This article was downloaded by: [University of Newcastle, Australia] On: 07 January 2015, At: 19:10 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Psychoactive Drugs Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ujpd20
Editor's Introduction: The Crack Epidemic Revisited James A. Inciardi
a
a
Center for Drug and Alcohol Studies University of Delaware—Newark Published online: 18 Jan 2012.
To cite this article: James A. Inciardi (1992) Editor's Introduction: The Crack Epidemic Revisited, Journal of Psychoactive Drugs, 24:4, 305-306, DOI: 10.1080/02791072.1992.10471655 To link to this article: http://dx.doi.org/10.1080/02791072.1992.10471655
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Editor's Introduction The Crack Epidemic Revisited
Downloaded by [University of Newcastle, Australia] at 19:10 07 January 2015
James A. Inciardi, Ph.D. Professor and Director Center for Drug and Alcohol Studies University of Delaware-Newark
Crack is a variety of cocaine base produced by "cooking" cocaine hydrochloride in boiling water and baking soda. It has been called the fast-food variety of cocaine, and it became popular in many inner-city communities because it is cheap, easy to conceal and vaporizes with practically no odor; the gratification is swift and is commonly described by users as an intense, penetrating, almost sexual euphoria. However, smoking cocaine, as opposed to snorting it, results in more immediate and direct absorption of the drug, producing a quicker and more compelling high, which greatly increases dependence potential. Moreover, there is increased risk of acute toxic reactions, including brain seizure, cardiac irregularities, respiratory paralysis, paranoid psychosis, and pulmonary dysfunction (Inciardi 1992, 1987; Wallace 1991). Users typically smoke for as long as they have crack or the means to purchase it: money, personal belongings, sexual services, stolen goods, or other drugs. It is rare that smokers have but a single hit of crack. More likely they spend $50 to $500 during what they call a "mission," a three- or four-day binge, smoking almost constantly, 3 to 50 rocks per day. During these cycles, crack users rarely eat or sleep. And once crack is tried, it is not long before it becomes a daily habit for many users. The tendency to binge on crack for days at a time, neglecting food, sleep, and basic hygiene, severely compromises physical health; consequently, crack users appear emaciated most of the time. They lose interest in their physical appearance; many have scabs on their faces, arms, and legs- the result of burns and picking at the skin (to remove bugs and other insects believed to be crawling under the skin). Crack users tend to have burned facial hair from carelessly lighting their smoking paraphernalia and may have burned lips and tongues from the hot stems of their pipes; many seem to cough constantly. It should be pointed out that crack cocaine is not a particularly new drug. Recent history and folklore suggest that it was originally known as "garbage freebase," and that it first appeared in the San Francisco free base culture Jourtwl of Psychoactive Drwgs
of the early 1970s. As the product of a shortcut method for transforming cocaine hydrochloride into the base state (and hence, without removing impurities), the drug was experimented with for only a short period, and then set aside as an inferior commodity (Inciardi 1992: 111). The use of crack did not become popular until it reemerged in many inner-city communities during the mid-1980s. Shortly after the drug was noticed by the media at the close of 1985, press and television reports began describing crack use as an "epidemic" and "plague" that was devastating entire communities (Inciardi 1987). Considerable focus was placed on how the high addiction liability of the drug instigated users to commit crimes to support their habits, how youths were drawn into the crack-selling business, how the violence associated with attempts to control crack distribution networks turned some communities into urban "dead zones" where crime was totally out of control, how crack engendered a "hypersexuality" among users, and how the drug was contributing to the further spread of HIV and AIDS! By the close of the 1980s, reports on field and clinical studies of crack began appearing in the professional literature (see Bourgois and Dunlap 1991; Chiasson eta! . 1991; Inciardi 1991; Inciardi and Pottieger 1991; Wallace 1991; Fulliloveet al. 1990; Bourgois 1989; Bowser 1989; Fullilove and Fullilove 1989; Guinan 1989; lnciardi 1989). As researchers and clinicians began grappling with the problems of crack, new policy initiatives also became evident at federal, state, and local levels. While a number of jurisdictions began prosecuting pregnant, crack-addicted women for child abuse and drug delivery (to a fetus), other legislatures passed enhanced and/or mandatory sentencing laws for those selling or trafficking in crack. Similarly, funding was increased at the federal level for enforcement, education, prevention, and treatment. Then, in 1988, at a time when the War on Crack was being waged on all fronts, the national high school and household surveys of drug abuse began showing declines in crack and cocaine use (Adams et al. 1990; Berke 1989). Subsequent surveys found that these declines were the beginning of a trend 305
Vol. 24(4), Oct-Dec 1992
Downloaded by [University of Newcastle, Australia] at 19:10 07 January 2015
Inciardl
Introduction
(University of Michigan 1992; Unsigned 1990a; Unsigned 1990b). Researchers, clinicians, and numerous other observers both within and outside the drug field readily understood, however, that the survey data reflected trends only within the stable in-school and at-home populations, and did not necessarily apply to dropouts, those living on the streets and in the drug subcultures, and other hard to reach populations. And, it was clear that while the use of crack and other forms of cocaine might be declining in middle and upper socioeconomic groups, that did not appear to be the situation in most of the nation's inner cities. Within this context, this issue of the Journal of Psychoactive Drugs revisits the crack epidemic in the United States, targeting the issues and problems that appear to be most enduring and troublesome. Readers will note at the outset that the majority of the articles in this thematic issue focus on crack in three cities- New York, San Francisco, and Miami- for witich there are several reasons. First, although crack has been and continues to be a major problem in many communities, it would appear that it has the longest history in these three cities. Second, and perhaps most notably, it is in these three locales that
much of the research on crack cocaine has been conducted during the second half of the 1980s and the opening years of the 1990s. And finally, the studies funded by the Centers for Disease Control to examine crack/HIV phenomena are based in these three metropolitan areas. Of significance as well is the fact that there has been considerable collaboration among researchers across studies, sites, and institutions.
NOTES 1. See New York Times November 29, 1989: 1A, B6; New York Doctor April10, 1989:1, 22; U.S. News & World Report AprillO, 1989:20-32; Miami Herald April24, 1988 ("Neighbors" suppl.):21-25; New York Times March 20, 1988: E9;New York Times June 23, 1988: AI, B4; Time December 5, 1988:32;Newsweek April27, 1987:35-36; Newsweek June 16, 1986:15-22; Newsweek June 30, 1986:52-53; New York Times August 25, 1986:B 1-B2; New York Times November 24, 1986: 1A,B2; USA Today June 16, 1986: 1A
REFERENCES Guinan, M.E. 1989. Women and crack addiction. Journal of the American Women's Medical Association44 :129. Inciardi, J.A. 1992. The War on Drugs II: The ConJinuing Epic of Heroin, Cocaine, Crack, Crime, AIDS, and Public Policy. Mountain View, California: Mayfield. Inciardi, J .A. 1991 . Kingrats, chicken heads, slow necks, freaks, and blood suckers: A glimpse at the Miami sex-for-crack market. Paper presented at the Annual Meeting of the Society for Applied Anthropology. Charleston, South Carolina, March 13-17. Inciardi, J.A. 1989. Trading sex for crack among juvenile drug users : A research note. Contemporary Drug Problems 16:689-700. Inciardi, J.A. 1987. Beyond cocaine: Basuco, crack, and olher coca products . Contemporary Drug Problems 14:461-492. lnciardi, J.A. & Pottieger, A. E. 1991. Kids, crack, and crime. Jowrnal of Drug Issues 21:257-270. University of Michigan News and Information Service. 1992. Most forms of drug use decline among American high school and college students. Press release, January 27. Unsigned. 1990a. High school survey shows continuing decline in illegal drug use. Alcoholism and Drug Abuse Week February 14:1. Unsigned 1990b. Latest household survey shows declining use of most illicit drugs. Alcoholism and Drug Abuse Week December 29:1. Wallace, B.C. 1991. Crack Cocaine: A Practical Treatment Approach for the Chemically Dependent. New York: Brunner/Mazel.
Adams, E.H.; Blanken, A.J.; Ferguson, L.D. & Kopstein, A. 1990. Overview of selected drug trends. Unpublished report. Division of Epidemiology and Prevention Research. Rockville, Maryland: National Institute on Drug Abuse. Berke, R.L. 1989. Student survey detects decline in use of crack. New YorkTimesMarch l:Al6. Bourgois, P. 1989. In search of Horatio Alger: Culture and ideology in the crack economy. Contemporary Drug Problems 16:619-649. Bourgois, P. & Dunlap, E. 1991. Sex-for-crack in Harlem, New York. Paper presented at the Annual Meeting of the Society for Applied Anthropology. Charleston, South Carolina, March 13-17. Bowser, B.P. 1989. Crack and AIDS : An ethnographic impression. Journal oftM National Medical Association 81:538-540. Chiasson, M.A; Stoneburner, R.L; Hildebrandt, D.S.; Ewing, W.E.; Telsak, E.E. & Jaffe, H.W. 1991. Heterosexual transmission of HIV1 associated with the use of smokable freebase cocaine (crack). AIDS 5:1121-1126. Fullilove, R.E.; Fullilove, M.T.; Bowser, B.P. & Gross, S.A. 1990. Risk of sexually transmiued disease among black adolescent crack users in Oakland and San Francisco, California. Journal of the American Medical Association263:85l-855. Fullilove, R.E.; Thompson, M. & Fullilove, R.E. 1989. Intersecting epidemics: Black teen crack use and sexually transmitted disease. Journal of the American Women's Medica1Association44: 146-153.
Journal of Psychoactive Drugs
306
Vol. 24(4), Oct-Dec 1992
Journal of Psychoactive Drugs Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ujpd20
Editor's Introduction: The Crack Epidemic Revisited James A. Inciardi
a
a
Center for Drug and Alcohol Studies University of Delaware—Newark Published online: 18 Jan 2012.
To cite this article: James A. Inciardi (1992) Editor's Introduction: The Crack Epidemic Revisited, Journal of Psychoactive Drugs, 24:4, 305-306, DOI: 10.1080/02791072.1992.10471655 To link to this article: http://dx.doi.org/10.1080/02791072.1992.10471655
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
Editor's Introduction The Crack Epidemic Revisited
Downloaded by [University of Newcastle, Australia] at 19:10 07 January 2015
James A. Inciardi, Ph.D. Professor and Director Center for Drug and Alcohol Studies University of Delaware-Newark
Crack is a variety of cocaine base produced by "cooking" cocaine hydrochloride in boiling water and baking soda. It has been called the fast-food variety of cocaine, and it became popular in many inner-city communities because it is cheap, easy to conceal and vaporizes with practically no odor; the gratification is swift and is commonly described by users as an intense, penetrating, almost sexual euphoria. However, smoking cocaine, as opposed to snorting it, results in more immediate and direct absorption of the drug, producing a quicker and more compelling high, which greatly increases dependence potential. Moreover, there is increased risk of acute toxic reactions, including brain seizure, cardiac irregularities, respiratory paralysis, paranoid psychosis, and pulmonary dysfunction (Inciardi 1992, 1987; Wallace 1991). Users typically smoke for as long as they have crack or the means to purchase it: money, personal belongings, sexual services, stolen goods, or other drugs. It is rare that smokers have but a single hit of crack. More likely they spend $50 to $500 during what they call a "mission," a three- or four-day binge, smoking almost constantly, 3 to 50 rocks per day. During these cycles, crack users rarely eat or sleep. And once crack is tried, it is not long before it becomes a daily habit for many users. The tendency to binge on crack for days at a time, neglecting food, sleep, and basic hygiene, severely compromises physical health; consequently, crack users appear emaciated most of the time. They lose interest in their physical appearance; many have scabs on their faces, arms, and legs- the result of burns and picking at the skin (to remove bugs and other insects believed to be crawling under the skin). Crack users tend to have burned facial hair from carelessly lighting their smoking paraphernalia and may have burned lips and tongues from the hot stems of their pipes; many seem to cough constantly. It should be pointed out that crack cocaine is not a particularly new drug. Recent history and folklore suggest that it was originally known as "garbage freebase," and that it first appeared in the San Francisco free base culture Jourtwl of Psychoactive Drwgs
of the early 1970s. As the product of a shortcut method for transforming cocaine hydrochloride into the base state (and hence, without removing impurities), the drug was experimented with for only a short period, and then set aside as an inferior commodity (Inciardi 1992: 111). The use of crack did not become popular until it reemerged in many inner-city communities during the mid-1980s. Shortly after the drug was noticed by the media at the close of 1985, press and television reports began describing crack use as an "epidemic" and "plague" that was devastating entire communities (Inciardi 1987). Considerable focus was placed on how the high addiction liability of the drug instigated users to commit crimes to support their habits, how youths were drawn into the crack-selling business, how the violence associated with attempts to control crack distribution networks turned some communities into urban "dead zones" where crime was totally out of control, how crack engendered a "hypersexuality" among users, and how the drug was contributing to the further spread of HIV and AIDS! By the close of the 1980s, reports on field and clinical studies of crack began appearing in the professional literature (see Bourgois and Dunlap 1991; Chiasson eta! . 1991; Inciardi 1991; Inciardi and Pottieger 1991; Wallace 1991; Fulliloveet al. 1990; Bourgois 1989; Bowser 1989; Fullilove and Fullilove 1989; Guinan 1989; lnciardi 1989). As researchers and clinicians began grappling with the problems of crack, new policy initiatives also became evident at federal, state, and local levels. While a number of jurisdictions began prosecuting pregnant, crack-addicted women for child abuse and drug delivery (to a fetus), other legislatures passed enhanced and/or mandatory sentencing laws for those selling or trafficking in crack. Similarly, funding was increased at the federal level for enforcement, education, prevention, and treatment. Then, in 1988, at a time when the War on Crack was being waged on all fronts, the national high school and household surveys of drug abuse began showing declines in crack and cocaine use (Adams et al. 1990; Berke 1989). Subsequent surveys found that these declines were the beginning of a trend 305
Vol. 24(4), Oct-Dec 1992
Downloaded by [University of Newcastle, Australia] at 19:10 07 January 2015
Inciardl
Introduction
(University of Michigan 1992; Unsigned 1990a; Unsigned 1990b). Researchers, clinicians, and numerous other observers both within and outside the drug field readily understood, however, that the survey data reflected trends only within the stable in-school and at-home populations, and did not necessarily apply to dropouts, those living on the streets and in the drug subcultures, and other hard to reach populations. And, it was clear that while the use of crack and other forms of cocaine might be declining in middle and upper socioeconomic groups, that did not appear to be the situation in most of the nation's inner cities. Within this context, this issue of the Journal of Psychoactive Drugs revisits the crack epidemic in the United States, targeting the issues and problems that appear to be most enduring and troublesome. Readers will note at the outset that the majority of the articles in this thematic issue focus on crack in three cities- New York, San Francisco, and Miami- for witich there are several reasons. First, although crack has been and continues to be a major problem in many communities, it would appear that it has the longest history in these three cities. Second, and perhaps most notably, it is in these three locales that
much of the research on crack cocaine has been conducted during the second half of the 1980s and the opening years of the 1990s. And finally, the studies funded by the Centers for Disease Control to examine crack/HIV phenomena are based in these three metropolitan areas. Of significance as well is the fact that there has been considerable collaboration among researchers across studies, sites, and institutions.
NOTES 1. See New York Times November 29, 1989: 1A, B6; New York Doctor April10, 1989:1, 22; U.S. News & World Report AprillO, 1989:20-32; Miami Herald April24, 1988 ("Neighbors" suppl.):21-25; New York Times March 20, 1988: E9;New York Times June 23, 1988: AI, B4; Time December 5, 1988:32;Newsweek April27, 1987:35-36; Newsweek June 16, 1986:15-22; Newsweek June 30, 1986:52-53; New York Times August 25, 1986:B 1-B2; New York Times November 24, 1986: 1A,B2; USA Today June 16, 1986: 1A
REFERENCES Guinan, M.E. 1989. Women and crack addiction. Journal of the American Women's Medical Association44 :129. Inciardi, J.A. 1992. The War on Drugs II: The ConJinuing Epic of Heroin, Cocaine, Crack, Crime, AIDS, and Public Policy. Mountain View, California: Mayfield. Inciardi, J .A. 1991 . Kingrats, chicken heads, slow necks, freaks, and blood suckers: A glimpse at the Miami sex-for-crack market. Paper presented at the Annual Meeting of the Society for Applied Anthropology. Charleston, South Carolina, March 13-17. Inciardi, J.A. 1989. Trading sex for crack among juvenile drug users : A research note. Contemporary Drug Problems 16:689-700. Inciardi, J.A. 1987. Beyond cocaine: Basuco, crack, and olher coca products . Contemporary Drug Problems 14:461-492. lnciardi, J.A. & Pottieger, A. E. 1991. Kids, crack, and crime. Jowrnal of Drug Issues 21:257-270. University of Michigan News and Information Service. 1992. Most forms of drug use decline among American high school and college students. Press release, January 27. Unsigned. 1990a. High school survey shows continuing decline in illegal drug use. Alcoholism and Drug Abuse Week February 14:1. Unsigned 1990b. Latest household survey shows declining use of most illicit drugs. Alcoholism and Drug Abuse Week December 29:1. Wallace, B.C. 1991. Crack Cocaine: A Practical Treatment Approach for the Chemically Dependent. New York: Brunner/Mazel.
Adams, E.H.; Blanken, A.J.; Ferguson, L.D. & Kopstein, A. 1990. Overview of selected drug trends. Unpublished report. Division of Epidemiology and Prevention Research. Rockville, Maryland: National Institute on Drug Abuse. Berke, R.L. 1989. Student survey detects decline in use of crack. New YorkTimesMarch l:Al6. Bourgois, P. 1989. In search of Horatio Alger: Culture and ideology in the crack economy. Contemporary Drug Problems 16:619-649. Bourgois, P. & Dunlap, E. 1991. Sex-for-crack in Harlem, New York. Paper presented at the Annual Meeting of the Society for Applied Anthropology. Charleston, South Carolina, March 13-17. Bowser, B.P. 1989. Crack and AIDS : An ethnographic impression. Journal oftM National Medical Association 81:538-540. Chiasson, M.A; Stoneburner, R.L; Hildebrandt, D.S.; Ewing, W.E.; Telsak, E.E. & Jaffe, H.W. 1991. Heterosexual transmission of HIV1 associated with the use of smokable freebase cocaine (crack). AIDS 5:1121-1126. Fullilove, R.E.; Fullilove, M.T.; Bowser, B.P. & Gross, S.A. 1990. Risk of sexually transmiued disease among black adolescent crack users in Oakland and San Francisco, California. Journal of the American Medical Association263:85l-855. Fullilove, R.E.; Thompson, M. & Fullilove, R.E. 1989. Intersecting epidemics: Black teen crack use and sexually transmitted disease. Journal of the American Women's Medica1Association44: 146-153.
Journal of Psychoactive Drugs
306
Vol. 24(4), Oct-Dec 1992
