Un jalón, un volteón y otra vez: High risk crack smoking paraphernalia in méxico city

The smoking of crack is a recent emerging phenomenon in Mexico. To date, limited information is available on how the practice of smoking crack has emerged and spread among local drug using subpopulations. Using analytical constructs from the Diffusion of Innovation Theory, this presentation provides an understanding of the complex processes associated with the emergence, initiation an adoption of crack use. We document the high risk practices of use including preparation and paraphernalia utilized by this subpopulation of crack users. In-depth semi-structured ethnographic interviews were conducted with 150 male and female adult current crack users from neighborhoods in three delegaciónes (boroughs) in México DF. Qualitative results reveal a wide array of paraphernalia ranging largely from makeshift items (i.e. soda cans, glass droppers, TV or car antennas, etc.) to neighborhood store bought pipes. Common patterns of paraphernalia sharing were observed, in particular among those subjects reporting daily use of crack. Subjects describe a deep-seated subculture that is sustained by easily accessible street level crack market and an extensive network that fosters the adoption of unsafe paraphernalia practices of smoking. Findings point to potential social and health risks associated with paraphernalia practices that have not been addressed in the existing international literature. Our data will contribute to the development of theory based HIV and STI interventions for crack using high risk populations in Mexico. These data will also contribute to designing peer-based brief interventions that address social and contextual factors associated with the innovation and diffusion of crack use in México DF.