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dc.contributor.authorFischer, Benedikt
dc.contributor.authorBlanken, Peter
dc.contributor.authorDa Silveira, Dartiu [UNIFESP]
dc.contributor.authorGallassi, Andrea
dc.contributor.authorGoldner, Elliot M.
dc.contributor.authorRehm, Juergen
dc.contributor.authorTyndall, Mark
dc.contributor.authorWood, Evan
dc.identifier.citationInternational Journal of Drug Policy. Amsterdam: Elsevier B.V., v. 26, n. 4, p. 352-363, 2015.
dc.description.abstractThere are an estimated several million crack-cocaine users globally; use is highest in the Americas. Most crack users are socio-economically marginalized (e.g., homeless), and feature elevated risks for morbidity (e.g., blood-borne viruses), mortality and crime/violence involvement, resulting in extensive burdens. No comprehensive reviews of evidence-based prevention and/or treatment interventions specifically for crack use exist. We conducted a comprehensive narrative overview of English-language studies on the efficacy of secondary prevention and treatment interventions for crack (cocaine) abuse/dependence. Literature searches (1990-2014) using pertinent keywords were conducted in main scientific databases. Titles/abstracts were reviewed for relevance, and full studies were included in the review if involving a primary prevention/treatment intervention study comprising a substantive crack user sample. Intervention outcomes considered included drug use, health risks/status (e.g., HIV or sexual risks) and select social outcome indicators. Targeted (e.g., behavioral/community-based) prevention measures show mixed and short-term effects on crack use/HIV risk outcomes. Material (e.g., safer crack use kit distribution) interventions also document modest efficacy in risk reduction; empirical assessments of environmental (e.g., drug consumption facilities) for crack smokers are not available. Diverse psychosocial treatment (including contingency management) interventions for crack abuse/dependence show some positive but also limited/short-term efficacy, yet likely constitute best currently available treatment options. Ancillary treatments show little effects but are understudied. Despite ample studies, pharmacotherapeutic/immunotherapy treatment agents have not produced convincing evidence; select agents may hold potential combined with personalized approaches and/or psycho-social strategies. No comprehensively effective 'gold-standard' prevention/treatment interventions for crack abuse exist; concerted research towards improved interventions is urgently needed. (C) 2015 Elsevier B.V. All rights reserved.en
dc.description.sponsorshipCIHR/PHAC Chair in Applied Public Health
dc.description.sponsorshipAssociation of Universities and Colleges of Canada's (AUCC) LACREG program
dc.publisherElsevier B.V.
dc.relation.ispartofInternational Journal of Drug Policy
dc.rightsAcesso restrito
dc.titleEffectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studiesen
dc.contributor.institutionCtr Addict & Mental Hlth
dc.contributor.institutionSimon Fraser Univ
dc.contributor.institutionUniv Toronto
dc.contributor.institutionParnassia Addict Res Ctr
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionFed Univ Brasilia
dc.contributor.institutionBritish Columbia Ctr Dis Control
dc.contributor.institutionUniv British Columbia
dc.contributor.institutionBC Ctr Excellence HIV AIDS
dc.description.affiliationCtr Addict & Mental Hlth, Social & Epidemiol Res Dept, Toronto, ON M5S 2S1, Canada
dc.description.affiliationSimon Fraser Univ, Fac Hlth Sci, Ctr Appl Res Mental Hlth & Addict, Vancouver, BC V6B 5K3, Canada
dc.description.affiliationUniv Toronto, Dept Psychiat, Toronto, ON M5T 1R8, Canada
dc.description.affiliationParnassia Addict Res Ctr, NL-2505 AA the Hague, Netherlands
dc.description.affiliationUniversidade Federal de São Paulo, Dept Psychiat, BR-04565000 São Paulo, Brazil
dc.description.affiliationFed Univ Brasilia, Fac Ceilandia, BR-72220900 Brasilia, DF, Brazil
dc.description.affiliationUniv Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON M5T 3M7, Canada
dc.description.affiliationBritish Columbia Ctr Dis Control, Vancouver, BC V5Z 4R4, Canada
dc.description.affiliationUniv British Columbia, Dept Med, Vancouver, BC V5Z 1M9, Canada
dc.description.affiliationBC Ctr Excellence HIV AIDS, Urban Hlth Res Initiat, Vancouver, BC V6Z 1Y6, Canada
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Psychiat, BR-04565000 São Paulo, Brazil
dc.description.sourceWeb of Science

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