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In January 2007, the company launched a streaming media service, introducing video on demand via the Internet. However, at that time it only had 1,000 films available for streaming, compared to 70,000 available on DVD.[70] The company had for some time considered offering movies online, but it was only in the mid-2000s that data speeds and bandwidth costs had improved sufficiently to allow customers to download movies from the net. The original idea was a "Netflix box" that could download movies overnight, and be ready to watch the next day. By 2005, Netflix had acquired movie rights and designed the box and service. But after witnessing how popular streaming services such as YouTube were despite the lack of high-definition content, the concept of using a hardware device was scrapped and replaced with a streaming concept.[71]
Globally, Netflix had 223.09 million paying subscribers at the end of Q3 2022.[359][360] Customers can subscribe to one of three plans; the difference in plans relate to video resolution, the number of simultaneous streams, and the number of devices to which content can be downloaded.[361]
On July 13, 2022, Netflix announced a partnership with Microsoft to launch an advertising-supported subscription plan.[364] On August 17, 2022, it was reported that Netflix's planned advertising tier would not allow subscribers to download content like the existing ad-free platform.[365] On July 20, 2022, it was announced that the advertising-supported tier would be coming to Netflix in 2023 but it would not feature the full library of content.[366] Netflix US launched with 5.1% of the library unavailable including 60 Netflix Originals.[367] In September, Netflix announced that the launch would be moved up to November 1, 2022,[368][369] but in October, the launch date was changed to November 3, 2022. The ad-supported plan is called "Basic with Ads" and it costs $6.99 per month in the United States.[370] In Canada, the plan was launched two days later, on November 1.[371]
Early onset of crack-cocaine use seems to be associated with exposure to family conflict, easy access to drugs and deviant behavior. Treatment and preventive programs should take these factors into account when designing and implementing community interventions.
In Brazil, crack-cocaine users are often part of vulnerable and marginalized groups in society and suffer from severe social and economic disadvantage [10, 11]. Exposure to violence and situations of abuse have also been associated with crack-cocaine use [7].
Many risk factors for drug use initiation are part of a complex and multifaceted framework which involves an interplay of genetic, psychological and social factors [18,19,20,21]. Individual and personality factors such as curiosity, impulsivity and sensation seeking are common in adolescence [22,23,24]. In addition, the perception of easy access is strongly related to the risk of starting psychoactive substances use [25]. Use of drugs by parents, family conflict and peer pressure also appear to be associated with future problematic drug use [17, 19, 26, 27]. The Brazilian National Survey of Crack-Cocaine Users [28] found that the main reasons for first crack-cocaine use were curiosity (58.3%), followed by family conflicts (29.2%) and influence of friends (26.7%).
More recently, cross-sectional and longitudinal studies, assessing predictors of early initiation of crack-cocaine use, found an association with sociodemographic factors, psychiatric comorbidities and previous use of any drug [4, 31,32,33]. Other studies investigated specific populations - for example, adolescents in street situations [14], however few multicenter studies focused on crack-cocaine users. To our knowledge, this if the first multicenter study in Brazil assessing risk and protective factors for early onset of crack-cocaine use with patients from Therapeutic Communities (TCs) who identified crack-cocaine as the substance that made them seek treatment.
During the 12-month period of the study, a total of 1341 individuals presented at one of 20 TCs with a substance use disorder. Of those, 719 crack-cocaine users were voluntarily admitted with the diagnosis of crack-cocaine use disorders (F14.2) in accordance with the International Classification of Diseases 10th (ICD-10) [35]. Among those, twenty-five patients (3.5%) refused to participate, while another 117 (16.3%) signed the consent form but interrupted treatment almost immediately, leaving at the end 577 (80.2%) patients eligible to participate in the study.
A detailed structured interview was developed to be used in this survey (in supplementary file). It was designed to obtain baseline data on factors associated with crack-cocaine early initiation and other related behaviors, as well as information about parental monitoring in childhood, peer pressure and deviant behaviors. To organize the information collected and to formulate questions in tune with the international literature, we selected three structured questionnaires widely used in other studies. Sociodemographic data was selected from the Maudsley Addiction Profile (MAP) questionnaire [36], a brief research instrument developed in the United Kingdom, assessing four domains: substance use, health risk behavior, physical and psychological health, and personal/social functioning.
This is the first multicenter study that investigated several risk and protective factors associated with the initiation of crack-cocaine use among individuals seeking treatment. Our results add new evidence on predictor factors for the early use of this substance. We found that involvement before the age of 15 in illegal acts - using a firearm to threaten someone - and the perception of easy access to illicit drugs during adolescence - marijuana and crack - were associated risk factors for the early initiation of the use of crack-cocaine, while the monitoring of free time by parents in the early years of adolescence was a protective factor and delayed the experimentation with the drug.
Although studies on the influence of the quality of family relationships at the initiation of illicit drug use are relatively scarce compared with other studies that evaluate these same influences for the initiation of licit drug use [49], it is believed that a supportive family environment with a strong bond with family members and a low level of family conflict can predict a lower risk of initiating drug use in adolescence [26, 49]. In this study, relationship problems with both parents, including violence between them, paternal absence and problematic alcohol consumption by the father were factors associated with the early onset of crack use; however, they did not have an independent effect when other family variables were analyzed together. In line with these findings, some studies have found that proximity to parents was associated with a significantly lower risk of starting to use illicit drugs; but they were also not predictors for starting illicit drug consumption when the effect of other variables was controlled [50, 51].
Similarly, studies interested in observing predictive factors of the first episode of drug use have noted that some deviant behaviors can be inhibited in the presence of parental monitoring, this same effect was observed in antisocial behaviors related peer pressure [17, 33, 41]. In light of this, considerations could be given to promote the strengthening of the parent-child bond, as well as stimulate parental monitoring as a way to counteract the effects of peers on early crack-cocaine initiation.
The abuse and dependence on crack-cocaine represents a challenge for our society, bringing countless losses at the individual and social levels. There is growing interest in research that seeks to find predictive risk factors for initiation of use as an effective way to prevent crack-cocaine addiction. The current study showed that accessibility factors to illicit drugs and involvement in deviant behaviors should be important factors for drug preventive efforts.
Among adult populations there have been far fewer studies examining the causal relationship between drug use and criminal behavior. Nurco, Hanlon, Kinlock, and Duszynski (1988), in their study of addicted males, found that individuals who did not have a criminal history before their addiction emerged had a steeper escalation in their criminal behavior during their addiction periods than those who already had a criminal history before they became addicted. A smaller scale study by Allen (2005) demonstrated that some kinds of acquisitive crime appear to be correlated with heroin and crack use; however, qualitative interviews showed that for the majority of individuals, property crimes preceded their drug use. Bennett and Holloway (2009) interviewed a number of drug using offenders who identified a variety of rationales for their drug use, some of which indicated drug use preceding crime and some cases where crime followed drug use. Given the lack of statistical evidence on adult drug-crime causation, and the relatively mixed results from both the juvenile studies and limited studies of adults, more research is required to illuminate the relationship between drug use and offending in adults.
The second endogenous measure examined substance use, measured as use of cocaine, heroin, or amphetamines in the last 30 days prior to each interview including baseline pre-release interview. This variable was coded as a dichotomous (1 = Yes, 0 = No) outcome. We selected this measure of substance use as previous research has found that heroin, cocaine, and crack, and amphetamines generally show the strongest associations with criminal actions (Bennett et al., 2008; Boles & Miotto, 2003).Footnote 2 2b1af7f3a8