'Virado': A New Method of Crack Consumption in Brazil

Crack emerged in the late 1980s in Brazil. This emergence was a critical moment for public health; the growing AIDS epidemic led intravenous cocaine users to migrate toward crack use to avoid the use of injection drugs. At the same time, young consumers of marijuana also began using crack, largely due to market strategies in drug trafficking that led to a shortage of marijuana and the availability of crack as a substitute. Twenty years later, crack use has spread throughout the country and among all social classes, creating a social burden on the State. This situation has led crack users to develop survival strategies, which, at times, increase the risks to users rather than protecting them. In this context, the use of virado has recently been identified in the city of Recife (northeast of Brazil). This letter is intended to comment on a new form of crack use, not previously described or quantified in epidemiological studies, which was identified during a large ethnographic study of crack cocaine use in Recife.

Solange A. Nappo, PhD, Zila M. Sanchez, PhD, Rossana Rameh, MPH, Renata Almeida, MPH, Roberta Uchoa, PhD
Received November 7, 2011; revised December 6, 2011; accepted January 5, 2012