According to the National Survey on Drug Use and Health, an estimated 1 million people had used cocaine for the first time in 2004, which was the same level of new users in 2002 and 2003. Most of the new users (66 percent) were ages 18 and older, and the average age for new users was 20 years. The number of people receiving treatment for a cocaine abuse problem at a specialty facility increased significantly from 276,000 in 2003 to 466,000 in 2004.
In considering the lifetime use of cocaine, about 34 million Americans (14.2 percent of the population) ages 12 and older had ever used cocaine in 2004. When the population was limited to adolescents who were ages 12-17 years, lower percentages were reported: 3.4 percent of eighth graders had ever used cocaine in 2004 and that percentage increased slightly to 3.7 percent in 2005. The percentages were higher among college students and young adults; for example, in 2004, 9.5 percent of college students had ever used cocaine, and 15.2 percent of young adults had ever abused this drug.
According to the National Survey on Drug Use and Health, there were 2.0 million current users of cocaine in the United States in 2004. Of these users, 467,000 used crack cocaine. According to the Monitoring the Future study for 2004, 16 percent of all Americans have tried cocaine by the age of 30, and of these 8 percent have tried cocaine by their senior year in high school.
In considering the lifetime prevalence of the abuse of cocaine, the highest rates were seen among the noncollege age peers of college students and young adults, and the lowest rates were seen among eighth graders.
In considering the annual prevalence of the abuse of cocaine, the highest rates were again seen among the noncollege age peers of college students and among young adults.
Last, in considering the 30-day prevalence of the abuse of cocaine, the rates were very similar (or identical) for high school seniors, college students, and their noncollege age peers and young adults. According to the United Nations Office on Drugs and Crime, an estimated 13.3 million people worldwide abused cocaine in 2003. In the United States, 20 percent of all drug-related emergency room visits involved cocaine in 2003, or 125,921 cases.
The Community Epidemiology Work Group reports on 21 areas in the United States on drug abuse patterns, and in their 2005 report, cocaine abuse continued to dominate in many areas of the country and to have serious consequences for users, service providers, and law enforcement officials. High levels of violence and GANG activity were associated with the trafficking (sale) of cocaine. Crack cocaine was also a major problem in many areas.
The Work Group found cocaine/crack to be a primary drug of abuse in Atlanta, Georgia, in 2004, as well as in Boston, Massachusetts; New Orleans, Louisiana (especially crack cocaine); Philadelphia, Pennsylvania; South Florida; and Washington, D.C. (especially crack).
Many cities have seen a decline in the percentage of treatment admissions due to cocaine since 2002, while some have stayed at about the same level. Cocaine/crack cocaine also represents a large percentage of treatment admissions in some areas of the country. For example, in Atlanta, Georgia, more than half (52.5 percent) of treatment admissions in 2004 were for cocaine (down from 68.1 percent in 2001). Of these admissions, most cases (77.2 percent) were for crack cocaine.
The prevalence of cocaine also varies greatly from city to city in terms of the highest percentage of total drug items, from a high of Miami in 2004 (69.1 percent) to a low of 14.3 percent in San Diego.
Some researchers have studied the relationship of a variety of factors to heavy cocaine use among adults and found predictive factors as well as protective factors against heavy use. These results were reported by the Office of National Drug Control Policy in 2004. The data were drawn from the Department of Labor's National Longitudinal Survey of Youth, from 1984 to 1998. A longitudinal study resurveys former respondents and provides an opportunity to observe behavior over time.
The researchers found many relationships between the early use of drugs and a later heavy cocaine use. For example, adolescents and young adults who were heavy marijuana users, and especially those who had started smoking marijuana by the age of 12 years, were also more likely to become heavy cocaine abusers. These early abusers of marijuana were more than four times more likely to become heavy cocaine abusers than those who did not start smoking marijuana at this early age. In addition, adolescents who had smoked marijuana more than 50 times were more than six times more likely than others to become heavy cocaine users in adulthood.
Another factor was the age when the individual first began using cocaine, with an early age being predictive for heavy use in adulthood. Those who began abusing cocaine before age 15 were found more likely to become heavy cocaine abusers than others; for example, youths who had used cocaine by the age of 15 years were nearly six times more likely to become heavy cocaine abusers than others.
Alcohol use at an early age was also associated with heavy cocaine use, and the heaviest rate of cocaine abuse was found among individuals who began drinking alcohol twice a week by the age of 12 years. They were about three times as likely to become heavy cocaine users as those who did not start drinking before age 12.
The researchers found other predictive factors for heavy cocaine use. Young men who were drug users were about twice as likely as young women drug users to become heavy users of cocaine. Students suspended from school were one to one and one-half times more likely to become heavy users of cocaine in adulthood. Adolescents and adults who obtained a significant portion of their income from illegal activities were twice as likely to become heavy cocaine users as those for whom none or little income was generated by illegal activities. Those who sold drugs in adolescence were twice as likely to become heavy cocaine abusers in adulthood.
Some factors mitigated against heavy cocaine use in adulthood. For example, adolescents and young adults who had attended religious services at least twice each month were one-third less likely to become heavy cocaine users than those who attended no religious services. Individuals who expected to be married within the next five years were significantly less likely to become heavy cocaine users. Those who expected to go to college or finish high school were also lower risks for becoming heavy cocaine abusers. In addition, those who reported feeling satisfied with themselves were at lower risk for heavy cocaine use.
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4) National Institute on Drug Abuse. Epidemiologic Trends in Drug Abuse. Vol. 1, Proceeding of the Community Epidemiology Work Group: Highlights and Executive Summary. Bethesda, Md.: National Institutes of Health, June 2005.
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