Is crack cocaine use associated with greater violence than powdered cocaine use? Results from a national sample

The question of whether crack cocaine use is associated with increased violence compared to powdered cocaine use has not been adequately explored in large nationally representative general population samples.

This study used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to 1) determine the comparative prevalences of violent behaviors among crack cocaine users and powdered cocaine users, 2) examine these differences while controlling for sociodemographic variables, lifetime psychiatric, alcohol and drug use disorders (a majority of cocaine users use other substances), and levels of crack cocaine and powdered cocaine use.

The likelihood of violence associated with crack cocaine users was greater compared to powdered cocaine users at the bivariate level. However, these differences were almost uniformly statistically nonsignificant when demographic, mood and non-cocaine substance use disorders were controlled for.

The substantial attenuation of the association of crack cocaine use with violence after adjustment suggests that the sociodemographic characteristics, psychiatric variables, and non-cocaine substance use disorders that make some individuals more likely to use crack cocaine than powder cocaine are responsible for the increased prevalence of violence observed among crack users, rather than crack itself.