Cocaine: A Review
John Wootton MD
Sheldon I. Miller MD1
1 Lizzie Gilman Professor and Chair, Department of Psychiatry and Behavioral Sciences, Northwestern University School of Medicine, Chicago, IL.
Epidemiology
Although there has been an encouraging decline in the number of Americans using cocaine in recent years, cocaine use remains at epidemic proportions. The National Household Survey on Drug Abuse showed a decrease from 12 million "past year" users in 1985 to 8 million in 1988. In 1988, the National Institute on Drug Abuse (NIDA) estimated that 30 million Americans had tried cocaine. Of that 30 million, 20% had gone on to become regular users and 5% had developed a compulsive pattern of use. In 1988 among 12- to 17-year-olds, cocaine use in the previous year was highest in Hispanics at 4%, followed by 3% in whites and 1% in African-Americans. However, the Drug Abuse Warning Network has documented a dramatic increase in the number of admissions to hospital emergency rooms as a result of cocaine use. In 1984, the number was 8831; it jumped to 46 020 in 1988.
The ready availability of "crack" cocaine in the US in 1985 may well be responsible for this dramatic increase of documented medical emergencies arising from cocaine use. Although the use of cocaine has decreased, the preferred method of ingestion—smoking—has increased. Sniffing of the drug has decreased. Concurrently, cocaine, which was once called the "champagne" of abused drugs, has dropped significantly in cost on the streets.
