Markers for Severity of Problems in Interpersonal Relationships of Crack Cocaine Users from a Brazilian Multicenter Study.

Crack cocaine users frequently report difficulties regarding having healthy and rewarding relationships. Factors other than the use of crack cocaine itself may be at play when it comes to being able to develop healthier connections with partners, adult relatives and close friends. To verify which factors, including demographics, substance abuse related factors and psychiatric comorbidities could be markers for a higher severity of problems in interpersonal relationships of crack cocaine users seeking for treatment. This was a cross-sectional study, conducted between April 2011 and November 2012. Participants were 407 crack cocaine users seeking treatment in specialized public facilities of six Brazilian capitals. The relationship of severity of problems in the family/social area and the prevalence of psychiatric disorders, exposure to stressful events, substance use related factors and practice of illicit activities were explored through multivariate analyses. Number of days using crack cocaine in the last 30 days, age of first time using alcohol and feeling its effects, a diagnosis of alcohol abuse, posttraumatic stress disorder, antisocial personality disorder and attention-deficit/hyperactivity disorder were significantly associated with a higher severity of problems in interpersonal relationships with partners, adult relatives and friends. Problems in interpersonal relationships are strongly related to specific psychiatric comorbidities and the frequency of crack cocaine use. Factors identified by this study can make the paths to recovery more challenging. These results support psychosocial interventions that focus in the improvement of interpersonal relationships of crack cocaine users.

Assessment of inhibitory control in crack and/or cocaine users: a systematic review.

OBJECTIVE: Impairments involving inhibitory control have been considered central deficits in drug users, but it appears that dysfunctions may be specific to users' drug of choice. This article aims to review recent findings on inhibitory control impairment in samples of crack and/or cocaine users. METHODS: Searches were conducted on the PubMed, PsycINFO, and Web of Knowledge databases in two stages according to eligibility criteria. Initially, databases were searched and the titles and abstracts of results were analyzed and then selected articles were read in full. Inclusion criteria were: empirical articles written in English, Portuguese, or Spanish, published in the last ten years and involving the assessment of inhibitory control in crack and/or cocaine users. RESULTS: The database searches returned a total of 3,796 titles, 56 of them were selected initially and then a further 20 were excluded. Thirty-six articles were included in this review. In 90% of the studies reviewed the presence of inhibitory control deficits was reported, verified by impaired cognitive processing and response monitoring, as well as high levels of impulsiveness, regardless of the pattern of crack and/or cocaine consumption (recreational or chronic). Former users showed high levels of impulsiveness even after long periods of abstinence. CONCLUSIONS: Crack and/or cocaine users may have inhibitory control deficits, irrespective of different consumption patterns. High levels of impulsiveness can represent a factor of vulnerability to drug use and relapse.

Assessment of inhibitory control in crack and/or cocaine users: a systematic review / Avaliação do controle inibitório em usuários de cocaína e/ou crack: uma revisão sistemática

Abstract Objective Impairments involving inhibitory control have been considered central deficits in drug users, but it appears that dysfunctions may be specific to users' drug of choice. This article aims to review recent findings on inhibitory control impairment in samples of crack and/or cocaine users. Methods Searches were conducted on the PubMed, PsycINFO, and Web of Knowledge databases in two stages according to eligibility criteria. Initially, databases were searched and the titles and abstracts of results were analyzed and then selected articles were read in full. Inclusion criteria were: empirical articles written in English, Portuguese, or Spanish, published in the last ten years and involving the assessment of inhibitory control in crack and/or cocaine users. Results The database searches returned a total of 3,796 titles, 56 of them were selected initially and then a further 20 were excluded. Thirty-six articles were included in this review. In 90% of the studies reviewed the presence of inhibitory control deficits was reported, verified by impaired cognitive processing and response monitoring, as well as high levels of impulsiveness, regardless of the pattern of crack and/or cocaine consumption (recreational or chronic). Former users showed high levels of impulsiveness even after long periods of abstinence. Conclusions Crack and/or cocaine users may have inhibitory control deficits, irrespective of different consumption patterns. High levels of impulsiveness can represent a factor of vulnerability to drug use and relapse.

Resumo Objetivo Prejuízos envolvendo o controle inibitório têm sido considerados déficits centrais em usuários de substâncias psicoativas, contudo parece haver disfunções específicas de acordo com a droga de escolha. Este artigo teve por objetivo revisar os achados recentes sobre alterações do controle inibitório em amostras de usuários de cocaína e/ou crack. Método A pesquisa foi realizada nas bases de dados PubMed, PsycINFO e Web of Knowledge, em duas etapas, de acordo com os critérios de elegibilidade: inicialmente foi feita uma pesquisa nas bases de dados com análise dos títulos e resumos; após, os artigos foram lidos na íntegra. Os critérios de inclusão foram: artigos empíricos publicados em inglês, português ou espanhol, nos últimos 10 anos e que tenham avaliado o controle inibitório em usuários de cocaína e/ou crack. Resultados Do total de 3.796 resultados, 56 títulos foram selecionados, sendo 20 excluídos. Como resultado, 36 artigos foram incluídos na revisão. Em 90% dos estudos revisados, foi relatada a presença de déficits de controle inibitório, verificados através de prejuízos no processamento cognitivo e no monitoramento de respostas, além de níveis elevados de impulsividade, independentemente do padrão de consumo de cocaína e/ou crack (uso recreativo ou crônico). Usuários em abstinência apresentaram níveis elevados de impulsividade, mesmo após longos períodos sem uso da droga. Conclusão Usuários de cocaína e/ou crack podem apresentar prejuízos de controle inibitório apesar dos diferentes padrões de consumo. Níveis elevados de impulsividade podem constituir fator de vulnerabilidade para o uso de drogas e para a recaída.