September 5, 2007

Results of Local Study on Crack Cocaine Have National Implications

Dayton, Ohio — A team of researchers from the Center for Interventions, Treatment, and Addictions Research (CITAR) at Wright State University's Boonshoft School of Medicine have reported the results of the first long-term study of crack cocaine smokers in the United States. In the National Institute on Drug Abuse-funded research, 430 crack users in the Dayton, Ohio, area were interviewed periodically over an eight-year period. The findings have implications for this country's efforts to address the problem of crack cocaine use.

The study found that people use crack cocaine for long periods of time, usually without prolonged periods of abstinence. Of the people in the study, nearly two-thirds of users continued to smoke crack over the eight-year observation period. Notably, the average length of time users reported having smoked crack cocaine before entering the study was 7.6 years. This suggests that once people become involved with crack they will continue to use it for a decade or longer.

"Unfortunately, our results suggest that crack cocaine use will not fade from the American street drug scene anytime soon," says Russel Falck, M.A., the principal investigator for the study and CITAR's associate director.

Crack cocaine use is associated with a wide range of cardiovascular, respiratory, neurological and psychiatric health problems, which are often exacerbated by the simultaneous use of alcohol. In fact, the rates of alcoholism among crack users in the study were more than double those found among the United States general population.

Robert Carlson, Ph.D., a study co-investigator and CITAR's director, explains, "When I began working here in Dayton in 1989, crack use and its associated lifestyle was a new and frightening phenomenon. No one knew what would happen regarding use of the drug. Crack cocaine use is now approaching epidemic proportions. National data show that more than 8 million Americans report having used crack; nearly a quarter-million between the ages of 12 and 49 years tried it for the first time in 2005. Crack is widely available and generally not expensive when purchased in small amounts. And, it is no longer a problem confined to urban areas."

"Although our study was carried out in the Dayton, Ohio, area, the composition of the sample approximates that of the general crack using population in the United States in terms of gender and race/ethnicity. Consequently, the natural history of crack cocaine use in Dayton is likely to reflect patterns of crack cocaine use in many areas across the country," Falck says. "The problem of crack cocaine has not been addressed very effectively. Although there was great concern about the drug in the mid-80's through the 1990s, crack use and all its negative consequences are now part of our country's socio-cultural landscape. It is not a pretty picture. We need to do a better job of reaching out to and treating crack cocaine users. We also need to rethink our prevention efforts since they are generally geared to young people and crack cocaine use is most often initiated after people leave high school."

The study, entitled "Crack cocaine trajectories among users in a midwestern American city," authored by Falck, Jichuan Wang, and Carlson, appears in the September issue of Addiction, a leading journal in the substance abuse field. An editorial appearing in the same issue of the journal, written by public health researchers in Canada, commenting on the Wright State group's results, called crack cocaine the "neglected epidemic" in North America and noted, "Policy makers need to embrace the fact that both quantitatively and qualitatively crack use is one of the largest and most destructive pieces in the overall picture of our cities' illicit drug problem."

Related article Addiction. 2007 Sep;102(9):1340-1