Lifetime crack cocaine use in young adults was associated with PTSD, antisocial personality disorder, suicide risk, and use of multiple other substances including cannabis.
Read this if you want to understand the psychiatric profile associated with crack cocaine use in young adults.
2.5% lifetime prevalence of crack cocaine use in a general population sample of 18-24 year olds
What the researchers found
Among 1,560 young adults aged 18-24 in the general population, 2.5% reported lifetime crack cocaine use. In the final regression model, crack cocaine use was independently associated with higher total psychiatric symptom scores, post-traumatic stress disorder, antisocial personality disorder, and suicide risk.
Substance use associations were broad: crack cocaine use was linked to tobacco, alcohol, cannabis, cocaine, amphetamine, and inhalant use and dependence. Cannabis use was among the substances most commonly co-occurring with crack cocaine use.
The study was population-based rather than drawn from treatment settings, which provides a less biased picture of the psychiatric profile associated with crack cocaine use in the community.
Why it matters
Understanding the psychiatric and substance use profile of young people who use crack cocaine helps inform targeted interventions. The association with PTSD and suicide risk suggests that trauma-informed approaches may be particularly important for this population.
The numbers in context
1,560 participants aged 18-24. Lifetime crack cocaine use prevalence: 2.5%. Associated conditions: PTSD, antisocial personality disorder, suicide risk. Associated substances: tobacco, alcohol, cannabis, cocaine, amphetamine, inhalants.
How the study worked
This was a cross-sectional population-based study in Pelotas, Brazil, involving 1,560 participants aged 18-24. Lifetime substance use was assessed using the ASSIST inventory. Psychiatric conditions were assessed using the Mini-International Neuropsychiatric Interview (MINI), and common mental disorder symptoms were evaluated with the Self-Reported Questionnaire (SRQ).
What this study cannot tell us
This was a cross-sectional study, so the direction of associations cannot be determined. Crack cocaine use may precede, follow, or co-occur with psychiatric conditions. Self-reported substance use may be underreported. The study was conducted in one Brazilian city and may not generalize to other settings.
How to read the evidence
This is a cross-sectional population-based study. While the sample is representative, the design cannot establish causal relationships.
When this study was published
Published in 2014 with data from Pelotas, Brazil. Crack cocaine use patterns vary substantially across regions.
The bigger picture
Crack cocaine use rarely occurs in isolation. This population-based study confirms that young crack cocaine users carry a heavy burden of psychiatric comorbidity and polysubstance use, suggesting that effective interventions need to address multiple conditions simultaneously rather than targeting one substance in isolation.
Questions still open
- Does treating PTSD reduce crack cocaine use in young adults? Are the psychiatric associations specific to crack cocaine or shared with other forms of cocaine? Would early intervention for trauma reduce later crack cocaine initiation?
Common questions
Why is this relevant to cannabis research?
What is the ASSIST inventory?
Read the original research
Psychiatric and substance-use comorbidities associated with lifetime crack cocaine use in young adults in the general population.
Comprehensive psychiatry, 55(6), 1369-76
Citation
Narvaez, Joana C M; Jansen, Karen; Pinheiro, Ricardo T; Kapczinski, Flávio; Silva, Ricardo A; Pechansky, Flávio; Magalhães, Pedro V. (2014). Psychiatric and substance-use comorbidities associated with lifetime crack cocaine use in young adults in the general population.. Comprehensive psychiatry, 55(6), 1369-76. https://doi.org/10.1016/j.comppsych.2014.04.021
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