A paradigm shift is taking place on harm reduction for smoking/inhaling stimulants (crack/paco or coca base paste). When sharing homemade pipes crack users get wounds on lips and gums and are susceptible to diseases such as herpes, tuberculoses, hepatitis and the HIV/AIDS virus. Crack use often implicates risky sexual behaviour in exchange for crack or to buy crack. At the local level in Brazil, Canada and the US ‘safer crack use kits’ are dispensed with condoms, pipes, pipe stems, tissues, vaseline and lip balm to counter infections and sexually transmitted diseases.
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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 2009This 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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Distributing safer crack use kits in Canada
Questions & Answers
Canadian HIV/AIDS Legal Network
September 2008A number of public health departments and community organizations in Canada distribute safer crack use kits to people who use crack cocaine. The kits typically include mouthpieces, glass stems and screens, as well as condoms and referral information for other health and support services. This document outlines why such health programs are needed and answers a number of legal questions related to the distribution of safer crack use kits.
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Characterization of the crack cocaine culture in the city of São Paulo: a controlled pattern of use
Lúcio Garcia de Oliveira and Solange Aparecida NappoRevista Saúde Pública
July 2008In the city of São Paulo, the culture of crack use has undergone considerable changes over these 11 years since it was first described. The sociodemographic profile of the users is practically the same and most use is still compulsive, with significant physical, moral and social impairment among them. Sole use of crack has overwhelmingly been replaced by associations between crack and other drugs, thus characterizing users in the city of São Paulo as multiple drug users.
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Lessons learned from the SCORE project
A document to support outreach and education related to safer crack use
Safer Crack Outreach, Research, and Education (SCORE)
June 2008The aim of this report is to provide key findings related to the SCORE project. It is our hope that the insights that we have gained may be of benefit to others engaged in similar initiatives and to ultimately improve the health of individuals who use crack. The SCORE project (Safer Crack Outreach, Research, and Education) grew out of the vision and hard work of the Safer Crack Use Coalition of Vancouver. Before the SCORE Project was funded, this coalition devoted much energy into raising awareness regarding the insufficient resources aimed at preventing the harms related to crack use.
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Cocaine paste and cannabis in the field of mental health in Chile
Ingrid Tartakowsky LópezJuly 2014Clinical observations and scientific evidence - The use of some drugs in Chile remains silenced in official discourses, making it important to clinically observe the various ways those drugs requiring more attention appear, and which are not seen as a priority in mental health. Specifically, this is the case with cocaine paste, widely used by people living in poverty.
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'Paco' Under Scrutiny
The cocaine base paste market in the Southern Cone
Transnational Institute (TNI)TNI Drugs & Conflict Debate Paper 14
October 2006Based on two studies carried out in the cities of Buenos Aires and Montevideo, this report examines the origin, characteristics and impact of the explosive increase in cocaine base paste in urban areas. It also highlights the variety of products consumed in these cities and the substance known as crack that is consumed in Brazilian cities. The Brazilian experience with this consumption could serve as an example and a lesson for the Southern Cone.
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Substitution therapy for amphetamine users
James Shearer, John Sherman, Alex Wodak and Ingrid van BeekDrug and Alcohol Review (2002) 21, pp. 179-185
June 2002The illicit use of amphetamines continues to be a growing problem in many countries around the world, yet treatment responses remain in need of further development. This is particularly true with regards to pharmacotherapy for amphetamine dependence. In this Harm Reduction Digest four authors who bring together considerable research and clinical experience in this area describe the nature of amphetamine-related problems and consider the role of amphetamine agonists in substitution therapy for amphetamine dependence.
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Crack Heads and Roots Daughters
The Therapeutic Use of Cannabis in Jamaica
Melanie DreherJournal of Cannabis Therapeutics, 2(3-4), 121-133
2002An ethnographic study of women and drug use in inner city neighborhoods in Kingston, Jamaica, revealed that cannabis is commonly used in conjunction with crack cocaine to minimize the undesirable effects of crack pipe smoking, specifically paranoia and weight loss.
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Coca leaf chewing as therapy for cocaine maintenance
Jorge Hurtado GumucioAnnales de médecine interne 151
October 2000The cocaine base, or “pasta”, may be seen as a type of South American crack. Its obligatory method of administration is smoking. A primary condition of the “pasta” smoker is compulsive drug-search behavior and addiction to cocaine base destroys emotional and mental balance. Socio-economic maladjustment is the norm amongst “pasta” addicts. Since 1984 I have recommended the chewing of the coca leaf, between 100 to 200 grams of coca leaf per week for the treatment of cocaine dependence.
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