Crack cocaine trajectories among users in a midwestern American city
Article first published online: 23 JUL 2007
Volume 102, Issue 9, pages 1421–1431, September 2007
How to Cite
Falck, R. S., Wang, J. and Carlson, R. G. (2007), Crack cocaine trajectories among users in a midwestern American city. Addiction, 102: 1421–1431. doi: 10.1111/j.1360-0443.2007.01915.x
- Issue published online: 9 AUG 2007
- Article first published online: 23 JUL 2007
- Submitted 20 December 2006; initial review completed 6 March 2007; final version accepted 20 April 2007
- crack cocaine;
- drug dependence;
- DSM-IV disorders;
- group-based modeling;
- natural history;
- substance abuse
Aims Although crack cocaine first appeared in cities in the United States in the mid-1980s, little is known about its use over long periods of time. This study identified crack cocaine user groups on the basis of long-term trajectories.
Design Following a natural history approach, data were collected periodically from 1996 to 2005. Group-based modeling assessed the probability of a crack smoker becoming abstinent during the observation period.
Setting A targeted sampling plan guided the recruitment of a community sample of crack cocaine users in Dayton, Ohio.
Participants Crack smokers (n = 430) 18 years or older whose urine tested positive for cocaine metabolites at the baseline interview.
Measurements Interviewer-administered and audio computer self-administered, structured questionnaires were used to collect data on a range of variables, including frequency of crack use. Abstinence was defined as not having used crack for at least 6 consecutive months during the study.
Findings Three trajectory-based groups were identified: (1) No Change, characterized by a very low probability of abstinence; (2) Some Change, characterized by a low to moderate probability of abstinence; and (3) Dramatic Change, characterized by a high probability of abstinence. African Americans and men were significantly less likely to become abstinent. For the majority of the people (63.6%), crack use was uninterrupted by extended periods of abstinence during the study.
Conclusion Crack cocaine use that persists for a decade or longer may well be the norm for a large proportion of people who have experience with the drug.