Stewart Melissa J, Fulton Heather G, Barrett Sean P
From the Department of Psychology & Neuroscience (MJS, SPB), Dalhousie University, Halifax, Nova Scotia, Canada; and Burnaby Centre for Mental Health and Addiction (HGF), Burnaby, British Columbia, Canada.
J Addict Med. 2014 Jul-Aug;8(4):264-70. doi: 10.1097/ADM.0000000000000047.
Problematic cocaine use is highly prevalent and is a significant public health concern. However, few investigations have distinguished between the 2 formulations of cocaine (ie, powder and crack cocaine) when examining the characteristics of cocaine use. Moreover, research has yet to assess the patterns of powder and crack cocaine use among opioid users, a clinical population in which problematic cocaine use is increasingly common. Using a within-subjects design, this study examined whether opioid users reported different patterns and features of powder and crack cocaine use, along with distinct trajectories and consequences of use.
Seventy-three clients enrolled in a low-threshold methadone maintenance treatment were interviewed regarding their lifetime use of powder and crack cocaine.
Compared with crack cocaine, initiation and peak use of powder cocaine occurred at a significantly younger age. In relation to recent cocaine use, participants were significantly more likely to report using crack cocaine than using powder cocaine. Differences in routes of administration, polysubstance use, and criminal activity associated with cocaine use were also found between the 2 forms of cocaine.
Results suggest that it may not be appropriate to consider powder and crack cocaine as diagnostically and clinically equivalent. As such, researchers may wish to distinguish explicitly between powder and crack cocaine when assessing the characteristics and patterns of cocaine use among substance users and treat these 2 forms of cocaine separately in analyses.
可卡因使用问题极为普遍，是一个重大的公共卫生问题。然而，在研究可卡因使用特征时，很少有调查区分可卡因的两种剂型（即粉末状可卡因和快克可卡因）。此外，研究尚未评估阿片类药物使用者中粉末状可卡因和快克可卡因的使用模式，而在这一临床人群中，可卡因使用问题日益普遍。本研究采用受试者内设计，考察阿片类药物使用者报告的粉末状可卡因和快克可卡因的使用模式及特征是否不同，以及使用的不同轨迹和后果。
对73名参加低门槛美沙酮维持治疗的患者进行了访谈，询问他们一生中粉末状可卡因和快克可卡因的使用情况。
与快克可卡因相比，粉末状可卡因的初次使用和使用高峰年龄显著更小。就近期可卡因使用情况而言，参与者报告使用快克可卡因的可能性显著高于使用粉末状可卡因。两种形式的可卡因在给药途径、多药使用以及与可卡因使用相关的犯罪活动方面也存在差异。
结果表明，将粉末状可卡因和快克可卡因视为在诊断和临床上等同可能并不合适。因此，研究人员在评估药物使用者中可卡因使用的特征和模式时，可能希望明确区分粉末状可卡因和快克可卡因，并在分析中对这两种形式的可卡因分别进行处理。
