“For cocaine and crack, there is no substitution treatment, but that does not mean that nothing can be done”

Professor Florence Vorspan, psychiatrist and addictologist, takes care of patients in withdrawal, in particular from crack, hospitalized in the addiction medicine department at the Lariboisière-Fernand-Widal hospital (Public assistance – Paris hospitals).

Is crack a drug like any other?

Whether it is about dependence, addiction, pathologies and complications that accompany the consumption of crack, there is no difference in nature with cocaine, stimulants, synthetic products … C is a drug like any other.

But we often compare different users. Those that we see in the media are the tip of the iceberg: street crackers, who consume several times a day, very quickly, on what are called “open stages”, obviously present faces more severe than injected cocaine users who are themselves, trivialized despite their addiction. But the person who injects cocaine in the same way, methamphetamines… or the homeless person who suffers from severe alcoholism, are just as damaged.

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There is a difference with heroin, which does not cause the same behavioral and psychiatric disorders, but above all for which there is a substitution treatment that works very well, with a “response rate” of 80% in users.

Can we get out of crack?

For cocaine and crack, there is no substitution treatment. A lot of research is being carried out on the question, I hope that within three to five years, we will have found a drug treatment.

But that does not mean that nothing can be done today. We have the tools to change a patient’s trajectory satisfactorily. We can enroll him in a treatment course, detect his psychiatric complications, treat them. And accompany him in a process of weaning. It may take months or years, but there are programs that work.

The defeatism around crack is due to the highlighting of users who accumulate difficulties, but it should be remembered that there are also more occasional crackers, inserted in society, who have a job, a family.

Are lower-risk consumption rooms, commonly known as “shooting rooms” a solution for this drug?

There is no quick fix, no straightforward or easy answer. But places of consumption are a good response to “open scenes”, it allows users to get out of public space, so that they can stabilize themselves, meet educators for a longer period of time, and formulate a request for care when they wish. .

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“For cocaine and crack, there is no substitution treatment, but that does not mean that nothing can be done”

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