ReviewEffectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies
Section snippets
Background
Based on recent studies, 0.3–0.5% (or 14–21 million people) of the global population aged 15–64, are estimated to be cocaine users (Degenhardt and Hall, 2012, UNODC, 2014). The prevalence of cocaine use is estimated to be highest – (1.4%) with some national surveys indicating even higher ‘past year’ prevalence rates – in the region of the Americas where it is recorded as the second most common type of illicit drug use following cannabis (Carlini et al., 2006, Health Canada, 2014, SAMHSA, 2013).
Methods
The present overview reports on the results of a series of literature searches, involving the principal search terms “crack cocaine”; “use” or “smoking” or “abuse” or “dependence”; and “prevention” or “intervention” or “treatment” or “harm reduction”, were conducted on journal-published English-language literature from 1990 up to March 2014, searching major medical and health-related databases – i.e., Embase, PubMed®, PsycINFO® – for relevant English-language journal publications. In addition
Secondary prevention interventions
Literature identified on secondary prevention interventions was heterogeneous, and further sub-categorized into behavioral/psycho-social and environmental/material interventions.
Discussion
We comprehensively reviewed the English-language evidence on secondary prevention and treatment interventions for crack-cocaine users.
A fairly substantive body of largely controlled studies on innovative or tailored behavioral – largely brief/outreach based – targeted prevention measures targeting crack users focused mainly on HIV-risk and crack use outcomes, indicating mixed evidence on efficacy slightly in favour of experimental over standard/control (e.g., NIDA HIV) interventions. While some
Acknowledgements
The authors acknowledge Chantal Burnett, Yoko Murphy, Steve Peat, Katherine Rudzinski and Maija Tiesmaki for their various contributions at different stages of this work. Dr. Fischer acknowledges funding/salary support from a CIHR/PHAC Chair in Applied Public Health, as well as international collaboration support funding from the Association of Universities and Colleges of Canada's (AUCC) LACREG program.
Conflict of interest: The authors have no conflict of interest to report.
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