To follow-up a group of 131 crack cocaine users and examine drug use, treatment experience, employment status, involvement in crime and mortality at 2 and 5 years.
Consecutive crack-dependent patients who were admitted to a detoxification unit in São Paulo between 1992 and 1994 were re-interviewed on two occasions: 1995-1996 and 1998-1999.
5 years after treatment information was obtained on 124 (95%) of the original cohort. 39.7% (n = 52) of the patients reported having been abstinent from cocaine for at least the last year, and 21.4% (n = 28) had used the drug. Of those subjects not using cocaine at 2 years, 19 (62%) were still abstinent at 5 years. Twenty-three (17.6%) patients had died by the 5-year follow-up with homicide, due to firearms or other weapons, being the commonest cause (n = 13). The annual adjusted mortality rate for the sample was 24.92 deaths/1,000 individuals, the excess mortality rate was of 21.64 deaths/1,000 individuals, and the standardized mortality ratio was 7.60. A history of injecting drug use, unemployment at the time of the index admission and administrative discharge at the index admission were factors that contributed to the risk of dying over the next 5 years.
There was a progressive movement towards abstinence over the follow-up period, and there was evidence that once abstinence had been achieved it was maintained. On the other hand, the mortality rate was extremely high and was higher among those who were still using crack at 2 years.
"Estudo longitudinal sobre cuidados continuados (follow-up em 36 meses) com usuários de álcool, cocaína e crack (internação, n = 134; ambulatorial, n = 370) Grupos com e sem cuidados continuados (12 sessões), sem diferenças entre os grupos quanto à origem dos usuários (internação ou ambulatório) Pacientes que receberam cuidados continuados, independente do contexto onde se deu o tratamento anterior, usaram menos crack nos primeiros 6 meses de seguimento Ribeiro et al. (2007) Estudo de coorte com usuários de crack pós-desintoxicação (follow-up em cinco anos) (n = 131) "
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: The objective of this paper is to present a systematic review of the literature on psychological treatments offered for crack users. METHODS: We performed a systematic review bysearching the international and national literature indexed in Medline, SciELO, Lilacs and Web of Science. The keywords used were: crack or crack cocaine or cocaine smokers (crack) and psychosocial treatment or psycotherapy or psychosocial treatment (psychological treatment) and the search included articles published between 2001-2011. RESULTS: A total of155 articles were found through the descriptors used. The articles were grouped into three dimensions: psychosocial treatments in hospital and continuedcare, deep breathing and other behavioral techniques and approaches based on Motivational Interviewing, Cognitive-Behavioral and Transtheoretical Model of Change. CONCLUSION: From the studies examined a cast of some interventions that are being studied for the treatment of crack users and some have satisfactory outcomescan be made. The few efforts to compare techniques resulted in evidence of little or no difference among them, even if they register the benefit tousers in the application of any of them. There is no consensus on the effectiveness in the treatment of crack users. It seems appropriate and necessary deepening of the studies in this field.
Jornal brasileiro de psiquiatria 12/2012; 62(3):208-216. DOI:10.1590/S0047-20852013000300005
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to follow-up 131 crack users and examine drug use, treatment experience, employment status, and mortality at 2, 5, and 12 years. Consecutive crack dependent patients were re-interviewed in 1995-1996, 1998-1999, and 2005-2006. Of those subjects not using cocaine at 2 years, 19 (63%) were still abstinent at 5 years. Almost half of the users were abstinent at the same period. The abstinent group was still the most prevalent at 12 years. Twenty-seven (20.6%) patients had died by the 12-year follow-up, with homicide being the most common cause (n = 16). After 2000, however, it declined sharply with only 2 deaths in 7 years. There was a progressive movement toward abstinence over the follow-up period, with the evidence that once abstinence had been achieved it was maintained. On the other hand, the mortality rate was extremely high and probably more related with socioeconomic factors instead of the drug use itself.
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