title: Comparing key characteristics of young adult crack users in and out-of-treatment in Rio de Janeiro, Brazil.
abstract: BACKGROUND
  Crack use is prevalent among street drug users in Brazilian cities, yet despite recent help system reforms and investments, treatment utilization is low. Other studies have identified a variety of - often inconsistent - factors associated with treatment status among crack or other drug users. This study compared socio-economic, drug use, health and service use characteristics between samples of young adult crack users in- and out-of-treatment in Rio de Janeiro, Brazil.
  
  
  RESULTS
  Street-involved crack users (n = 81) were recruited by community-based methods, and privately assessed by way of an anonymous interviewer-administered questionnaire as well as biological methods, following informed consent. In-treatment users (n = 30) were recruited from a public service in-patient treatment facility and assessed based on the same protocol. Key indicators of interest were statistically cross-compared. Not-in-treatment users were less likely to: be white, educated, stably housed, to be involved in drug dealing, to report lifetime marijuana and current alcohol use, to report low mental health status and general health or addiction/mental health care; they were more likely to: be involved in begging and utilize social services, compared to the in-treatment sample (statistical significance for differences set at p < .05).
  
  
  CONCLUSIONS
  In-treatment and not-in-treatment crack users differed on several key characteristics. Overall, in-treatment users appeared to be more socio-economically integrated and connected to the health system, yet not acutely needier in terms of health or drug problems. Given overall low treatment utilization but high need, efforts are required to facilitate improved treatment access and use for marginalized crack users in Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Cruz
authors.forename: Neilane
authors.initials: N
authors.lastname: Bertoni
authors.forename: Francisco I
authors.initials: FI
authors.lastname: Bastos
authors.forename: Chantal
authors.initials: C
authors.lastname: Burnett
authors.forename: Jenna
authors.initials: J
authors.lastname: Gooch
authors.affiliation: Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, 2400-515 West Hastings St,, Vancouver V6B 5 K3, Canada. bfischer@sfu.ca.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D001938:Brazil; D019970:Cocaine-Related Disorders / Q000523:psychology*; D016578:Crack Cocaine; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D062487:Social Marginalization / Q000523:psychology; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D016578:Crack Cocaine