title: Crack/cocaine use in a rural county of England.
abstract: Crack/cocaine use is an increasing problem in the UK. This study is the first to ascertain the magnitude of the crack/cocaine problem in a rural county of the UK and to determine users' needs for treatment services. A questionnaire on drug dependence and risk behaviour was completed by 306 users of drug treatment services, and focus groups were conducted with 45 self-selected crack/cocaine users. It is estimated that 31% (95% C.I., 26% to 37%) of drug users in treatment services have moderate/severe dependence on crack/cocaine. Factors associated with severe crack/cocaine dependence are severe dependence on benzodiazepines, increasing number of drugs used, engaging in sex work and non-white ethnicity. Those with severe dependence have a higher prevalence of hepatitis B and C compared with those with moderate or no dependence. All focus group participants describe a frenzied drug life so when entering treatment they require additional support to give structure to their lives to prevent relapse. Current service provision appears not to provide help to crack/cocaine users. Given the lack of pharmacological treatment, programmes should incorporate a wide range of activities and interventions to provide structure to clients' lives. Learning from ex-users was perceived as an important component of treatment.
authors.affiliation: School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK.
authors.forename: Roberto
authors.initials: R
authors.lastname: Vivancos
authors.forename: Viviene
authors.initials: V
authors.lastname: Maskrey
authors.forename: Daphne
authors.initials: D
authors.lastname: Rumball
authors.forename: Ian
authors.initials: I
authors.lastname: Harvey
authors.forename: Richard
authors.initials: R
authors.lastname: Holland
mesh_terms: D000328:Adult; D016578:Crack Cocaine; D004739:England / Q000453:epidemiology; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006402:Hematologic Diseases; D006505:Hepatitis / Q000821:virology; D006801:Humans; D008297:Male; D011634:Public Health; D012424:Rural Population; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000628:therapy; D011795:Surveys and Questionnaires
chemical_list: D016578:Crack Cocaine