![]() ![]() Crack smoking also involves particular risks and harms, including HIV incidence, potential HCV and tuberculosis transmission, and agranulocytosis from crack cocaine containing levamisole. Results of a population-based study revealed that recent-onset crack cocaine smokers were about twice as likely to experience cocaine dependence, as compared to recent-onset cocaine HCl powder users who did not smoke crack. (2009) reported that crack smokers smoke a median of 4 times per day. While cocaine users in general are at elevated risk of risky sexual practices, the crack house environment has been implicated in increased “sex for crack” exchanges and unprotected sexual encounters. ![]() Crack using populations are more likely than nondrug using populations to engage in illegal activities, to experience homelessness and health problems yet they are less likely to access health and social services. In Canada, many services for people who use drugs are targeted to people who inject therefore, people who only smoke crack may not be linked with appropriate health and social services.Ĭompared to other drug using populations, people who use crack cocaine are described as a particularly chaotic population. On the other hand, in a study of people who smoked crack in Vancouver only 39% of those who smoked crack also reported injecting drugs. However, there was considerable regional variation, with crack use reported ranging from 86.2% in Vancouver to 2.4% in Quebec City. Another Canadian cohort of illicit opioid users in five cities indicated that 54.6% (371/679) of baseline participants had smoked crack in the 30 days prior to the survey. A recent surveillance report of 794 people who inject drugs across Canada indicated that 52.2% of the total sample had also used crack cocaine in the last 6 months. Ĭanadian data also provides evidence of high prevalence of crack use among drug user populations. The Vancouver Injection Drug Users Study found that crack use in a group of injection drug users in Vancouver almost doubled from about 31% in 1997 to over 60% in 2004 and daily crack smoking in this population rose from <10% in 1996 to 40% in 2002/05 period. Smoking crack cocaine is a relatively neglected public health problem in Canada in comparison to injection drug use (IDU), despite indications that crack use in Canada is increasing. This study examines narratives which add to prior reports of the association of crack smoking and increased chaos and suggests that, for some, inhaled crack may represent efforts towards self-directed harm reduction. The phenomenological lens of smoking crack instead of injecting cocaine “to control chaos” contributes a novel perspective to our understanding of the crack-smoking population. Controlling chaos was self-defined using nontraditional measures such as the ability to maintain day-to-day commitments and housing stability. Subjects reported that smoking rather than injecting cocaine allows them to begin “controlling chaos” in their lives. We applied Rhodes’ risk environment to the phenomenological understanding that individuals have regarding how crack has affected their lives. Focus groups were transcribed and analyzed by constant comparative methodology. Six gender-specific focus groups ( ) of individuals who currently smoke crack in Vancouver, Canada, were conducted using a semi-structured interview guide. We explored the lived experience of people who smoke crack cocaine. However, little is known about how individuals perceive smoking crack as compared to other forms of cocaine use, especially injection. ![]() People who smoke crack cocaine are described as chaotic and more likely to engage in risky sex, polysubstance use and contract infectious diseases. ![]()
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