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Crack cocaine has been associated with socio-economic and racial disparities characterized by the presence of marginalized communities such as drug-impacted and low-income neighborhoods, and drug-impacted communities of color "particularly African Americans". These networks of dense, impoverished neighborhoods form in metropolitan areas around economic centers such as housing projects, commercial areas, and recreational areas such as parks and fairgrounds [5].”

Community settings, such as housing projects and drug-impacted neighborhoods, together with a heavy advertising and marketing of crack cocaine in the media, lend themselves to vicious drug epidemics such as the crack epidemic of the 1990s in many metropolitan areas of the U.S. Distinctive features of crack cocaine dependence were experienced by marginalized populations that were not well-represented in clinical studies and research, such as suburban crack cocaine users, crack cocaine smokers who had never tried powder cocaine, and crack cocaine users who were homeless [1, 5]. Conclusions made and stories told by the media and policy makers regarding crack cocaine and its impact on vulnerable populations influenced the response to crack cocaine in the U.S. [2, 4].

Crack cocaine emerged among urban settings in the U.S. during the late 1980s. Within the context of the crack epidemic, the majority of the research on crack cocaine abuse occurs in urban settings, which may be due to the disproportionate influx of crack cocaine users into treatment in metropolitan areas. Other factors that may contribute to this trend are the media portrayal of crack cocaine as a dangerous drug, which may lead to a fear of crack cocaine among policymakers, and a possible preference for treating people with crack cocaine through the criminal justice system rather than through treatment. In fact, when treatment structures specifically designed for a diagnosis such as crack cocaine abuse were utilized, the rates of recovery were lower than those utilized in the general addiction population. This likely results from the fact that crack cocaine users are predominately males who have spent a significant amount of time in the criminal justice system and therefore enter treatment with a negative attitude toward it. Although, most probation and parole officers, probation agents, police officers, and public defenders are not trained to detect cocaine abuse, they are required to report suspected drug use by probationers and parolees to the parole or probation officer d2c66b5586