The interplay between drug-use behaviors, settings, and access to care: a qualitative study exploring attitudes and experiences of crack cocaine users in Rio de Janeiro and São Paulo, Brazil

Harm Reduction Journal

Francisco I. Bastos²  Carlos Linhares Veloso Filho¹  Noa Krawczyk² 

[1] Psychiatry Institute, Federal University of Rio de Janeiro, Avenida Venceslau Brás, 71 - Fundos - Botafogo, Rio de Janeiro 22290-140, RJ, Brazil;FIOCRUZ—Oswaldo Cruz Foundation, Av. Brasil, 4365, Biblioteca de Manguinhos #229, Rio de Janeiro 21045-900, Brazil

关键词: Qualitative analysis;    Risk environments;    Health-service utilization;    Access to care;    Drug-use behaviors;    Marginalization;    Stigma;    Crack cocaine;   

Others  :  1223381
DOI  :  10.1186/s12954-015-0059-9

 received in 2015-04-13, accepted in 2015-07-29,  发布年份 2015

【 摘 要 】

Background

Despite the growing attention surrounding crack cocaine use in Brazil, little is understood about crack users’ histories, use patterns and the interplay of drug-use behaviors, settings, and access/barriers to care. Qualitative studies seldom cross-compare findings regarding people who use crack from different settings. This study aims to explore the insights of regular crack users in two major Brazilian cities and to examine how social and contextual factors, including stigma and marginalization, influence initial use and a range of health and social issues.

Methods

In-depth interviews and focus groups were conducted with 38 adult crack cocaine users recruited from impoverished neighborhoods in Rio de Janeiro and São Paulo. Interviews and focus groups were audio recorded and transcribed verbatim. Qualitative analysis was carried out, and content was organized and analyzed by recurrent themes relevant to study interests.

Results

For study participants from both cities, frequent crack cocaine use plays a central role in daily life and leads to a range of physical, psychological, and social consequences. Common concerns among users include excessive crack use, engagement in risky habits, infrequent health service utilization, marginalization, and difficulty reducing use.

Conclusions

Disadvantaged conditions in which many crack cocaine users grow up and live may perpetuate risk behaviors and stigma may further marginalize users from necessary health and recovery services. Reducing stigma and moralizing discourse related to drug use, especially among health professionals and law enforcement personnel, may help encourage users to seek necessary care. New harm-reduction-based care and treatment alternatives for marginalized drug users are being developed in parts of Brazil and elsewhere and should be adapted and expanded for other populations in need.

【 授权许可】

   
2015 Krawczyk et al.

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