Association between alcohol and crack: Prevalence, effects, associated factors and experiences of combined use.

OBJECTIVE: To estimate the prevalence and factors associated with the effect of alcohol on crack cocaine use and to analyze experiences related to combined use. Materials and methods: sequential mixed methods (qualitative and quantitative) research, carried out between August 2014 and August 2015 with people who use crack. In the quantitative approach, a cross-sectional study was conducted with 1,062 participants. Factors associated with "alcohol use with the effect of increasing the effect of crack/crack craving" were estimated by multiple regression. In the qualitative approach, 39 interviews were conducted using Bardin's content analysis technique. RESULTS: 871 (82.0%) participants reported consuming alcohol, among them, 668 (76.7%) used alcohol combined with crack: 219 (32.8%) reported feeling an effect of reduction in paranoia and/or crack craving and 384 (57.5%) reported feeling an increase in the effect of crack and in the craving to consume the drug. This relationship was also observed in the narratives of the people who use crack, with the possibility of a cyclic effect of consumption of the two substances. Those who related alcohol use to the effect of increasing crack craving (384) were more likely to use alcohol before crack (OR: 1.81; 95%CI: 1.13-2.89); to consume more than 20 stones daily (OR: 1.48; 95%CI: 1.01-2.16); to remain in abstinence from crack for less than one month (OR: 3.20; 95%CI: 1.91-5.35); to use dependence treatment services (OR: 1.85; 95%CI: 1.26-2.71); and to commit physical violence (OR:1.67; 95%CI:1.08-2.56). CONCLUSION: The findings of this study indicate that the modulation of the effect of alcohol use on crack cocaine depends on the moment when the drugs are consumed, and the use of alcohol before crack consumption is associated with characteristics that suggest a greater vulnerability to patterns of harmful crack use. Even though combined use is referred to as a way of reducing the negative effects of crack, the damage of this association may be greater than its possible benefits.

Histórico de violência entre mulheres que fazem uso de crack no estado de Pernambuco, Brasil / History of violence among women who use crack in the state of Pernambuco, Brazil

RESUMO Neste artigo, abordou-se o histórico de violência contra mulheres em contexto de uso abusivo de crack. Trata-se de um estudo transversal, envolvendo 243 usuárias de crack atendidas pelo Programa Atitude, em Pernambuco, entre 2014 e 2015. Observou-se que a maioria era jovem, negra, com baixa escolaridade e renda, início precoce da vida sexual, em uso compulsivo de crack, morando na rua e comercializando o corpo como a principal fonte de renda. A maioria (96,2%) relatou histórico de violência: psicológica (83,5%), física (87,7%) e sexual (55,1%), praticadas por parentes/amigos. Fatores como desigualdades sociais e de gênero foram relevantes nas situações de violência observadas.

ABSTRACT In this article, it was discussed the history of violence against women in the context of abusive use of crack. It is a cross-sectional study, involving 243 crack users attended by the Atitude Program, in Pernambuco, between 2014 and 2015. It was observed that they were mostly young, black, with low schooling and low-income, early start of sexual life, in compulsive use of crack, living on the street and commercializing the body as the main source of income. The majority (96.2%) reported a violence history: psychological (83.5%), physical (87.7%) and sexual (55.1%), practiced by relatives/friends. Factors such as social and gender inequalities were relevant in the situations of violence observed.