack Use by Clients in Standard and Enhanced Methadone Maintenance Treatment

This paper reports on the patterns of cocaine use among subjects (N = 427) admitted to a methadone maintenance treatment demonstration project designed to reduce risk for HIV. Assessments were conducted at intake and at approximately 18–24 months after treatment admission. Self-reported data on cocaine use was compared with results of urinalysis tests at both intake and follow-up; 29 subjects who falsely reported no use were recoded as users. Over one-third used some form of cocaine at both intake and follow-up, while approximately 30% abstained at both points. Approximately 20% ceased as well as initiated cocaine use between intake and follow-up. Use of powder cocaine, either alone or combined with heroin in “speedballs,” decreased at follow-up, whereas crack use increased. Discriminant function analyses were performed to determine the predictors of the different patterns of cocaine use by type. Receipt of enhanced methadone treatment compared with standard methadone treatment, treatment duration, or average duration of counselor contact appeared unrelated to cocaine use. Cocaine use at follow-up was associated with polydrug and alcohol use, illegal activity, a negative emotional state, and sex work. Crack users were more likely to be African American than nonusers; continuous users of powder cocaine were more likely to also be using heroin than were nonusers: and continuous speedball users were more likely to be women sex workers with high levels of depression. This analysis demonstrated that cessation or continuation of cocaine use after entry into methadone maintenance treatment is not uniform across different types of cocaine.