OBJECTIVE:To understand crack cocaine craving among users and describe craving behaviors and coping strategies.

OBJECTIVE:To characterize the situation regarding crack cocaine use in the city of São Paulo, along with the sociodemographic profi le of its users. METHODOLOGICAL PROCEDURES:Qualitative ethnographic study carried out with an intentional sample of crack cocaine users (n=45) and former users (n=17). The participants were recruited by means of the chain sampling method and they underwent a semi-structured interview guided by a questionnaire, in 2004 and 2005. The combination of each question and its respective responses gave rise to specifi c reports that were interpreted individually. ANALYSIS OF THE RESULTS:The predominating profi le of the crack cocaine users was that they were single young men of low socioeconomic class and low schooling level, without formal employment ties. The pattern of use most frequently cited was compulsive, characterized by multiple drug use and carrying out illegal activities in exchange for crack cocaine or money. However, controlled use was also identifi ed. This consisted of non-daily use of crack cocaine mediated by individual factors that were developed intuitively by the user. Controlled use was similar in nature to the strategies adopted by former users to achieve a state of abstinence. CONCLUSIONS:The culture of crack cocaine use has undergone changes regarding the pattern of use. Although most users do so compulsively, the existence of controlled use was observed. This deserves to be investigated in more detail, particularly with regard to the strategies adopted to attain this.

OBJETIVO: Identificar, entre usuários de crack, uma progressão no uso de drogas e seus fatores interferentes. MÉTODOS: Utilizou-se metodologia qualitativa para uma investigação mais profunda, considerando o ponto de vista que o entrevistado tem do fenômeno. Foram aplicados entrevistas de longa duração e questionários semi-estruturados. Foi delineada uma amostra intencional, e uma amostragem com critérios foi conseguida. Para atingir a saturação teórica, foram entrevistados 31 usuários ou ex-usuários de crack. RESULTADOS: Foram detectadas duas fases distintas de uso de drogas. A primeira, com drogas lícitas, sendo o cigarro e o álcool as mais citadas pela amostra. Parentes e amigos dos entrevistados foram os incentivadores do consumo, e o motivo alegado para o uso dessas substâncias foi a necessidade de autoconfiança. A idade precoce do consumo e o uso pesado de uma ou ambas as drogas foram determinantes para o início de uma escalada de drogas ilícitas. A maconha foi a primeira droga dessa segunda fase. Uma postura mais ativa na busca da droga como fonte de prazer passou a ser o motivo do consumo. CONCLUSÕES: O estudo revela que a identificação de uma seqüência de drogas parece estar mais associada a fatores externos (pressões de grupo, influência do tráfico etc.) do que à preferência do usuário. Foram identificadas duas progressões diferentes: entre os mais jovens (=30 anos), cuja a escalada começou com o cigarro e/ou álcool e passou pela maconha e cocaína aspirada até o uso de crack; e os mais velhos (>30 anos), que iniciaram o uso de drogas pelo cigarro e/ou álcool, seguido de maconha, medicamentos endovenosos, cocaína aspirada, cocaína endovenosa e, por fim, crack.

OBJECTIVE:To characterize the situation regarding crack cocaine use in the city of São Paulo, along with the sociodemographic profi le of its users. METHODOLOGICAL PROCEDURES:Qualitative ethnographic study carried out with an intentional sample of crack cocaine users (n=45) and former users (n=17). The participants were recruited by means of the chain sampling method and they underwent a semi-structured interview guided by a questionnaire, in 2004 and 2005. The combination of each question and its respective responses gave rise to specifi c reports that were interpreted individually. ANALYSIS OF THE RESULTS:The predominating profi le of the crack cocaine users was that they were single young men of low socioeconomic class and low schooling level, without formal employment ties. The pattern of use most frequently cited was compulsive, characterized by multiple drug use and carrying out illegal activities in exchange for crack cocaine or money. However, controlled use was also identifi ed. This consisted of non-daily use of crack cocaine mediated by individual factors that were developed intuitively by the user. Controlled use was similar in nature to the strategies adopted by former users to achieve a state of abstinence. CONCLUSIONS:The culture of crack cocaine use has undergone changes regarding the pattern of use. Although most users do so compulsively, the existence of controlled use was observed. This deserves to be investigated in more detail, particularly with regard to the strategies adopted to attain this.

The consumption of psychotropic drugs among Brazilian secondary school students was examined by comparing data from four surveys using a questionnaire adapted from the WHO's Program on Research and Reporting on the Epidemiology of Drug Dependence. Students filled out the form in their classrooms without the presence of teachers. The target population consisted of 10-18-year-old students (on average, 15,000 students responded to each survey) in Brazil's ten largest state capitals: Belém, Belo Horizonte, Brasília, Curitiba, Fortaleza, Porto Alegre, Recife, Rio de Janeiro, Salvador, and São Paulo. Among the legal drugs, lifetime use (use at least once during life) of tobacco was increased in seven cities (the exceptions were Brasília, Porto Alegre and Rio de Janeiro). There was also a significant increase in frequent use of alcohol (six times or more per month) in 6 of the cities, from an average of 9.2% in 1987 to 15.0% in 1997. With respect to illegal drugs, there was a significant increase in lifetime use of marijuana (a 3-fold increase from 2.8% in 1987 to 7.6% in 1997). Cocaine use increased 4-fold over the survey period (0.5% in 1987 to 2.0% in 1997). Lifetime use of cocaine significantly increased in eight capitals (except Recife and Rio de Janeiro). However, frequent cocaine use increased in only three capitals (Belém, Fortaleza and Porto Alegre), from an average of 1.0% in 1987 to 3.6% in 1997. Lifetime use of medications such as anxiolytics and amphetamines increased 2-fold on average over the survey period. Comparing the four studies, the main conclusion is that there were significant increases in the frequencies for lifetime use, frequent use and heavy use of many drugs