ABSTRACT
BACKGROUND: The international literature has expressed different and sometimes contrasting perspectives when addressing criminal involvement by crack cocaine users, highlighting psychopharmacological aspects, the cycles of craving and pressing economic need, and the interplay with overall deprivation and structural violence. The current study aims to identify variables associated with the arrest and imprisonment of regular crack cocaine users. METHODS: Interviewees were recruited from open drug scenes in the city of Rio de Janeiro and Greater Metropolitan Area from September 2011 to June 2013. Multilevel logistic regression models were fitted to the data. RESULTS: Most of the recruited crack cocaine users were male (78.2% [95%CI: 76.3-79.4]), 18-30 years old (64.7% [95%CI: 62.5-66.2]), non-white (92.9% [95%CI: 91.2-93.4]), single (68.9% [95%CI: 66.8-70.3]), and with 0-7 years of schooling (70.6% [95%CI: 68.5-71.9]). Factors independently associated with arrest were history of inpatient addiction treatment (adjOR 4.31 [95%CI: 1.70-11.32]); male gender (adjOR 2.05 [95%CI: 1.40-3.04); polydrug use (adjOR 1.82 [95%CI: 1.32-2.51]); and 0 to 7 years of schooling (adjOR 1.64 [95%CI: 1.17-2.32]). As for the outcome variable lifetime history of incarceration, the independently associated factors were: male gender (adjOR 2.47 [95%CI: 1.74-3.55]) and longer use of crack cocaine and related substances (e.g., free base and local varieties/denominations of coca products) (adjOR 1.05 [95%CI: 1.01-1.10]). CONCLUSION: The study's findings support the use of comprehensive multisector interventions, integrating health promotion and mental health rehabilitation, access to quality education, and management of combined/concomitant use of different substances to reduce and/or prevent criminal involvement by individuals that use crack cocaine and other substances, as well as to prevent/manage relapse.
Subject(s)
Cocaine-Related Disorders/psychology , Crack Cocaine , Criminal Law/legislation & jurisprudence , Public Health/legislation & jurisprudence , Adolescent , Adult , Brazil , Craving , Female , Humans , Male , Prisons , Sex Factors , Socioeconomic Factors , Surveys and Questionnaires , Violence , Young AdultABSTRACT
No Brasil, o consumo de crack em cenas abertas tem sido associado, pelo senso comum e grande mídia à problemas relacionados à violência, desordem urbana e criminalidade nas grandes cidades. Todavia os estudos sobre este tema no Brasil são pouquíssimos. Sendo assim, no primeiro artigo da tese, identificamos variáveis preditoras para detenção e prisão dos usuários de crack e similares no município do Rio de Janeiroe Região Metropolitana, no período de setembro de 2011 a junho de 2013, através de modelos de regressão logística multinível. As variáveis que se mostraram preditoras de detenção e/ou prisão foram: ter utilizado leito de internação clínica, ser do sexo masculino, ser poliusuário, ter de 0 a 7 anos de estudo, raça/cor preto e acréscimo de 1ano no tempo de uso de crack e similares. No segundo artigo, buscamos verificar a possível associação entre um conjunto de cenas abertas de uso de crack com a ocorrência de determinados crimes em seu entorno, no município do Rio de Janeiro, no período de janeiro de 2011 a outubro de 2012, através de um modelo de regressão linear múltipla.As análises evidenciam para uma possível associação entre as cenas abertas de uso de crack e crimes contra propriedade, assim como diferença significativa na média de crimes contra propriedade entre as cenas que estavam localizadas em favelas em relação àquelas que estavam localizadas no asfalto. Os resultados apontam associações de algumas variáveis no nível individual com detenção e prisão e associação espacial das cenas abertas com os crimes no entorno, tornando-se necessárias intervenções multisetoriais, que considerem a promoção da saúde, o acesso dos usuários aos serviços,o manejo do uso de múltiplas drogas, a diminuição da evasão escolar, alternativas não repressoras para lidar com o uso de drogas em espaço públicos dando prioridade aos programas de abordagem de saúde e assistência social.
In Brazil, crack use in open scenes have been linked by common sense andmainstream media on issues related to violence, urban disorder and criminality in largecities. However studies on this topic in Brazil are very few. Thus, in the first article of thethesis, we identified predictors for arrest and detention of crack and similar users in thecity of Rio de Janeiro and the metropolitan area, from September 2011 to June 2013, bylogistic regression models multilevel. The variables that were predictive of detention and/ or imprisonment were: use of clinical hospital bed, being male, being poliusuário, have0-7 years of education, race/color "black" and 1-year increase in time crack and similaruse. In the second article, we seek to verify the possible association between a set ofscenes open crack use with the occurrence of certain crimes in their surroundings, in thecity of Rio de Janeiro, from January 2011 to October 2012, through a multiple linearregression model. The analyzes show for a possible association between the open crackscenes of use and crimes against property, as well as significant difference in mean crimesagainst property between scenes that were located in "favelas" than those who werelocated in the "asphalt. The results show associations of some variables at the individuallevel with arrest and detention and spatial association of scenes open with the crimes inthe surroundings, making it necessary multisectoral interventions that consider healthpromotion, user access to services, the management of multiple drug use, reduction ofschool supply, not repressive alternatives to deal with the use of public space in drugsgiving priority to health approach to programs and social assistance.