{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:31Z","timestamp":1787022091262,"version":"build-2736575974"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006506","name":"Minist\u00e9rio da Sa\u00fade","doi-asserted-by":"publisher","award":["Public Notice 20\/2013 of the Health Surveillance Department"],"award-info":[{"award-number":["Public Notice 20\/2013 of the Health Surveillance Department"]}],"id":[{"id":"10.13039\/501100006506","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the prevalence and factors associated with the effect of alcohol on crack cocaine use and to analyze experiences related to combined use. Materials and methods: sequential mixed methods (qualitative and quantitative) research, carried out between August 2014 and August 2015 with people who use crack. In the quantitative approach, a cross-sectional study was conducted with 1,062 participants. Factors associated with \u201calcohol use with the effect of increasing the effect of crack\/crack craving\u201d were estimated by multiple regression. In the qualitative approach, 39 interviews were conducted using Bardin\u2019s content analysis technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>871 (82.0%) participants reported consuming alcohol, among them, 668 (76.7%) used alcohol combined with crack: 219 (32.8%) reported feeling an effect of reduction in paranoia and\/or crack craving and 384 (57.5%) reported feeling an increase in the effect of crack and in the craving to consume the drug. This relationship was also observed in the narratives of the people who use crack, with the possibility of a cyclic effect of consumption of the two substances. Those who related alcohol use to the effect of increasing crack craving (384) were more likely to use alcohol before crack (OR: 1.81; 95%CI: 1.13\u20132.89); to consume more than 20 stones daily (OR: 1.48; 95%CI: 1.01\u20132.16); to remain in abstinence from crack for less than one month (OR: 3.20; 95%CI: 1.91\u20135.35); to use dependence treatment services (OR: 1.85; 95%CI: 1.26\u20132.71); and to commit physical violence (OR:1.67; 95%CI:1.08\u20132.56).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings of this study indicate that the modulation of the effect of alcohol use on crack cocaine depends on the moment when the drugs are consumed, and the use of alcohol before crack consumption is associated with characteristics that suggest a greater vulnerability to patterns of harmful crack use. Even though combined use is referred to as a way of reducing the negative effects of crack, the damage of this association may be greater than its possible benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0256414","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T14:10:38Z","timestamp":1630591838000},"page":"e0256414","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Association between alcohol and crack: Prevalence, effects, associated factors and experiences of combined use"],"prefix":"10.1371","volume":"16","author":[{"given":"Na\u00edde","family":"Teod\u00f3sio Valois-Santos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Barreto Fernandes de","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iracema de Jesus Almeida Alves","family":"Jacques","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daianny de Paula","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0291-0708","authenticated-orcid":true,"given":"Keila Silene de Brito e","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solange Aparecida","family":"Nappo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria de","family":"Brito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"issue":"2","key":"pone.0256414.ref001","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1590\/S0034-89102004000200019","article-title":"Consumo abusivo de \u00e1lcool e fatores associados: estudo de base populacional","volume":"38","author":"JSD Costa","year":"2004","journal-title":"Sa\u00fade P\u00fablica"},{"key":"pone.0256414.ref002","first-page":"450","volume-title":"Global status report on alcohol and health","author":"World Health Organization","year":"2018"},{"key":"pone.0256414.ref003","volume-title":"III Levantamento Nacional sobre o Uso de Drogas pela Popula\u00e7\u00e3o Brasileira","author":"FI Bastos","year":"2017"},{"issue":"1","key":"pone.0256414.ref004","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1001\/archpsyc.60.9.1043","article-title":"Community reinforcement therapy for cocaine-dependent outpatients","volume":"60","author":"ST Higgins","year":"2003","journal-title":"Arch. 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