title: Emerging patterns of crack use in Mexico City.
abstract: BACKGROUND
  Recent studies in Mexico have documented a significant increase in crack cocaine use, indicating the potential for an emerging drug epidemic.
  
  
  METHODS
  Ethnographic observations and interviews were used describe the profiles and patterns of use among street-recruited crack users in Mexico City. The data came from an international research collaboration funded by the National Institutes of Health.
  
  
  RESULTS
  A polythetic typology was developed based on five dimensions central to categorizing patterns of crack use behavior: frequency of use, duration of use, context, social networks, and social contracts. Four types of users were discovered applying these dimensions: dabblers, stable users, crack heads, and old heads. Although several similarities were documented between patterns of crack use in Mexico and those in the United States and Western Europe, several key aspects distinguished crack users in this population: (1) self-regulated use; (2) non-linear progression of crack; and (3) the influence of the dimensions pertaining to setting, social networks, and social contract as contributing to understanding of the previous two. Further, we provide a discussion of how specific contextual factors in Mexico may be giving rise to these emerging patterns.
  
  
  CONCLUSIONS
  Compared to the U.S. and Europe, this study finds that the majority of crack users were able to self-regulate their use without major disruption to daily social functioning. As crack use spreads in Mexico and other Latin American countries, we need to recognize the importance of social context in developing more tailored health and social responses that are specific to these developing countries.
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, CA, USA. Electronic address: a.valdez@usc.edu.
authors.forename: Avelardo
authors.initials: A
authors.lastname: Valdez
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, CA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Kaplan
authors.affiliation: Department of Sociology & Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Nowotny
authors.affiliation: Instituto Nacional de Psiquiatría, Ramón de la Fuente Muñiz, Mexico City, Mexico.
authors.forename: Guillermina
authors.initials: G
authors.lastname: Natera-Rey
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, CA, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Cepeda
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D016578:Crack Cocaine / Q000633:toxicity*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology
chemical_list: D016578:Crack Cocaine
keywords: Crack use; Marginalization; Mexico; Self-regulation; Social context