STAGE 4. Selecting the theoretical approach

What steps should be completed?

Step 1: Select the theoretical approach or approaches on which the intervention will be based


What are their bases?

In recent years, and faced with a high prevalence of cocaine use and the problems associated with this substance, the need to implement harm reduction strategies targeting cocaine users has been raised. With regard to synthetic drug and/or cannabis derivative use, some institutions have developed proposals to reduce the harm associated with their use.

Practical implications

Cocaine-related harm reduction strategies

The European Monitoring Centre for Drugs and Drug Addiction1 identifies different lines of work in this area, such as those aimed at making users of this substance aware of the higher toxicity involved in the combination of cocaine with other drugs (especially alcohol, heroin and methadone) or promoting methods of self-evaluation and controlling consumption, and of its relationship with various detrimental effects on health. In response to the different consumption profiles and patterns of cocaine users, efforts have been made to adapt harm reduction strategies to each of these user groups. For example, some European cities have integrated supervised cocaine inhalation into their supervised consumption rooms.

The British Royal College of General Practitioners2 has formulated various proposals to reduce harm to cocaine users, such as information and care for users with respect to the harm associated with the different routes of consumption, or information and advice on small adverse reactions to use.

In the last few years, programmes have been developed to distribute kits for safer crack use in several countries (including Brazil, Canada and the United States). These programmes aim to reduce the use of hazardous materials or sharing instruments for crack consumption, facilitating pipes, pipe nipples, condoms, Vaseline and lip balm to prevent particular injuries (burns, etc.) and the transmission of infectious diseases. The distribution of kits is supplemented by information (verbal and written) on how to avoid unsafe consumption or sexual habits, and about the health and treatment services3,4 available.

Ecstasy and other drug-related harm reduction strategies

These include producing informative guides intended for users of these substances, with special emphasis on preventing so-called "heat stroke" (in the case of ecstasy and other synthetic drugs) and setting up information and drug-testing points in the usual drug use areas (nightclubs, music concerts, etc.).



1 European Monitoring Centre for Drugs and Drug Addiction. (2007). Treatment of problem cocaine use: a review of the literature. EMCDDA Literature reviews. Lisbon: EMCDDA.

2 Ford C. (2004).. Guidance for working with cocaine and crack users in primary care. Royal College of General Practitioners.

3 Ivins A et al. (2011). Uptake, benefits of and barriers to safer crack use kit (SCUK) distribution programmes in Victoria, Canada-A qualitative exploration. International Journal of Drug Policy.22(4): 292-300.

4 Leslie A et al. (2011). Do crack smoking practices change with the introduction of safer crack kits? Canadian Journal of Public Health. 102(3):188-92.