Craving in crack cocaine users according to individual and behavioral characteristics

Silveira, Karine Langmantel; Oliveira, Michele Mandagará de; Nunes, Bruno Pereira; Alves, Poliana Farias; Pereira, Gabriela Botelho

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Epidemiologia e Serviços de Saúde

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RESEARCH NOTE • Epidemiol. Serv. Saúde 28 (1) • 2019 • https://doi.org/10.5123/S1679-49742019000100022 copy

Craving in crack cocaine users according to individual and behavioral characteristics^* *Article derived from the Master’s Degree thesis “The influence of social determinants of health in the variation of craving levels in crack users”, defended by Karine Langmantel Silveira at the Postgraduate Program in Nursing of the Universidade Federal de Pelotas (UFPel) in 2017. Study funded with resources from the National Council for Scientific and Technological Development (CNPq)/Ministry of Science, Technology, Innovation and Communications (MCTIC): Process No. 402777/2010-7.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze variation in craving levels according to individual and behavioral characteristics of crack cocaine users at two public treatment services in Pelotas, Rio Grande do Sul, Brazil.

Methods:

this was a cross sectional study with a sample of 133 participants; the Cocaine Craving Questionnaire scale was used to verify craving levels.

Results:

86% of interviewees had moderate and severe craving levels; regarding individual factors, a higher level of severe craving was found in women (45%), those with brown skin color/“mestizos” (60%), low schooling (46%) and minor psychiatric disorders (59%); regarding behavioral factors, the level of severe craving was higher in users who divorced the last year (44%), those who had problems with the Law (61%), those who practiced violence acts (57%), those using more than four psychoactive substances (67%), and those with heavy crack consumption (57%).

Conclusion:

almost all crack users were found to have high craving levels; these were proportionally higher in some individual and behavioral variables.

Keywords:
Crack Cocaine; Craving; Health Vulnerability; Drug Users; Social Determinants of Health; Cross-Sectional Studies

Variables	Total		Craving level								P-value^a
	Total		Minimum 0-11		Mild 12-16		Moderate 17-22		Severe ≥23
	n	%	n	%	n	%	n	%	n	%
Sex
Female	22	16.5	2	9.1	1	4.6	9	40.9	10	45.4	0.248
Male	111	83.5	4	3.6	11	9.9	49	44.1	47	42.3	0.248
Age group (in years)
<20	6	4.5	0	0.0	1	16.7	2	33.3	3	50.0	0.983
20-24	25	18.8	0	0.0	1	4.0	16	64.0	8	32.0
25-29	31	23.3	1	3.2	1	3.2	12	38.7	17	54.9
30-39	50	37.6	5	10.0	8	16.0	18	36.0	19	38.0
40-49	16	12.0	0	0.0	1	6.2	8	50.0	7	43.8
≥50	5	3.8	0	0.0	0	0.0	2	40.0	3	60.0
Ethnicity/skin color
White	74	55.6	2	2.7	9	12.2	34	45.9	29	39.2	0.045
Black	34	25.6	3	8.8	2	5.9	16	47.1	13	38.2
Brown skin color/ “mestizo”	25	18.8	1	4.0	1	4.0	8	32.0	15	60.0
Marital status
Single	94	70.7	4	4.3	11	11.7	40	42.5	39	41.5	0.942
Married/stable relationship	26	19.5	2	7.7	1	3.8	13	50.0	10	38.5
Divorced/widowed	13	9.8	0	0.0	0	0.0	5	38.5	8	61.5
Schooling
None	1	0.8	0	0.0	0	0.0	0	0.0	1	0.8	0.083
Elementary school	107	80.4	6	5.6	7	6.5	45	42.1	49	45.8
High school and technical education	21	15.8	0	0.0	4	19.1	11	52.4	6	28.6
Higher education	4	3.0	0	0.0	1	25.0	2	50.0	1	25.0
Family income (in monthly minimum wages - MMW)
No income/<1 MMW^b	43	32.3	3	7.0	0	0.0	17	39.5	23	53.5	0.304
1-2 MMW^b	46	34.6	3	6.5	5	10.9	21	45.6	17	37.0
>2 MMW^b	44	33.1	0	0.0	7	15.9	20	45.5	17	38.6
Occupation
Unemployed	43	32.3	3	7.0	5	11.6	15	34.9	20	46.5	0.863
Formal employment	20	15.0	1	5.0	1	5.0	11	55.0	7	35.0
Informal employment	38	28.6	0	0.0	3	7.9	18	47.4	17	44.7
Self-employed worker	32	24.1	2	6.2	3	9.4	14	43.8	13	40.6
Health problems
No	80	60.2	4	5.0	7	8.8	34	42.5	35	43.7	0.674
Yes	53	39.8	2	3.8	5	9.4	24	45.3	22	41.5	0.674
Common mental disorder (estimated by SRQ-20^c)
Negative	75	56.4	4	5.3	9	12.0	39	52.0	23	30.7	0.014
Positive	58	43.6	2	3.4	3	5.2	19	32.8	34	58.6	0.014

Variables	Total		Craving level								P-value^a
	Total		Minimum 0-11		Mild 12-16		Moderate 17-22		Severe ≥23
	n	%	n	%	n	%	n	%	n	%
Have children
No	41	31.1	0	0.0	3	7.3	25	61.0	13	31.7	0.045
Yes	91	68.9	6	6.6	9	9.9	32	35.2	44	48.3
Events in the last year
Divorce/separation	34	25.6	4	11.8	1	2.9	14	41.2	15	44.1	0.040
Imprisonment or problems with the Law	51	38.4	0	0.0	5	9.8	15	29.4	31	60.8	0.305
Change in financial condition	58	43.6	1	1.7	6	10.3	27	46.6	24	41.4	0.239
Practiced violent act	37	27.8	2	5.4	1	2.7	13	35.1	21	56.8	0.029
Suffered violent act	45	33.8	2	4.4	3	6.7	18	40.0	22	48.9	0.345
Suffered sexual violence	4	3.0	0	0.0	0	0.0	2	50.0	2	50.0	0.840
Time of use (in years)
<1	2	1.5	0	0.0	0	0.0	2	100	0	0.0	0.262
1-5	50	37.9	1	2.0	4	8.0	24	48.0	21	42.0
6-10	61	46.2	3	4.9	6	9.8	25	41.0	27	44.3
≥11	19	14.4	2	10.5	2	10.5	6	31.6	9	47.4
Pattern of use
Mild	45	37.5	4	8.9	4	8.9	21	46.7	16	35.5	0.565
Moderate	10	8.3	0	0.0	2	20.0	6	60.0	2	20.0
Heavy	65	54.2	1	1.5	4	6.2	23	35.4	37	56.9
Use with other drugs
No	47	35.3	4	8.5	6	12.8	20	42.6	17	36.2	0.774
Yes	86	64.7	2	2.3	6	7.0	38	44.2	40	46.5	0.774
Number of psychoactive substances used on the same day (n=86)
1	26	30.2	1	3.8	2	7.7	16	61.5	7	26.9	0.042
2-3	39	45.4	1	2.6	4	10.3	15	38.5	19	48.7
≥4	21	24.4	0	0.0	0	0.0	7	33.3	14	66.7

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[1] Correspondence: Karine Langmantel Silveira - Rua Gomes Carneiro, No. 1, Porto, Pelotas, Rio Grande do Sul, Brazil. Postcode: 96010-610. E-mail: kaa_langmantel@hotmail.com