CRACK COCAINE

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CRACK COCAINE
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What we shall cover

• History of cocaine
• The Drug
• The Users
• Caring for the user in the surgery
• Sharing care outside the surgery
• Group specific issues

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History of Cocaine

• Erythroxyolon coca
• Grown in High Andes
• Cocaine first isolated circa 1850
• Rapidly popular in many formulations

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The Drug

• What is cocaine?
• How is it used?
• What are the main physical and psychological
  effects?

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Coca can be harvested four times a year.
Traditionally, chewing the sacred leaf promotes
contact with the spirit world. Chewing or smoking
coca leaves invigorates the user, allowing him to
absorb the plant's magical powers and protect
body and spirit alike. Ancient Peruvians used
coca as a local anaesthetic before trepanning -
the hazardous surgical technique of drilling a
hole in the skull to relieve various physical and
psychic woes.
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How is it used?

• Dabbing
• Snorting
• Piping

• Injecting
• Chasing
• Smoking/chipping

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What are the main effects?

• Physical
• Psychological

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The Users

• The recreational user
• The binge or problematic user
• The chronic high dose or dependent user

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Caring for the user in the surgery

• First presentation
• Assessment for first presentation
• Examination
• Ongoing care in the surgery
• Treatment options in the surgery

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Sharing care outside the surgery

• Psychological interventions
• Formal drug treatment settings

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Psychological Intervention

• CBT
• MI
• 12 Step
• Relapse prevention
• Complementary therapies

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Formal drug treatment settings

• Open access services (Tier 2)
• Community prescribing services (Tier 3)
• Structured day programmes (Tier 3)
• Residential care (Tier 4)
• Aftercare

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Group Specific Issues

• Users of different drugs
• Different types of user communities
• Women, pregnancy and child protection issues
• Cocaine and the sex industry
• Crack and the criminal justice system

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Crack has no BRAKES
apply the BREAKS