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Cannabis to substitute crack
A step by step rehabilitation
Tom Blickman Amira ArmentaMonday, April 22, 2013
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The mayor of Bogota has recently proposed a pilot scheme with crack cocaine addicts to explore the substitution of crack made of cocaine base paste (or bazuco as it is called in Colombia) by marijuana. The substitution treatment plan will include 15 problematic users from the marginalized Bronx area who are already receiving health assistance of the CAMAD operating in that sector of the city. The treatment will last approximately eight months, after which the results will be evaluated. -
Cannabis as a substitute for alcohol and other drugs
A dispensary-based survey of substitution effect in Canadian medical cannabis patients
Philippe Lucas, Amanda Reiman, Mitch Earleywine, Stephanie K. McGowan, Megan Oleson, Michael P. Coward & Brian ThomasAddiction Research & Theory
November 20, 2012
This article examines the subjective impact of medical cannabis on the use of both licit and illicit substances via self-report from 404 medical cannabis patients recruited from four dispensaries in British Columbia, Canada. The aim of this study is to examine a phenomenon called substitution effect, in which the use of one product or substance is influenced by the use or availability of another.
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Cocaine addiction treatments to improve control and reduce harm (CATCH)
New pharmacological treatment options for crack-cocaine dependence in the Netherlands
Mascha Nuijten, Peter Blanken, Wim van den Brink and Vincent HendriksBMC Psychiatry 2011, 11:135
August 2011
Cocaine, particularly in its base form ('crack'), has become one of the drugs of most concern in the Netherlands, being associated with a wide range of medical, psychiatric and social problems for the individual, and with significant public order consequences for society. Available treatment options for cocaine dependent users are limited, and a substantial part of the cocaine dependent population is not reached by the addiction treatment system.
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Uptake, benefits of and barriers to safer crack use kit (SCUK) distribution programmes in Victoria, Canada
A qualitative exploration
Andrew Ivsins, Eric Roth, Nadine Nakamura, Mel Krajden & Benedikt FischerInternational Journal of Drug Policy 22(4):292-300
July 2011Crack use is prevalent amongst street drug users in Canadian cities, and associated with severe drug use, health and social problems. Whilst few targeted interventions are available for crack use, the common use and sharing of hazardous makeshift paraphernalia are a key concern, as these risks may be associated with oral injury and blood-borne virus (BBV) transmission amongst users. Recently, distribution programmes of so-called 'safer crack use kits' (SCUKs) have been initiated in select Canadian cities, primarily to reduce the use of unsafe materials and paraphernalia sharing amongst crack users. This study explored uptake and benefits of, barriers to, and possible improvements to two recently implemented SCUK distribution programme in Victoria, Canada.
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Do crack smoking practices change with the introduction of safer crack kits?
Leslie A. Malchy, Vicky Bungay, Joy L. Johnson & Jane BuxtonCanadian Journal of Public Health 102(3):188-92.
May-June 2011Crack smoking has increased in Vancouver despite the harms associated with its use. Many people who smoke crack share their equipment, thereby increasing their risk for infectious disease. This project explored the effects of outreach distribution of "safer crack kits" on smoking practices. While kit distribution made safer use items more accessible, its impact on safer use practice was limited. Our findings highlight the need for targeted distribution of safer use items. Future research should explore the dynamics of unsafe crack smoking practices and ways to leverage safer use messaging.
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The Safer Crack Use Program
Fact sheet
Toronto Public Health
June 2010
This fact sheet explains the Safer Crack Use Program of the Public Health Department of Toronto (Canada). In Toronto, a range of community-based, government and institutional agencies deliver harm reduction services. As with other harm reduction measures, there is no evidence that the distribution of safer crack use kits encourages drug use. Only people who are already using crack cocaine participate in the Safer Crack Use Program.Download the document (PDF)
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The fast and the furious
Cocaine, amphetamines and harm reduction
Jean-Paul Grund, Philip Coffin, Marie Jauffret-Roustide, Minke Dijkstra, Dick de Bruin and Peter BlankenEuropean Monitoring Centre for Drugs and Drug Addiction (EMCDDA)
April 2010
Harm reduction programmes targeting stimulants like cocaine and (meth)amphetamines in several countries have shown positive results. However, these programmes are limited to Australia and North America. As the effectiveness of pharmacological and psychosocial interventions for stimulant users is limited, interventions to stabilise and minimise the negative consequences of ongoing methamphetamine use are of paramount importance. A wide range of health and social problems associated with stimulant use are largely unaddressed by current services.
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Smoking of crack cocaine as a risk factor for HIV infection among people who use injection drugs
Kora DeBeck et. al.Canadian Medical Association Journal (CMAJ)
October 27, 2009This paper examined whether use of crack cocaine has become a risk factor for HIV infection. Smoking of crack cocaine was found to be an independent risk factor for HIV seroconversion among injection drug users. This finding points to the urgent need for evidence-based public health initiatives targeted at people who smoke crack cocaine. Innovative interventions that have the potential to reduce HIV transmission in this population, including the distribution of safer crack kits and medically supervised inhalation rooms, need to be evaluated.
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Randomized controlled trial of dexamphetamine maintenance for the treatment of methamphetamine dependence
Marie Longo, Wendy Wickes, Matthew Smout, Sonia Harrison, Sharon Cahill & Jason M. WhiteAddiction 105, pp. 146–154
June 2009
This study tested the impact of a long-acting form of amphetamine as medication to help control dependent use of the closely allied stimulant, methamphetamine. Prescribed usually for the treatment of pathological sleepiness or attention deficit/hyperactivity disorder, effects of the amphetamine tablets prescribed in the study take several hours longer to emerge than normal amphetamine and last three to six hours longer, giving it a 'smoothing' profile similar to methadone for heroin users; non-rapid onset make it less intensely pleasurable, and longer duration suits it to once-daily administration.
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Opportunities to learn and barriers to change
Crack cocaine use in the Downtown Eastside of Vancouver
Susan Boyd, Joy L. Johnson and Barbara MoffatHarm Reduction Journal 2008, 5:34
November 17, 2008In 2004, a team comprised of researchers and service providers launched the Safer Crack Use, Outreach, Research and Education (SCORE) project in the Downtown Eastside of Vancouver, British Columbia, Canada. The project was aimed at developing a better understanding of the harms associated with crack cocaine smoking and determining the feasibility of introducing specific harm reduction strategies.
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