Smokable cocaines are commonly referred to as “the most harmful drug”, and considered not just a threat to public health, but also to public security in the urban centres of many large cities. As a result, its users are frequently subject to hostility and stigmatization.
The smokable cocaine market was established decades ago, and is definitely not a new phenomenon. Rather than disappear, it is undergoing a slow expansion: from constituting a rather localized and isolated habit in the Andean region in the 1970s, its reach has extended in all directions, throughout North and South-America, including the Caribbean and Central American regions. Societies in the Americas have coexisted with smokable cocaines for over four decades, but - surprisingly - there is a dearth of research on the development of the market, or much first-hand evidence of how this substance is actually commercialized and used by millions of people in the region.
The different forms of violence confronted by users of smokable cocaine need to be recognized and attended by public services. All policy interventions at the street level should aim to destigmatize and find concrete practical solutions to the immediate problems faced by users’ communities - initiatives inspired by the broad concept of “bed, bread and bath”.
In the design of a broader policy framework, users themselves need to be consulted and involved, enabling a form of implementation that can be checked and evaluated by its effects on the community itself. The experiences obtained in the past decade in a number of cities mentioned in this report make a strong case for developing public policy models that combine all the above features, and need to be given the appreciation and resources they deserve. A region-wide systematic evaluation of these experiences could contribute to more humane and effective polices regarding the different forms of smokable cocaine.