Smoking Crack Cocaine Research Articles

Crack cocaine smokers as adult children of alcoholics: The dysfunctional family link

The paper presents data on a sample (N = 61) of crack-cocaine-dependent patients who were treated on an inpatient detoxification unit. The investigation explores adult child of an alcoholic status as a possible etiological factor in the development of addiction to crack cocaine. Data suggests the prevalence of adult child of an alcoholic (ACA) status in this population (61%). Adult child of a dysfunctional family (ACDF) status is also explored as possibly playing an important role as an antecedent or determinant of addiction. The vast majority of patients are adult children of a dysfunctional family (ACDF) of one kind or another (97%); for example, patients experienced domestic violence (25%) and physical abuse (28%). Perhaps as a result of less than ideal object relations in dysfunctional families, many patients were also diagnosed as having personality disorders (31%) or affective disorders (21%). Case vignettes augment research findings, supporting the contention that childhood development in a dysfunctional family constitutes a specific etiological factor in the development of crack cocaine dependence. The paper recommends matching crack-addicted ACAs/ACDFs to treatment modalities that address and remediate the personality and emotional problems that characterize ACAs/ACDFs.

PASSIVE INHALATION OF COCAINE BY INFANTS

Cocaine abuse has increased greatly in recent years, creating important medical, legal, and social problems. Urine drug testing is used to diagnose cocaine ingestion. The presence of the cocaine metabolite benzoylecgonine (BZ) is commonly believed to be proof of recent cocaine intoxication. However, oral ingestion of even a minute quantity of cocaine can result in a positive test result. BZ was detected in the urine of four nonbreast-fed infants aged 6 weeks to 14 months who were admitted with diagnoses unrelated to cocaine poisoning. These infants were exposed to cocaine by passive inhalation of vapors generated by adult caretakers smoking crack cocaine. Two of the infants were retested 12 hours later and had no detectable BZ, strongly suggesting ingestion of a subpharmacologic amount of cocaine. Because passive inhalation of cocaine can produce measurable urine BZ concentrations, a positive urine screen does not necessarily indicate poisoning or intentional administration of the substance and therefore is not proof of child abuse or neglect.

Federal Officials Plot Strategy To Stop Methamphetamine Spread

Just two years ago, Hawaiian officials believed their state had dodged the worst of the drug epidemic that has plagued the U.S. mainland. Forewarned by law enforcement and drug treatment professionals from other states, Hawaii had mounted a vigorous education campaign that seemed successfully to steer its citizens away from using crack, the smokable form of cocaine. But during 1987 the state realized it was becoming mired in a drug crisis of its own: Hawaiians, in escalating numbers, were smoking ice, rocklike crystals of methamphetamine imported from Asia. Smoking methamphetamine ice gives the user a high very similar to smoking crack cocaine—but one that lasts for hours rather than minutes. Now federal officials are hoping Hawaii's experience can be used to help prevent ice from becoming the drug nemesis of the '90s throughout the U.S. Last month, Rep. Charles B. Rangel (D.-N.Y.), chairman of the House Select Committee on Narcotics Abuse, convened a hearing on ...

Outpatient treatment of 'crack' cocaine smoking with flupenthixol decanoate. A preliminary report.

"Crack" cocaine abuse often produces severe cocaine dependence that is refractory to available pharmacological and outpatient psychotherapeutic treatments. We conducted two preliminary investigations evaluating the efficacy of flupenthixol decanoate, a depot xanthene requiring infrequent intramuscular administration, in the treatment of cocaine withdrawal. Ten outpatient crack cocaine smokers with poor prognoses were administered flupenthixol decanoate in an open-label, open-ended trial. Flupenthixol decanoate was well tolerated and appeared to decrease cocaine craving and use markedly and rapidly, producing a 260% increase in the average time retained in treatment among these subjects. These promising but preliminary data, combined with the magnitude of problems presented by crack, warrant rapid, expanded double-blind assessment of flupenthixol decanoate in cocaine-abuse treatment.

Psychological and environmental determinants of relapse in crack cocaine smokers

The paper reviews approaches to relapse in the treatment of cocaine abusers. Approaches reveal a common mechanism underlying relapse that involves drug craving, recall of euphoria, environmental cues, denial, myths of being able to sell or use drugs, and painful affect states necessitating use of a multifaceted clinical technique. Empirical validation of a common mechanism underlying relapse establishes a typology of psychological and environmental determinants of relapse for crack cocaine smokers (N = 35) who relapse after hospital detoxification and return a second time. Major findings are that relapse follows a painful emotional state (40%), failure to enter arranged aftercare treatment (37%), or encounters with conditioned environmental stimuli (34%), and involves narcissistic psychopathology and denial (28.5%) and interpersonal stress (24%); 85.7% involve multideterminants. Case examples illustrate the role of multideterminants in relapse. The paper educates clinicians to the integrated theory and multifaceted clinical technique necessary for efficacious treatment of cocaine patients, while the typology predicts probable relapse situations.

Relapse prevention in psychoeducational groups for compulsive crack cocaine smokers

The paper presents a model of relapse prevention that utilizes metaphor, education, and psychodynamic and cognitive-behavioral principles in psychoeducational groups for compulsive crack cocaine smokers during inpatient detoxification. Relapse prevention teaches engagement in preventive alternative behaviors after inpatient detoxification. Clinical interventions impress patients with the nature of their psychological vulnerability to internal and external dangers and the importance of aftercare treatment post detoxification to receive needed support negotiating high risk situations. The paper provides a detailed description of the group process and of the actual interventions the clinician utilizes, thereby expanding clinical options on what to do and say when educating patients on relapse. Interventions prepare patients to negotiate the numerous high risk situations they will encounter after inpatient treatment that could easily trigger relapse. Psychoeducation provides patients with a cognitive and intellectual framework in which to understand the process of psychotherapy, the difficulties regulating affect and self esteem, and how aftercare treatment addresses their psychological problems and decreases chances of relapse.

The reliability and validity of interview data obtained from 59 narcotic drug addicts.

The reliability and validity of interview data obtained from 59 narcotic drug addicts.