Changes in cocaine use as viewed by key informants: a qualitative study carried out in 1994 and 1999 in São Paulo, Brazil.

The characteristics of coca products use in São Paulo, Brazil during the years of 1994 and 1999 were investigated through interviews with 26 key informants (KIs; persons with knowledge of coca product users) in each of these years. The following information was yielded by the KIs: (1) there has been a large increase in coca products use in São Paulo from 1994 to 1999; concomitantly, there has been a decrease of hydrochloride use; (2) the increase has occurred due to the dissemination of crack which became cheap and easily available; (3) reasons for crack use changed greatly: in 1994, use was attributed mostly to pleasurable sensations produced by smoking; in 1999, use was intended to overcome compulsion/dependence or to put up with frustration/family conflicts; (4) crack users in 1999 came from practically all social classes of São Paulo; (5) use of alcohol and/or marijuana to cut down the anxiety and excitement produced by crack increased from 1994 to 1999; (6) even when police repression of traffic was effective, which rarely occurred, it affected only the price of coca products; (7) treatment services available were considered insufficient both in number and quality, and were run by ill-trained health professionals (this situation deteriorated even more in 1999); (8) many KIs heavily criticized the prevention programs because of the use of "scare techniques"; and (9) all KIs in 1999 believed that, unless the government changes its policy toward the drug problem, the situation would become worse in the next few years.