What is the scope of cocaine use in the United States?
In 2002, an estimated 1.5 million Americans could be classified as dependent on or abusing cocaine in the past 12 months, according to the NSDUH. The same survey estimates that there are 2.0 million current (past-month) users. Cocaine initiation steadily increased during the 1990s, reaching 1.2 million in 2001.
Adults 18 to 25 years old have a higher rate of current cocaine use than those in any other age group. Overall, men have a higher rate of current cocaine use than do women. Also, according to the 2002 NSDUH, estimated rates of current cocaine users were 2.0 percent for American Indians or Alaskan Natives, 1.6 percent for African-Americans, 0.8 percent for both Whites and Hispanics, 0.6 percent for Native Hawaiian or other Pacific Islanders, and 0.2 percent for Asians.
The 2003 Monitoring the Future Survey, which annually surveys teen attitudes and recent drug use, reports that crack cocaine use decreased among 10th-graders in 30-day, annual, and lifetime use prevalence periods. This was the only statistically significant change affecting cocaine in any form. Past-year use of crack declined
from 2.3 percent in 2002 to 1.6 percent in 2003. Last year, the rate increased from 1.8 percent to 2.3 percent, and this year’s decline brings it to approximately its 2001 level.
Data from the Drug Abuse Warning Network (DAWN) showed that cocaine-related emergency department visits increased 33 percent between 1995 and 2002, rising from 58 to 78 mentions per 100,000
population.
How is Cocaine Used?
The principal routes of cocaine administration are oral, intranasal, intravenous, and inhalation. The slang terms for these routes are, respectively, “chewing,” “snorting,” “mainlining” or “injecting,” and “smoking” (including freebase and crack cocaine). Snorting is the process of inhaling cocaine powder through the nostrils, where it is absorbed into the bloodstream through the nasal tissues. Injecting releases the drug directly into the bloodstream, and heightens the intensity of its effects. Smoking involves the inhalation of cocaine vapor or smoke into the lungs, where absorption into the bloodstream is as rapid as by injection. The drug also can be rubbed onto mucous tissues. Some users combine cocaine powder or crack with heroin in a “speedball.”
Cocaine use ranges from occasional use to repeated or compulsive use, with a variety of patterns between these extremes. Other than medical uses, there is no safe way to use cocaine. Any route of administration can lead to absorption of toxic amounts of cocaine, leading to acute cardiovascular or cerebrovascular emergencies that could result in sudden death. Repeated cocaine use by any route of administration can produce addiction and other adverse health consequences.
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From the Endowment for Human Development website.