Cocaine use and social transformation

There is little disagreement that the drug cocaine extracted from the plant Erythroxylon coca has had an extraordinary effect in the transformation of economies, lifestyles and governance. Those at the higher levels who are active in the trade, often with the consent of governments are untouchable and accumulate vast amounts of wealth and prestige, while the working class, those to whom it is peddled is further pushed downwards into the poverty line and death through drug-seeking behaviour. Not only has cocaine use resulted in social transformation but has had deleterious effects on the mental and physical health of nations. This chapter traces the history, introduction, development, culture, methods of use and effects of the use of cocaine in Trinidad and Tobago and its worldwide implications. Cocaine remains a scourge to mankind.

Drug use, sexual behaviour and HIV risk of the homeless in Port-of-Spain, Trinidad

Data were collected from 88 homeless persons in Port-of-Spain, Trinidad to assess HIV risk. 68 percent of the sample were engaging in unprotected sex with multiple partners, 25 percent were exchanging sex for money, and 29.5 percent were regularly smoking crack cocaine. Many had two or more of these behaviours that put them at high risk of HIV infection. Females were significantly more likely to be sex traders, to engage in bisexual behaviour and to have a history of psychiatric illness. The relationship between psychiatric illness and HIV risk behaviours among homeless female persons is explored. Educational interventions are suggested to reduce the public health risks in this population.(AU)

Modified EMIT Dau Immunossay to allow cocaine metabolites determination in urine of crack cocaine smokers - abstract

Alkaloidal cocaine (COPC) is widely sold in the West Indies in a form suitable for smoking. These little rocks called "crack", addictive in high doses (typically 120 mg), produce a rapid, intense, high and a very compelling type of COC dependence. The bioavailability and the metabolism of the smoked form (half-life of 56 min versus 78 and 80 min, respectively, after IV and IN COC administration) conduce to low levels of metabolites in serum and in urine. Clinical and forensic toxicology laboratories are more and more solicited for testing major cocaine metabolite: benzoylecgonine (BZE). The Enzyme Multiplied Immunossay Technique (EMIT) is a fast, simple and reliable technology. However, the assay cut off concentration for BZE of the commercially available kit: (EMIT dau Cocaine Metabolite Immunoassay) is too high (300ng/ml) for serum or urine detectable levels of BZE in cocaine smokers. We proposed a modified EMIT assay to make this technique suitable for level of detection. The immunoassay was applied to ROCHE COBAS MIRA Plus analyser. The increase of the sample volume up to 25 ul and the use of calibration standards 0 to 300 ng/ml conduce to a lower detection limit of 50ng/ml. The within run precision of the assay was less than 10 percent. The results were confirmed by gas chromatography mass spectrometry. The increase of sensitivity was near 30 percent. No false positive results were observed. The presented modification demonstrates the application of currently available EMIT Immunoassay to rapid and reliable testing for BZE in cocaine smokers. (AU)

Characteristics of HIV-infected pregnant women in the Bahamas

The Commonwealth of the Bahamas has one of the highest rates of acquired immunodeficiency syndrome (AIDS) in the English-speaking Caribbean. A seropositive study of the pregnant women attending antenatal clinics in New Providence in 1990-91 showed that of 3,914 pregnant women tested, 2.9 percent were human immunodeficiency virus (HIV) infected. Women born in the Bahamas constituted 79.2 percent of the women tested; 17.7 percent were born in Haiti. The rate of HIV infection was 2.5 percent in the Bahamian women as compared with 4.5 percent in those born in Haiti. The highest incidence was in women aged 25-34 years and in women who had multiple pregnancies. There was a significant association with a history of crack cocaine use by the Bahamian women. There was also a significant association between a lack of education and HIV infection in this group. There was a lower rate of condom use among women with less education and also among women in common-l

Drug abuse in all age schools

Drug abuse is a serious problem in Jamaica and around the world, affecting people from all walks of life. The most significant impact is among our youths who remain the most affected by drug abuse. A survey designed to assess knowledge, attitude and practice of students with regard to drug use was undertaken in schools. The study was conducted among 200 students in four all age schools, in the metropolitan area. In order to do the study a random sample was selected and a self administered questionnaire was used to collect the data. The results revealed that drug abuse was rising and was more common in males than females, in some cases the male to female ratio being four to one. Alcohol was the most commonly used drug, followed by tobacco, cannabis and inhalants. 90 percent of alcohol users became regular users. Among the illicit drugs, cannabis was most prevalent. For both crack and cocaine, the prevalence for current usage had increased significantly since 1987. Twenty percent of students believed there was no risk involved in taking drugs. In general the trend of drug use and abuse is on the rise and fifty percent of students taking drugs began before ten year of age. The author concluded that the problem of drug use and abuse had risen and made recommendations, including that institutions should be set up to deal with drug abuse in adolescents and existing educational programmes be strengthened and targeted at the lower age groups. (AU)

The Rastafarian community and the "gateway" theory: lessons to be learned

The findings presented in this paper are drawn from a national ethnographic study conducted in six Jamaican populations, one of which was composed of members of the Rastafarian religion recruited from Kingston and south coast villages. Ninety-one members of the Rastafarian sect were formally interviewed and observed. The ethnographic study purposely over-sampled the Rastafarian community (1) because it was not sufficiently represented in the 1987 survey and (2) in order to examine the relationship between use of ganja and crack/cocaine. If ganja is, in fact, a "gateway" drug to cocaine, we would anticipate a high prevalence of crack/cocaine in this population. The data revealed that, as a group, members of the Rastafarian community were the most vigorous in shaping the definition of the term "drug". Cocaine is considered a drug but ganja, despite its illegal status, is considered a "natural" substance with health rendering properties and ritual functions. Not surprisingly, 0.4 percent of the Rastafarians surveyed believed that ganja should be legalized. Of all the populations investigated, Rastafarians were most likely to report that crack/cocaine was easy to obtain and to rank crack and cocaine as the most commonly used drugs. As a group, they are, in many ways, the most at risk for crack/cocaine use and addiction; compared with the rest of the sample, they have more urban, tourist and overseas experience as well as high potential for exposure to crack/cocaine. Yet the Rastafarian doctrine and design for living frequently were cited as the justification for preventing and/or for relinquishing the use of crack/cocaine. In its exception to the gateway theory, the Rastafarians community suggests protective mechanisms that inhibit the shift toward crack/cocaine use in high risk populations. (AU)

Some health issues on the Cave Hill Campus, U.W.I. - abstract

In response to concerns expressed about drug abuse among students attending the Cave Hill Campus, a survey was conducted among the entire campus community to determine views about a wide range of health related issues. The survey was conducted by a pretested, self-administered, anonymous questionnaire, and was done on a single day on campus. The sample was chosen as a stratified sample of the campus personnel from the staff and student lists. Thirty-six per cent of the 1 in 4 sample responded to the questionnaire (7.9 per cent of all students, and 14 per cent of all staff). The age, sex, race and religious affiliations of the respondents were representative of the campus community. The numbers of responding students, administrative, academic and clerical staff were sufficient for their conclusions to be considered in the analysis. Staff and students generally considered themselves to be in good health. They were conscious of the bad effects on health of smoking cigarettes, and the use of ganja or cocaine. They also considered being overweight, worry and stress as being bad for health. Drugs were not a regular subject for discussion on the campus. While 3 of 5 respondents said they could recognise cocaine, crack or speed. Less than 1 per cent admitted to the use of any of these drugs and 80 per cent said they had never used cigarettes. Alcohol use was far more frequent, particularly among members of the academic staff, as was the use of cigarettes. Generally, members of the campus community were aware of the lifestyles that were at high risk for HIV, although 30 per cent of respondents considered lesbians as being at high risk. Using "one night stands" as indicative of high-risk sexual behaviour, 28.6 per cent of academics and 14.5 per cent of students said they had had such experiences within the last five years. Respondents reported a reduction in sexual partners compared to the previous year, and five years before. As regards problems which students considered may affect their health, concerns were expressed about stress, overwork, and insufficient money. Academics and students considered drug use as a minor problem among students, while clerical staff were more concerned about this as a problem. Generally, students did not consider themselves to be sexually harassed, although administrative and clerical staff expressed concerns in this regard. The campus emerges as a relatively abstemious one in every regard. However, both students and staff expressed significant concerns about stress and underfunding of students (AU)

Nine years of the freebase cocaine epidemic in the Bahamas: emergence of a new pattern

Nine years the beginning of the first reported nationwide epidemic of freebase (crack) cocaine abuse, which occurred in the Bahamas, a follow-up study was done to determine the pattern of the epidemic and the effectiveness of control measures. Data included the incidence of new cases at the only psychiatric hospital in the Bahamas and the primary community pschiatric clinic in the nation. Data on police arrests, drug seizures, and results for urine screenings for cocaine abuse came from the reports of the Royal Bahamas Police Force. The number of new cases of crack abuse presenting for treatment fell from 1987 to mid-1991, with a corresponding reduction of load at the treatment facilities. However, hospitalized cocaine abuse cases began rising again in mid-1991. This paper analyzes correlates of the fall and partial resurgences of the epidemic. In 1992, crack is much more difficult to obtain than in the early and middle 1980's. The Bahamian reponse to the epidemic - including 1) demand reduction, 2) supply reduction and 3) reduction of money laundering - played an important role in the decline of new cases. Crack has not been replaced by other illegal drugs, but alcohol has resumed its former place of preference. However, despite a reduction in the rate of new crack abuse cases appearing for treatment, there has been a recent rise in violent, robberies and gang activity. This apparently is due to chronic cocainism, a pattern of long term use of crack and other forms cocaine that is resistant to treatment (AU)

Crack: new directions in drug research. Part 1. Differences between the marijuana economy and the cocaine/crack economy

Crack use and trafficking in low-income, minority communities in New York City have pushed into prominence many aspects of drug use/misuse and distribution which had formerly received inadequate attention. For example, the generation and reinvestment of drug incomes are important determinants of how various drugs are experienced. While in retrospect marijuana trafficking appears to have been an almost benign affair, crack trafficking is fast-paced, ruthless, steeped in violence, and improvishes everyone who becomes engaged in it. In this part the differences between rates, volumes, and methods of income generation related to the use and distribution of marijuana and cocaine are elaborated. The contrast raises a question: Do economies like drug distribution follow a particular rhythmic pattern (capital accumulation during the benign marijuana passage followed by capital depletion in the overheated crack era), and how is it related to the changing demands of the regional economy? Viewed from this perspective, drug distributors and users appear not so much as "deviant" or "alienated" or as a "reserve pool of labor," but rather as a type of labor force which does indispensable work for the whole society. (AU)

From Ganja to crack: Caribbean participation in the underground economy in Brooklyn, 1976-1986. Part 2. Establishment of the cocaine (and crack) economy

Shortages in the supply of marijuana, which became acute around 1981, caused Rastafari marijuana distributors very reluctantly to disregard religious injunctions against the use of any psychoactive substance except marijuana, and to experiment with the use and distribution of cocaine hydrochloride powder for intranasal administration and, later, for smoking (freebase and crack). This experimentation became ruinous, and many were retired ignominiously from drug distribution. In the crack era they have been succeeded by completely new social, cultural, and economic arrangements. (AU)