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In Brazil, an epidemic is taking hold - an outbreak of crack cocaine use nationwide, even in cities in the Amazon. It's an image at odds with the one Brazil wants to project, as it prepares to host soccer's World Cup in 2014 and the Summer Olympics two years later.

NPR's Juan Forero reports from the country's biggest open-air drug bazaar.

JUAN FORERO, BYLINE: The Luz District of central Sao Paulo was once grand, with its old train station and opulent buildings.

(SOUNDBITE OF CITY AMBIENCE)

FORERO: Now, this neighborhood is known as Cracolandia - Crackland. And on a recent night, skeletal figures in tattered, dirty clothes emerge - mostly men, but some women. They're glassy eyed and jumpy and looking for a quick fix, oblivious to the police helicopters overhead.

(SOUNDBITE OF A HELICOPTER)

FORERO: The only buffer between them and the rest of society this evening is Isabel Campos, a health worker who tries convincing addicts into seeking help.

ISABEL CAMPOS: (Foreign language spoken)

FORERO: They're here all day, she says, smoking crack.

Crack has been in Brazil since the 1990s but its use exploded in the past six years, say health and police officials. The reason, they say, has to do with proximity and porosity. Brazil is neighbor to the world's biggest cocaine-producing countries and its borders are vast, remote and largely unguarded.

Eloisa Arruda, secretary of justice for Sao Paulo State, says the market here is also alluring.

ELOISA ARRUDA: (Foreign language spoken)

FORERO: Brazil offers a big market of cocaine and crack consumers, says Arruda, and that's partly because people have more buying power. She also says the problem here is similar to the crack crisis in the United States in the 1980s, when the drug engulfed whole districts and generated waves of violence.

ARRUDA: (Foreign language spoken)

FORERO: It's a big growth of people using crack in public, Arruda says, people permanently in the streets consuming drugs day and night.

The Brazilian approach has been to treat the problem as a health care crisis. President Dilma Rousseff responded with a $2 billion drug prevention and treatment program. In Sao Paulo, addicts are urged to seek help at Psycho-Social Attention Centers, 80 clinics where addicts can receive a bed for the night.

(SOUNDBITE OF MUSIC)

FORERO: On a recent day, a group of crack users gathers at one center to watch a documentary and talk about drugs and society. A woman addict says the real enemy is the state.

UNIDENTIFIED WOMAN: (Foreign language spoken)

FORERO: And she rattles off how low wages are in Brazil, how education is shoddy and opportunity scant.

Antonio Sergio Goncalves offers another reason. He's a psychoanalyst and has been working with addicts for 27 years.

ANTONIO SERGIO GONCALVES: (Foreign language spoken)

FORERO: It's the well-organized distribution of crack, he says, which can be found in most cities.

And then there's also crack's powerful addictive qualities. Marcelo Cordeiro is a crack addict.

MARCELO CORDEIRO: (Foreign language spoken)

FORERO: You feel instant ecstasy, he says, the only thing is the depression that comes when you don't have it.

Cordeiro says crack is so much more intense than cocaine, but dangerous - what he calls euphoria with morbidity.

(SOUNDBITE OF A VEHICLE)

FORERO: It's a euphoria the addicts in Sao Paulo's Cracolandia crave. One of them is Paulino, who won't give his last name. He's 50, very skinny, energetic and musically inclined, playing the harmonica.

(SOUNDBITE OF HARMONICA)

FORERO: He also uses crack every day.

PAULINO: (Foreign language spoken)

FORERO: I'm chemically dependent, he says, I need crack in my blood. Then he says that his illness is like a snake, and what's the medicine for a snake? He says its venom, crack.

Juan Forero, NPR News.

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