SciELO - Scientific Electronic Library Online

vol.11 issue2The probabilities of psychiatric hospitalization of mental health clinic patients author indexsubject indexarticles search
Home Pagealphabetic serial listing  

SMAD. Revista eletrônica saúde mental álcool e drogas

On-line version ISSN 1806-6976

SMAD, Rev. Eletrônica Saúde Mental Álcool Drog. (Ed. port.) vol.11 no.2 Ribeirão Preto June 2015


Contemporary questions about the use of cocaine/crack



Sandra Cristina Pillon

Associate Editor, SMAD - Revista Eletrônica Saúde Mental Álcool e Drogas, and Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil, e-mail:




The use of psychoactive substances is considered a worldwide health problem. Data's from the worldwide report about drugs shows that in the last decades there were elevated use of cocaine and crack, however the magnitude of illicit drugs has maintained itself stable among the adult population(1).

In the Brazilian scenery, the epidemiological data shows transition in relationship to the drug type of choice(2). The results of the National Alcohol and Drug research allowed to outline a view of the use of cocaine and its derivatives (crack, merla, oxi) in Brazil. The study identified around six million Brazilians (4% of the adult population) declared that they have tried drugs at some point in life, and that 2,8 million have used the drug in the last 12 months. From these contingent of individuals, almost half (48%) became dependent, which has generated creasing demands for health service.

The abuse of these substantives increases the psychosocial vulnerability of the users and generates numerous health consequences, implying a significant increase of demands to the health system. In this population, numerous physical problems appear due to the exposure of drugs and risk behaviour, such as the risk of STD infection, AIDS, acute clinical complications (overdose and abstinence syndrome), in addition to high rates of psychiatric comorbidity(3).

In the context of care, the nurses' role stands out for its performance at different levels of health care, from primary prevention to treatment and psychosocial rehabilitation. The nurse is one of the key professionals working on the front care along with this vulnerable population, helping to strengthen the promotion of self-care. However, the nursing professional who works in the field of intervention, is used to find various barriers in approaching the service users. These barriers include a lack of knowledge and clinical competence as a result from educational deficiency, low treatment interest, lack of systematic protocols to provide quality care, lack of time or interest, work stress, low motivation for the patient's change and limited compensation(4).

On the other hand, evidence suggests that the team engaging in primary health care, once trained to recognize and intervene early, can effectively contribute to the reduction of damage and adverse effects of chronic substance use(5). In this context it is necessary to produce knowledge on the prevalence, predictive factors such as personal, family and environmental which contributes to the drug consume in the Brazilian reality. The focused topics are current and the presented results are relevant to the point of view of public health.

This fascicle of SMAD consists of six articles (original studies) that address specific issues related to alcohol and other psychoactive substances, predominantly cocaine/crack. The studies deals with; predictive of drug use, biopsychosocial aspects (interpersonal, family, and spiritual), use of trajectories in populations such as adolescents, adults and pregnant woman.

Focused topics are current and the results are relevant from the point of view of the public health agenda, contributing to systematize policies and interventions targeted to these populations. The studies were conducted by researchers from various regions of the country and reflect the cultural diversity of the population's specific to each context.

The challenge of prevention is to create a safety net users by inserting them in social programs and occupational alternatives capable of restoring the dignity and rights of citizenship.



1. United Nations Office on Drugs and Crime (UNODC). World Drug Report 2013. [Internet]. 2013. [acesso 6 abr 2015]. Disponível em:        [ Links ]

2. Instituto Nacional de Ciência e Tecnologia para Políticas Públicas do Álcool e Outras Drogas (INPAD). II Levantamento Nacional de Alcool e Drogas (LENAD). [Internet]. 2012. [acesso 6 abr 2015]. Disponível em:        [ Links ]

3. Diehl A, Vieira DL, Rassool GH, Pillon SC, Laranjeira R. Sexual risk behaviors in non-injecting substance-dependent Brazilian patients. Adicciones. 2014;26(3):208-20.         [ Links ]

4. Pillon SC, Laranjeira R. Formal education and nurses attitudes towards alcohol and alcoholism in a Brazilian sample. São Paulo Med J. 2005;123(4):175-80.         [ Links ]

5. Junqueira MAB, Santos MA, Pillon SC. Competências atitudinais de estudantes de Enfermagem na assistência a usuários de álcool. Rev Enferm Atenção Saúde. 2014; 3(2):76-85.         [ Links ]