ABSTRACT
Nine years the beginning of the first reported nationwide epidemic of freebase (crack) cocaine abuse, which occurred in the Bahamas, a follow-up study was done to determine the pattern of the epidemic and the effectiveness of control measures. Data included the incidence of new cases at the only psychiatric hospital in the Bahamas and the primary community pschiatric clinic in the nation. Data on police arrests, drug seizures, and results for urine screenings for cocaine abuse came from the reports of the Royal Bahamas Police Force. The number of new cases of crack abuse presenting for treatment fell from 1987 to mid-1991, with a corresponding reduction of load at the treatment facilities. However, hospitalized cocaine abuse cases began rising again in mid-1991. This paper analyzes correlates of the fall and partial resurgences of the epidemic. In 1992, crack is much more difficult to obtain than in the early and middle 1980's. The Bahamian reponse to the epidemic - including 1) demand reduction, 2) supply reduction and 3) reduction of money laundering - played an important role in the decline of new cases. Crack has not been replaced by other illegal drugs, but alcohol has resumed its former place of preference. However, despite a reduction in the rate of new crack abuse cases appearing for treatment, there has been a recent rise in violent, robberies and gang activity. This apparently is due to chronic cocainism, a pattern of long term use of crack and other forms cocaine that is resistant to treatment