Follow-up Study of Crack Cocaine Users: Situation of the Patients after 2, 5, and 12 years.
Andréa Costa Dias MScia, Marcelo Ribeiro PhDa, John Dunn PhDb, Ricardo Sesso PhDc, Ronaldo Laranjeira PhDa
Complications related to crack consumption represent a public health problem, especially in the Americas and Europe (1, 2). Cocaine crack was brought to Brazil in the late 1980’s (3, 4) and reached the less economically favored people, particularly the adolescents (4-6). During the next decade the crack consumption increased, and the treatment services were sought by the majority of crack users (3). In addition, most individuals using cocaine via injection and inhalation have changed these original administration routes because of AIDS and crack’s low price, respectively (7). Although a small portion of the general population has been affected (8, 9), overdose, criminality, and violence involving young individuals have transformed the crack cocaine dependence into a public health problem of extreme importance (2).
Little is known about the natural history of crack consumption. Most longitudinal studies have investigated those outcomes related to the efficacy of therapeutic interventions (10-13). The existing data on mortality and death cause are still inaccurate. A 2-year follow-up study of 131 crack cocaine users who had been treated in São Paulo between 1992 and 1994 was carried out in October 1995 and December 1996 (14). The authors have found a very high annual mortality rate, mainly caused by AIDS and homicides. These findings had encouraged us to go on following up the same subjects, but the mortality trend was found to be extremely high over that 5-year follow-up (15-17).