Factors Associated with Crack Cocaine Early Initiation: A Brazilian Multicentric Study

Abstract

Background: Crack cocaine is a serious public health issue, with many psychiatric and psychosocial consequences. The crack cocaine user is usually inserted in a context of great social vulnerability, often associated to violence, unstructured family functioning, antisocial peer factors and easy access to the consumption of alcohol, tobacco and illicit drugs such as crack, since an early age. Objective: To compare whether there was a relative influence of risk and protection factors in several domains on the age of onset of crack use by therapeutic community patients. Methods: This cross-sectional enrolled a consecutive sample of 577 patients admitted to 20 therapeutic communities located in different Brazilian states between September 2012 and September 2013. A detailed structured questionnaire was developed to be used that included investigations into possible pre-use predictive factors, such as parental monitoring in childhood, deviant behaviors and peer pressure, and subsequent factors such as deviant behaviors and involvement with crime. Student t test were performed to assess the association between associated factors and the mean age of onset of crack use. Results: The presence of constant problems in the family relationship (p=0.0020), situations of maltreatment (p=0.0162), and the presence of deviant behaviors resulted in significant differences in the age at which crack consumption began. Whereas, adolescents who had parental monitoring until the beginning of adolescence started use later (p=0.000). Conclusions: The age of onset of crack consumption seems to be influenced by numerous combinations of protective and risk factors, within a system that integrates social environments, relationship groups, individual characteristics and behavior patterns, highlighting these factors will allow the development of prevention strategies, as well as specific control strategies, both based on scientific-based information.