Crack cocaine users: New data from Brazil

Last September, the Brazilian Ministries of Health and Justice presented data of two key surveys – “Estimated number of crack and similar drug users in capital cities of the country" and "Profile of crack and similar drug users – Brazil".

Both surveys were headed by Francisco Bastos from FIOCRUZ, a very respected and traditional Foundation in Brazil. Bastos’ surveys are the largest and most comprehensive ones in the world on the subject. The study found that crack cocaine and similar drugs are used by approximately 370,000 people in the capitals and the DC. In a country of more than 200 million inhabitants it is far from an “epidemic”. But it is an important health and social problem.

Conducted in 2012, the research used a methodology that allowed for a more accurate estimation of hard-to-reach populations such as crack users. Below are some of the main findings of the survey:

• sexual behavior – over a third (39.5%) of users reported not having used a condom
• sharing of equipment – over 70% of users share injecting equipment
• estimated number of people who use drugs – about 1 million
• proportion of people using crack cocaine or similar drugs - 35% of people who use drugs
• age groups – about 14% of the 370,000 crack users in the country are minors, that is, approximately 50,000 children
• users’ profile – mostly men (78.7%), almost half are homeless (47.3%), on average 30 years old, predominantly non-white (80%)
• education – the majority of users leave school, which emphasizes the importance of prevention programs developed in schools.
• average time of use of crack and similar drugs – approximately 8 years (91 months) in the capital, and 5 years in the inner cities.

For about eight months, the publication of the two studies was blocked by important government authorities (the data has been available since the end of 2012), preventing the researchers from disseminating the results, until the reports were officially launched in September 2013. The outcomes were presented during a press conference attended by Justice Minister José Eduardo Cardozo, the Secretary of Health Care in the Ministry of Health, Helvécio Magalhães, the Secretary of Social Welfare in the Ministry of Social Development, Denise Colin, the National Secretary of Public Security, Regina Miki, and Secretary Vitore Maximian of the National Drug Policy Secretariat (SENAD).

The main reason for blocking the publication of the research was because crack use (and policies to respond to it) is highly politicized in Brazil, with politicians trying to gain votes thanks to their drug policy positions, and therapeutic communities becoming more and more prominent in the debates. And the research outcomes did not show the results they wanted – in fact, as showed above, the data indicated that crack is not spread as an epidemic or a “viral disease” as those groups made Brazilian people believe.

In fact, the studies come at a time when the Brazilian House of Representatives voted in favour of a new bill that alters significant portions of Brazil’s 2006 drug law. Among the changes are an increase in the minimum mandatory sentences for drug traffickers from five to eight years in prison; mandatory treatment for people dependent on drugs (with permission from family or authorization from a medical professional); and federal funding for “therapeutic” treatment centers. These centers, known as “therapeutic communities”, are privately run treatment facilities, often with a religious focus. These community centers have little oversight and have been criticized for using unscientific methods and lacking proper medical staff and expertise. The bill is now being discussed and awaiting vote in the Brazilian Senate, and will likely pass in the coming months. Many activists, including the REDUC team, are advocating against the changes in the drug law. From our point of view those changes appear to be more an attempt to “get drug users off the streets” – whether they be placed in prisons or treatment centers – rather than an attempt to really deal with drug dependence using scientific research.

It is hoped that the new data can be used to improve policies and strengthen the current network of care for users of crack and other drugs, using an evidence and human rights based approach.

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