Evolution of drug use in a cohort of treated crack cocaine users
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/33038 |
Resumo: | OBJECTIVE: To analyze the evolution of drug use among treated crack cocaine users. METHODS: A cohort originally comprising 131 crack addicts admitted to a detoxification unit in the city of São Paulo, Southeastern Brazil, between 1992 and 1994 were followed up on three occasions: 1995-96, 1998-99, and 2005-06. Variables investigated included demographical data, risky sexual behaviors, intake patterns for crack and other substances, incarceration, disappearance, and death. Statistical analysis was carried out using chi-square tests, multinomial logistic regression and Cox regression. RESULTS: Among the patients evaluated, 43 were crack-free (12 months or longer), 22 were users, 13 were imprisoned, two were missing, and 27 were deceased. Three groups with distinct post-discharge drug use patterns were identified. Safe sexual behavior (condom use) was correlated with stable abstinence (p=0.001). Positive HIV test upon admission (p=0.046), use of snorted cocaine in the last year (p=0.001), and lifetime use of snorted cocaine (132 months or longer) (p=0.000) were associated with long term use of crack cocaine. History of intravenous cocaine use increased the probability of death at 12 years by 2.5 fold (p=0.031) (95%CI: 1.08; 5.79). CONCLUSIONS: Recurrence and persistence of crack use in the years following discharge reflect new modalities of drug use. On the other hand, stable abstinence patterns provide evidence of the feasibility of recovery from crack addiction. |
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Evolution of drug use in a cohort of treated crack cocaine users Evolución del consumo de crack en cohorte con historia de tratamiento Evolução do consumo de crack em coorte com histórico de tratamento Usuários de DrogasCocaína CrackTranstornos Relacionados ao Uso de SubstânciasepidemiologiaEstudos de CoortesConsumidores de DrogasCocaína CrackTrastornos Relacionados con SustanciasepidemiologíaEstudios de CohortesDrug UsersCrack CocaineSubstance-Related DisordersepidemiologyCohort Studies OBJECTIVE: To analyze the evolution of drug use among treated crack cocaine users. METHODS: A cohort originally comprising 131 crack addicts admitted to a detoxification unit in the city of São Paulo, Southeastern Brazil, between 1992 and 1994 were followed up on three occasions: 1995-96, 1998-99, and 2005-06. Variables investigated included demographical data, risky sexual behaviors, intake patterns for crack and other substances, incarceration, disappearance, and death. Statistical analysis was carried out using chi-square tests, multinomial logistic regression and Cox regression. RESULTS: Among the patients evaluated, 43 were crack-free (12 months or longer), 22 were users, 13 were imprisoned, two were missing, and 27 were deceased. Three groups with distinct post-discharge drug use patterns were identified. Safe sexual behavior (condom use) was correlated with stable abstinence (p=0.001). Positive HIV test upon admission (p=0.046), use of snorted cocaine in the last year (p=0.001), and lifetime use of snorted cocaine (132 months or longer) (p=0.000) were associated with long term use of crack cocaine. History of intravenous cocaine use increased the probability of death at 12 years by 2.5 fold (p=0.031) (95%CI: 1.08; 5.79). CONCLUSIONS: Recurrence and persistence of crack use in the years following discharge reflect new modalities of drug use. On the other hand, stable abstinence patterns provide evidence of the feasibility of recovery from crack addiction. OBJETIVO: Analizar la evolución del consumo entre usuarios de crack con historia de tratamiento. MÉTODOS: Una cohorte de, originalmente, 131 dependientes de crack admitidos en una enfermería de desintoxicación en Sao Paulo, Sureste de Brasil, entre 1992 y 1994, fueron entrevistados nuevamente en tres ocasiones: 1995-1996, 1998-1999 y 2005-2006. Las variables investigadas fueron: datos demográficos, comportamiento sexual de riesgo, patrones de consumo de crack y otras sustancias, prisiones, desaparecimientos y óbitos. En el análisis estadístico se utilizó la prueba de chi-cuadrado, la regresión logística mulinomial y regresión de Cox. RESULTADOS: De los pacientes evaluados, 43 estaban abstinentes del crack (12 meses o más), 22 eran usuarios, 13 estaban presos, dos desaparecidos y 27 estaban muertos. Se identificaron tres grupos con trayectorias distintas de consumo post-alta. Comportamiento seguro con uso de preservativo fue identificado como factor relacionado al grupo de abstinentes estables (p=0,001). Prueba VIH positiva en la internación (p=0,046); consumo de cocaína aspirada en el último año (p=0,001) y tiempo de uso de cocaína aspirada en la vida (más de 132 meses) (p=0,000) fueron factores relacionados al uso por largo tiempo. Uso previo de cocaína endovenosa aumentó en 2,5 veces las chances de óbito en 12 años (p=0,031) (IC95%:1,08;5,79). CONCLUSIONES: La recurrencia y persistencia de consumo en los años post-alta de tratamiento reflejan nuevas modalidades de uso de crack. Por otro lado, patrones de abstinencia estable apuntan la viabilidad de los procesos de recuperación relativos al uso de crack. OBJETIVO: Analisar a evolução do consumo entre usuários de crack com histórico de tratamento. MÉTODOS: Uma coorte de, originalmente, 131 dependentes de crack admitidos em uma enfermaria de desintoxicação em São Paulo, SP, entre 1992 e 1994, foi re-entrevistada em três ocasiões: 1995-1996, 1998-1999 e 2005-2006. As variáveis averiguadas foram: dados demográficos, comportamento sexual de risco, padrões de consumo de crack e outras substâncias, prisões, desaparecimentos e óbitos. Na análise estatística empregou-se o teste de qui-quadrado, a regressão logística multinomial e regressão de Cox. RESULTADOS: Dos pacientes avaliados, 43 estavam abstinentes do crack (12 meses ou mais), 22 eram usuários, 13 estavam presos, dois desaparecidos e 27 estavam mortos. Foram identificados três grupos com trajetórias distintas de consumo pós-alta. Comportamento seguro com uso de preservativo foi identificado como fator relacionado ao grupo de abstinentes estáveis (p = 0,001). Teste HIV positivo na internação (p = 0,046); consumo de cocaína aspirada no último ano (p = 0,001) e tempo de uso de cocaína aspirada na vida (mais de 132 meses) (p = 0,000) foram fatores relacionados a uso de longo termo. Uso pregresso de cocaína endovenosa aumentou em 2,5 vezes as chances de óbito em 12 anos (p = 0,031) (IC95%: 1,08; 5,79). CONCLUSÕES: A recorrência e persistência do consumo nos anos pós-alta de tratamento refletem novas modalidades de uso do crack. Por outro lado, padrões de abstinência estável apontam a viabilidade dos processos de recuperação relativos ao uso de crack. Universidade de São Paulo. Faculdade de Saúde Pública2011-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3303810.1590/S0034-89102011005000049Revista de Saúde Pública; Vol. 45 No. 5 (2011); 938-948 Revista de Saúde Pública; Vol. 45 Núm. 5 (2011); 938-948 Revista de Saúde Pública; v. 45 n. 5 (2011); 938-948 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/33038/35701https://www.revistas.usp.br/rsp/article/view/33038/35702Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessDias, Andréa CostaAraújo, Marcelo RibeiroLaranjeira, Ronaldo2012-07-11T22:51:47Zoai:revistas.usp.br:article/33038Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-11T22:51:47Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Evolution of drug use in a cohort of treated crack cocaine users Evolución del consumo de crack en cohorte con historia de tratamiento Evolução do consumo de crack em coorte com histórico de tratamento |
title |
Evolution of drug use in a cohort of treated crack cocaine users |
spellingShingle |
Evolution of drug use in a cohort of treated crack cocaine users Dias, Andréa Costa Usuários de Drogas Cocaína Crack Transtornos Relacionados ao Uso de Substâncias epidemiologia Estudos de Coortes Consumidores de Drogas Cocaína Crack Trastornos Relacionados con Sustancias epidemiología Estudios de Cohortes Drug Users Crack Cocaine Substance-Related Disorders epidemiology Cohort Studies |
title_short |
Evolution of drug use in a cohort of treated crack cocaine users |
title_full |
Evolution of drug use in a cohort of treated crack cocaine users |
title_fullStr |
Evolution of drug use in a cohort of treated crack cocaine users |
title_full_unstemmed |
Evolution of drug use in a cohort of treated crack cocaine users |
title_sort |
Evolution of drug use in a cohort of treated crack cocaine users |
author |
Dias, Andréa Costa |
author_facet |
Dias, Andréa Costa Araújo, Marcelo Ribeiro Laranjeira, Ronaldo |
author_role |
author |
author2 |
Araújo, Marcelo Ribeiro Laranjeira, Ronaldo |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Dias, Andréa Costa Araújo, Marcelo Ribeiro Laranjeira, Ronaldo |
dc.subject.por.fl_str_mv |
Usuários de Drogas Cocaína Crack Transtornos Relacionados ao Uso de Substâncias epidemiologia Estudos de Coortes Consumidores de Drogas Cocaína Crack Trastornos Relacionados con Sustancias epidemiología Estudios de Cohortes Drug Users Crack Cocaine Substance-Related Disorders epidemiology Cohort Studies |
topic |
Usuários de Drogas Cocaína Crack Transtornos Relacionados ao Uso de Substâncias epidemiologia Estudos de Coortes Consumidores de Drogas Cocaína Crack Trastornos Relacionados con Sustancias epidemiología Estudios de Cohortes Drug Users Crack Cocaine Substance-Related Disorders epidemiology Cohort Studies |
description |
OBJECTIVE: To analyze the evolution of drug use among treated crack cocaine users. METHODS: A cohort originally comprising 131 crack addicts admitted to a detoxification unit in the city of São Paulo, Southeastern Brazil, between 1992 and 1994 were followed up on three occasions: 1995-96, 1998-99, and 2005-06. Variables investigated included demographical data, risky sexual behaviors, intake patterns for crack and other substances, incarceration, disappearance, and death. Statistical analysis was carried out using chi-square tests, multinomial logistic regression and Cox regression. RESULTS: Among the patients evaluated, 43 were crack-free (12 months or longer), 22 were users, 13 were imprisoned, two were missing, and 27 were deceased. Three groups with distinct post-discharge drug use patterns were identified. Safe sexual behavior (condom use) was correlated with stable abstinence (p=0.001). Positive HIV test upon admission (p=0.046), use of snorted cocaine in the last year (p=0.001), and lifetime use of snorted cocaine (132 months or longer) (p=0.000) were associated with long term use of crack cocaine. History of intravenous cocaine use increased the probability of death at 12 years by 2.5 fold (p=0.031) (95%CI: 1.08; 5.79). CONCLUSIONS: Recurrence and persistence of crack use in the years following discharge reflect new modalities of drug use. On the other hand, stable abstinence patterns provide evidence of the feasibility of recovery from crack addiction. |
publishDate |
2011 |
dc.date.none.fl_str_mv |
2011-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/33038 10.1590/S0034-89102011005000049 |
url |
https://www.revistas.usp.br/rsp/article/view/33038 |
identifier_str_mv |
10.1590/S0034-89102011005000049 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/33038/35701 https://www.revistas.usp.br/rsp/article/view/33038/35702 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 45 No. 5 (2011); 938-948 Revista de Saúde Pública; Vol. 45 Núm. 5 (2011); 938-948 Revista de Saúde Pública; v. 45 n. 5 (2011); 938-948 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221792594296832 |