Drug User activist from Costa Rica. Bachelor degree in Social Anthropology, Master´s in Criminology and another Master´s in Mental Health. Director of the Costa Rican Association of Drug Studies and Interventions and member of the Latin American Network of People who Use Drugs. Professor of Anthropology University of Costa Rica

Smokable cocaine, known as crack, basuco, or pasta base, has been part of Latin American drug markets for over 35 years, yet harm reduction programs targeting these users remain scarce. These substances are often viewed as cheap and associated with marginalization, leading to stigma and criminalization that restrict access to healthcare and expose users to police harassment. Although not all users are marginalized, there is a clear correlation with socioeconomic vulnerability, increased rates of HIV and STDs, mental health issues, and human rights violations.
Research published in 2019 by TNI and ACEID showed that smokable cocaine varies significantly between coca-producing countries in the Andes and transit or consumer nations across Latin America. Differences between pasta base and free base affect how it is smoked and associated risks. These variations are evident across countries and even cities, each with distinct cultural practices related to the creation, use, and distribution of smoking paraphernalia,
In contrast to the Global North, where there is extensive research on the health impacts of smoking cocaine, Latin America has limited studies. Brazil, Mexico, and Colombia have a few harm reduction programs tailored to these populations, yet few provide essential materials like pipes. There still remains skepticism about distributing cocaine smoking kits, due to limited resources like guidelines translated to Spanish or insufficient funding from governments or international donors.
A decolonial perspective of HR from Latin America includes the concept: “Broad-Spectrum Harm Reduction.” This approach addresses many issues of drug-related harms, such as stigma, criminalization and human rights of people who use drugs. Smokable cocaine pipes from a Broad-Spectrum approach means to address cultural and socioeconomic contexts, to engage in political advocacy and to promote community-based organization. This will prove that it is an evidence-based intervention and that it should be part in every harm reduction program.