title: Predictors of early relapse among adolescent crack users.
abstract: Relapse is associated with a poor prognosis among drug users. Crack cocaine users are more prone to severe dependence because of the intensity of use. Additionally, initiating drug use during adolescence worsens users' prognosis due to the increased rates of impulsivity and other risk behaviors. This study aimed to identify the predictors of early relapse among adolescent crack users discharged from inpatient treatment. A cohort study was conducted with 89 psychiatric inpatients aged 12-17 years from two different hospitals in southern Brazil who met the criteria for crack abuse or dependence. Demographic data, substance use disorders, psychiatric comorbidities, and crack consumption profile were assessed during hospitalization using the Teen Addiction Severity Index, Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime, and Crack Consumption Profile. Participants were re-assessed at 1 and 3 months after hospital discharge to determine their crack cocaine use based on self-report, family/caregiver information, and urine tests, whenever possible. There were extremely high rates of relapse (valid percent) in the first and third months, 65.9 and 86.4%, respectively. Statistically significant associations were observed between relapse in the first month and length of cocaine/crack cocaine use, and length of hospital stay. Data at 3 months were not analyzed because of the small number of patients who did not relapse. The high rates and significant associations found in this study suggest that intensive outpatient treatment strategies targeting this population should be developed and implemented to prevent early relapse after detoxification. One of the possible approaches, based on recent studies, might explore motivation as a strategy to reduce the rate of early relapse.
authors.affiliation: a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
authors.forename: Ronaldo
authors.initials: R
authors.lastname: Lopes-Rosa
authors.affiliation: a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
authors.forename: Félix P
authors.initials: FP
authors.lastname: Kessler
authors.affiliation: a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
authors.forename: Thiago G
authors.initials: TG
authors.lastname: Pianca
authors.affiliation: a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
authors.forename: Luciano
authors.initials: L
authors.lastname: Guimarães
authors.affiliation: a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Ferronato
authors.affiliation: b Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , RS , Brazil.
authors.forename: Esequiel
authors.initials: E
authors.lastname: Pagnussat
authors.affiliation: a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
authors.forename: Helena
authors.initials: H
authors.lastname: Moura
authors.affiliation: a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
authors.forename: Flavio
authors.initials: F
authors.lastname: Pechansky
authors.affiliation: a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
authors.forename: Lisia
authors.initials: L
authors.lastname: von Diemen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001938:Brazil / Q000453:epidemiology; D002648:Child; D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D016578:Crack Cocaine; D017831:Diagnosis, Dual (Psychiatry) / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D012008:Recurrence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D016578:Crack Cocaine
keywords: Crack cocaine; adolescence; predictors of relapse; relapse; substance use