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September 16, 1988

Intravenous Cocaine, Crack, and HIV Infection

Author Affiliations

Austin, Tex

Austin, Tex

JAMA. 1988;260(11):1555-1556. doi:10.1001/jama.1988.03410110063025

To the Editor.—  I am very concerned about one aspect of the otherwise excellent letter in the April 1 issue of THE Journal1 about the acquired immunodeficiency syndrome (AIDS) crisis as it relates to intravenous drug use.I am shocked by the suggestion that "one form of AIDS risk reduction that IV [intravenous] cocaine users might adopt would be to switch from injecting cocaine hydrochloride to smoking 'crack' or 'freebase.' " The authors, who apparently approve of this rationale, suggest that this substitution may give the desired "high" without the risk of transmitting AIDS.I think it is time to draw the line and explain to the drug user that he or she will need to take full responsibility for whatever consequence of their drug use befalls them and to let them know that this is another excellent reason for avoiding such drug use. To endorse the substitution of crack