Crack Cocaine—Accelerating Use in Brazil

Andrea  Domanico

Andrea Domanico1, M. Malta2, C. Latkin1. 1Johns Hopkins Bloomberg School of Public Health, United States; 2Sergio Arouca Public Health School, FIOCRUZ, Brazil

Around 1987, crack cocaine appeared in Brazil and began to be used by the poor in São Paulo and Salvador. Interestingly, powder cocaine dealers in Rio de Janeiro prohibited sales and distribution of crack in the city for many years because they felt that increasing crack use would have a negative effect on their markets. Therefore, they decreased the price of cocaine powder so that users would continue to consume this rather than move to crack. However, in about 2000, drug dealers in Rio de Janeiro began to allow the use and sale of crack in the favelas (i.e., slums; favelas is the generally used term for shantytown in Brazil). What followed was an increase in drug-related harm and crimes (murders, drug arrests, infectious diseases such as HIV, hepatitis C virus, and tuberculosis) in the favelas. This change has led crack cocaine to be viewed and treated by other Brazilians as the main problem of the favelas, taking the focus away from the long-entrenched social problems of poverty and segregation. In addition, crack cocaine users are perceived as a population of drug users who are difficult to engage with harm reduction services including infectious disease prevention interventions.

This session will present an analysis of “news” in the “television news” that present crack cocaine, consider theories on why change in drug use and associated public perceptions has developed, and highlight some harm reduction initiatives delivered between 2001– 2006 that showed promise in reducing drug use, related crimes, and associated health problems. It also will demonstrate how harm reduction interventions, with an emphasis on respecting human rights, appear to be effective in addressing some of the problems associated with crack use.

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Latin America & Caribbean
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