Abstract: Documented crack use emerged in São Paulo, Brazil, from 1991 onward. Therefore, it is a recent behavior among drug users. The present work draws a profile of São Paulo crack users, employing an ethnographic approach. Twenty-five crack users were interviewed on selected social and demographic characteristics, on the drug itself and its consumption, and on the consequences of this use. Crack cocaine is harmful for the user, leading within a short period to a condition of dependence. The crack users reported ultimately lapsing into “marginality” due to social isolation, neglect of bodily needs, and breakdown of family ties and other relationships.

Abstract: alcohol exei.ts numerous pharmacological effects through its interaction with various neurotransmitters and neuromodulators. Among the latter, the endogenous opioids playa key role in the rewarding (addictive) properties of ethanol. Three types of opioid receptors represent the respective targets of the major opioid peptides (p-endorphin, enkephalins and dynorphins, respectively). The rewarding (reinforcing) properties of 11- and 8-receptor ligands are brought about by activation of the mesolimbic dopamine system which ascends from the ventral tegmentum of the midbrain (VTA) to rostral structures: of these, the nucleus accumbens (NAC) is of particular importance in drug addiction. In contrast, dysphoria results from activation of K-receptors. The neurochemical manifestations of these opposing effects are, respectively, increases and decreases in dopamine release in the NAC. Several lines of evidence indicate that alcohol interferes with endogenous opioid mechanisms which are closely linked with dopamine transmission in the mesolimbic pathway. The view that condensation products of dopamine and alcohol-derived aldehyde (tetrahydroisoquinolines) playa role remains controversial. There is. however, much information on the direct (acute and chronic) effects of alcohol on the binding properties of opioid receptors, as well as modulation of opioid peptide synthesis and secretion (e.g. a suggested increase in p-endorphin release). In view of the reinforcing properties of alcohol. it is relevant to consider behavioural studies involving alcohol self-administration in rodents and primates. Low doses of morphine have been found to increase. and higher doses of the opiate to decrease, alcohol consumption. Conversely, opi()id antagonists such as naloxone and naltrexone (which bind to non-selectively opioid receptors) have been shown to decrease alcohol consumption under various experimental conditions. Similar results have been reported when selective 11- or b-receptor antagonists are administered. Results obtained in genetic models of high preference for alcohol also support the view that alcohol intake depends on the activity of the endogenous opioid reward system and that alcohol consumption may serve to compensate for inherent deficits in this system. One hypothetical model proposes that reward results from activation of opioid receptors in the VTA and/or b-receptors in the NAC; both these nuclei are targets of endogenous p-endorphin. It is suggested that alcohol interferes with this reward pathway either directly or indirectly. The available experimental data accord well with those obtained from clinical studies in which opioid antagonists have been used to prevent relapse in alcoholics. Conceptual considerations concerning communalities between various forms of addictions are also discussed in this review.

Abstract: Eine Projektidee zur Sekundärprävention von Alkoholmissbrauch bei jungen 16- bis 25-jährigen Arbeitslosen wurde untersucht. Mit Hilfe von Einrichtungen, die sich in der Deutschschweiz primär mit Jugendarbeitslosigkeit beschäftigen, sollten junge Arbeitslose mit Alkoholproblemen gefunden und in Präventionsgruppen geleitet werden, um dort neue Kompetenzen im Umgang mit der Arbeitslosigket und dem Alkoholkonsum zu lernen. Zwei Umfagen bei entsprechenden Einrichtungen ergaben ein nur geringes Problembewusstsein und keinen Bedarf an einem entsprechenden Projekt. Arbeitslose Jugendliche in der Schweiz sind nur relativ kurz in dieser Lage. Zudem scheinen sie keine manifesten Alkoholprobleme zu haben. Diese Sichtweise stellen die Autoren der Arbeits- und Sozialbehörden in Frage.