Factors associated with crack-cocaine early initiation: a Brazilian multicenter study

Abstract

Background Crack-cocaine dependence is a serious public health issue, related to several psychiatric and psychosocial problems. Crack-cocaine users are usually embedded in a context of great social vulnerability, often associated with violence, poverty, family conflict and easy and early access to alcohol, tobacco and other drugs. Methods This cross-sectional study enrolled a consecutive sample of 577 patients admitted to 20 therapeutic communities located in Southern Brazil, between September 2012 and September 2013. A structured interview assessed life-time exposure to risk and protective factors for drug use, such as parental monitoring in childhood, deviant behaviors and peer pressure. Results Presence of family conflict (p = 0.002), maltreatment (p = 0.016), and deviant behavior prior to age 15 in a bivariate analysis predicted an earlier age of crack-cocaine initiation, whereas adolescents experiencing parental monitoring during adolescence started use later (p < 0.001). In the multivariate model, perceptions related to ease of access of illicit drugs (marijuana: p = 0.028, 95% CI = − 3.81, − 0.22; crack-cocaine: p < 0.001, 95% CI = − 7.40, − 4.90), and deviant behavior (threatening someone with a gun: p = 0.028, 95% CI = − 2.57, − 0.14) remained independent predictors of early age of crack-cocaine initiation. Conclusions Early onset of crack-cocaine use seems to be associated with exposure to family conflict, easy access to drugs and deviant behavior. Treatment and preventive programs should take these factors into account when designing and implementing community interventions.

Factores de riesgo y protección del consumo de drogas ilícitas en adolescentes latinoamericanos

“…De los 17 estudios incluidos algunos fueron realizados en México (Alonso et al, 2018;Álvarez et al, 2011;Ramírez et al, 2020;Vega et al, 2018;Villatoro et al, 2016), Colombia (Aguirre et al, 2017González & Lodoño, 2017;Moreno & Palomar, 2017;Trujillo et al, 2019), Brasil (Carvalho et al, 2015Da Silva et al, 2021;Perrenoud et al Revista inteRnacional de investigación en adicciones 2023.9(1).101-112…”

“…En México y Brasil se describen los factores de riesgo socioambientales, los cuales apoyan la idea de que vivir en barrios inseguros se relaciona con una alta prevalencia de consumo, así como vivir en territorios de alta circulación de drogas (Alonso et al, 2018;Álvarez et al, 2011;Da Silva et al, 2021;Perrenoud et al, 2021;Villatoro et al, 2016). Además, en Argentina se documentó que la falta de apoyo social del gobierno, la influencia negativa de los medios masivos de comunicación y del ambiente social, son factores de riesgo socioambientales que favorecen el consumo de drogas ilícitas en los adolescentes (Páramo, 2011).…”

Comparison of risk and protective factors associated with the prevalence of alcohol and drug addiction among young people, adults and the elderly: an integrative review

“…• Marital relationship problems 28 • Encouraging educational activities 42 • Anxiety and Depressive Disorder 28,38,40,44 • Religious Activities 41,28,42,44 • Use of tobacco and/or alcohol in adolescence 28,42,36,43 • Implement anti-drug education policies and programs 28,38,42,36,43,44 • Difficulty in accessing psychosocial rehabilitation services 30.44 • Avoidance of individual and group therapies 44 • Humanization and empathy in the treatment for rehabilitation in chemical dependency 30,39,40 • Social stigmas regarding the use of being a drug user 30,44 • Demotivation to seek help 30 • Health professionals specialized in the treatment of chemical dependence 30,40 • History of violence and abuse in adolescence 34,36 • Family conflicts 34 • Participation in therapeutic groups and self-help 39 • Living with family and friends who are drug users 40,34,36,44 • Misconduct/involvement in crime 34,36,44 • Facilitate access to psychosocial rehabilitation services chemical dependence 30,44 • deprivation of liberty • School dropout or low academic performance 38,40,36,…”

Fatores de risco e proteção decorrentes do uso de crack na capital do Brasil

“…A possibilidade de controlar e reduzir danos por meio da articulação de estratégias programadas e orientadas com vistas a melhorar as condições físicas, psíquicas e sociais do usuário de drogas, fortalece a tomada de decisão pelos profissionais de saúde nos serviços de saúde mental 3,4 . Sob a perspectiva da abordagem biopsicossocial, o aprimoramento do estudo sobre esses fatores no contexto de uso de substâncias psicotrópicas com especificidade para o crack possibilita subsidiar a tomada de decisão no planejamento terapêutico, na gestão da organização do trabalho em equipes de saúde multidisciplinares e no aperfeiçoamento da formulação de políticas públicas no âmbito da saúde mental 5 .…”