Cocaine is a very powerful central nervous system stimulant drug that is refined from coca leaves. The coca plant, Erythroxylum coca, is found in Central and South America. Cocaine is an alkaloid derivative that is refined from the leaves of the plant.
Although it is illegal for private citizens to possess cocaine, the drug does have medicinal uses and is classified in the Schedule II category of controlled substances by the U.S. Drug Enforcement Administration (DEA). This classification means the drug has some recognized medicinal uses, but it is also a significant drug of abuse with the serious potential to produce physical dependence in people who use it.
The drug is rarely (if ever) prescribed in the United States. Its medicinal uses remain limited to use as a local anesthetic and as an agent to constrict blood vessels and veins by physicians performing oral or nasal surgery.
Cocaine is typically snorted, injected, or smoked. The drug mainly affects the neurotransmitter dopamine, but it also affects other neurotransmitters, such as norepinephrine and serotonin, by blocking their reuptake mechanism.
When a drug blocks the reuptake of the neurotransmitter, it remains available in the brain, enhancing its ability to produce euphoria and stimulation. The stimulation from cocaine typically doesn’t last long, and individuals abusing the drug will binge on multiple doses to maintain the euphoric feelings.
Crack cocaine is even more potent than powdered cocaine. Crack is typically smoked, making the delivery of the drug to the brain more efficient but also producing extremely short-lasting effects.
OVERALL STATISTICS ON COCAINE USE
According to the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA), abuse of cocaine in the United States has remained relatively steady since the early 2000s with a recent increase in cocaine use. This is most likely due to strict enforcement of methamphetamine abuse and individuals who wish to abuse stimulants seeking an alternative.
There isn’t yet data regarding cocaine use in 2019. The latest SAMHSA statistics are from 2017.
The Monitoring the Future Study is an ongoing investigation of attitudes, behavior, and values of American students and young adults. Every year, about 50,000 students between grades eight and 12 are surveyed and given follow-up questions.
The data indicate an increase in the number of students reporting cocaine and crack use since 2015 across these three grade levels.
MALE VS. FEMALE USE
Males historically use cocaine at greater rates than females. This trend has never changed. In 2017:
According to the latest data from SAMHSA in 2017, the breakdown of people by ethnicity reporting cocaine use at least once within the prior year includes:
The breakdown for crack use by ethnicity for 2017 includes:
Cocaine use has leveled off in the United States since the popularity of other drugs, like opioids and methamphetamine, increased. As the crackdown on methamphetamine abuse became more aggressive across the country, there appears to have been a rise in cocaine use (especially crack cocaine). This increase is certainly not as significant as the increase in the use of heroin and fentanyl across the country.
Overall, rates of cocaine use remain lower than those of marijuana, alcohol, and prescription medications, but rising cocaine use is troublesome. Because the drug is a stimulant drug that is often mixed with other drugs of abuse, its effects can be significant.
Although recreational cocaine use in anyone should be considered a significant problem, the use of cocaine in individuals under the age of 18 is very concerning. Ensuring that educational programs are directed at younger individuals is important.
According to the U.S. Centers for Disease Control and Prevention (CDC) and NIDA, drug overdoses occur across all demographic groups and geographic regions. The majority of drug overdose deaths involve opiates, but there has been an increase in overdose deaths from other drugs.
Deaths from cocaine overdose remained relatively stable in the U.S. (under 10,000 per year) until 2016 when they rose above 10,000. The estimates for cocaine overdose deaths for 2017 are still provisional, according to NIDA, but they are estimated to be over 14,500, which is a significant increase from previous years.
Males appear to be victims of cocaine overdose deaths at a rate of 2:1 to females, although rates of overdose deaths associated with cocaine continue to rise for both males and females.
The explanation for the increase in cocaine overdose deaths is that many more individuals now mix cocaine with other drugs of abuse, including alcohol, benzodiazepines, other stimulants like methamphetamine, or central nervous system depressants like opiates. Cocaine mixed with fentanyl is becoming an increasing problem.
About 74 percent of individuals who died from a cocaine overdose in 2016 also had other drugs in their system.
Although cocaine use appeared to be leveling off in the early 2000s, there’s been a recent upward trend in use. The most concerning issues regarding cocaine use in the United States are the number of individuals under age 18 who admit to some cocaine use and the recent rise in cocaine-related overdose deaths.
People who take cocaine for recreational purposes are subject to numerous physical, mental, and legal problems associated with their use of the drug. Based on the most recent statistics, it seems that cocaine use in the U.S. will continue to increase in 2019.
DEA: (N.D.) Drug Scheduling. Drug Enforcement Administration. Retrieved January 2019 from https://www.dea.gov/drug-scheduling
(July 2014). Position Statement: Medical Use of Cocaine. American Academy of Otolaryngology—Head and Neck Surgery or Foundation. Retrieved January 2019 from https://www.entnet.org/content/medical-use-cocaine
(July 2018). Cocaine. National Institute on Drug Abuse. Retrieved January 2019 from https://www.drugabuse.gov/publications/drugfacts/cocaine
(October 2018). National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration. Retrieved January 2019 from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf
(March 2018). U.S. Drug Overdose Deaths Continue to Rise; Increase Fueled by Synthetic Opioids. Centers for Disease Control and Prevention. Retrieved January 2019 from https://www.cdc.gov/media/releases/2018/p0329-drug-overdose-deaths.html
(August 2018). Overdose Death Rates. National Institute on Drug Abuse. Retrieved January 2019 from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates