title: Implementation of harm reduction toward crack users in Brazil: barriers and achievements.
abstract: From 2002 to 2005, we evaluated five Brazilian harm reduction programs ran by active drug users who distributed pipes, condoms, educational material, and provided referral to crack users. System-wide barriers identified: funds discontinuation and legislation barriers toward fieldwork. Major achievements: increased access to health, social, and psychological support. Crack-cocaine users experience a plethora of health/social problems, attenuated by low-threshold and user-friendly interventions, particularly those developed by other drug users. However, a stronger political commitment is needed to face a fast growing crack-cocaine epidemic in Brazil, aiming to ensure availability/continuity of funds, implementation of large-scale interventions, outreach workers training, and proper evaluation.
authors.affiliation: Porto Alegre Health Secretariat, Porto Alegre-RS, Brazil. andreadomanico@gmail.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Domanico
authors.forename: Monica
authors.initials: M
authors.lastname: Malta
mesh_terms: D000328:Adult; D001938:Brazil; D016578:Crack Cocaine; D055030:Drug Users / Q000193:education; D005260:Female; D040261:Harm Reduction; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010379:Peer Group; D010865:Pilot Projects; D016730:Program Development; D012017:Referral and Consultation; D040242:Risk Reduction Behavior; D019966:Substance-Related Disorders / Q000517:prevention & control; D055815:Young Adult
chemical_list: D016578:Crack Cocaine