While the statistics tell a staggering story—from 1.4 million Americans grappling with cocaine use disorder to its devastating 24-fold spike in heart attack risk—the true cost of this drug is measured in shattered health, broken families, and billions in societal damage.
Key Takeaways
- In 2022, about 1.4 million Americans aged 12 or older had cocaine use disorder in the past year
- Globally, 22 million people used cocaine in 2021 according to UNODC estimates
- Past-month cocaine use among US high school seniors dropped to 1.0% in 2022 from 1.8% in 2019
- In 2020, cocaine was involved in 24% of all US drug overdose deaths combined with opioids
- Cocaine use increases risk of heart attack by 24 times within 60 minutes of use per NIDA studies
- Chronic cocaine users have 6.5 times higher risk of stroke according to a 2019 meta-analysis
- US males aged 18-25 had past-year cocaine use of 3.5% in 2022
- Among US Hispanics, cocaine use disorder prevalence was 0.8% vs 0.5% for non-Hispanics in 2021
- Women aged 26+ in US had 1.1% past-year cocaine use compared to 1.6% for men in 2022
- In 2022, cocaine-related healthcare costs in US exceeded $18 billion annually
- Global cocaine market value estimated at $94 billion in 2021 per UNODC
- US lost 2.4 million workdays to cocaine use in 2019 per productivity studies
- In 2022, 1.7 million Americans received treatment for cocaine use disorder
- Only 14% of US cocaine users with disorder receive any treatment annually
- Cocaine treatment admission rates increased 20% from 2018-2022 in US
Cocaine use remains a dangerous global problem despite some recent declines.
Demographics
- US males aged 18-25 had past-year cocaine use of 3.5% in 2022
- Among US Hispanics, cocaine use disorder prevalence was 0.8% vs 0.5% for non-Hispanics in 2021
- Women aged 26+ in US had 1.1% past-year cocaine use compared to 1.6% for men in 2022
- Black Americans had 2.1% past-year crack cocaine use vs 0.2% for powder in 2021 NSDUH
- Urban residents in US had 1.8% cocaine use rate vs 0.9% rural in 2020
- Among US college students, 5.1% reported past-year cocaine use in 2022
- LGBTQ+ youth had 12% past-year cocaine use vs 4% heterosexual peers in 2021
- US veterans had 1.5% cocaine use disorder rate, higher than civilians at 0.6% in 2019
- In US, those with annual income >$75k had 2.4% cocaine use vs 0.8% for <$25k in 2021
- American Indian/Alaska Native adults had 2.3% past-year cocaine use in 2021
- Females initiating cocaine use before 18 have 5x higher addiction risk later
- In US prisons, 20-30% of inmates report lifetime cocaine use history
- College-educated US adults had 2.0% cocaine use vs 1.0% high school only in 2022
- US adults 18-25 in large metros had 3.2% cocaine use vs 1.5% small towns
- Among US pregnant women, 0.3% used cocaine in past month in 2021
- White non-Hispanic US adults had 1.6% cocaine use disorder in 2021
- Males comprise 70% of cocaine treatment admissions in US
- US adults with mental illness had 4x higher cocaine use rates in 2020
- US Asians had lowest cocaine use at 0.6% past-year vs 2.0% Blacks in 2022
- Among US 18-25 year old females, cocaine use was 1.8% in 2021
- Homeless US adults had 15% past-year cocaine use rate in 2020 HUD survey
- US adults with bachelor's degree had 2.2% cocaine use vs 1.2% no diploma
- In US, 25-34 age group had highest cocaine use disorder at 1.0% in 2022
- Transgender individuals report 10x higher cocaine use than cisgender peers
- US rural white males had 1.2% cocaine use vs urban 2.5% in 2021
- 65% of US cocaine users are employed full-time per NSDUH 2021
- Black females aged 18-25 had 2.5% past-year cocaine use in US 2022
- US insured adults had 1.5% cocaine use vs 2.5% uninsured in 2020
- Among US musicians/entertainers, cocaine use estimated at 12% lifetime
- Gen Z US adults (18-25) had 2.3% past-year cocaine use in 2022
- Cocaine use highest in US Northeast at 2.1% vs 1.2% South in 2021
- US adults with depression had 4.2% cocaine use disorder comorbidity
Demographics Interpretation
While these percentages may seem like a statistical quilt of disparate vulnerabilities, they actually stitch together a stark portrait of how addiction meticulously targets American society, exploiting disparities in geography, identity, income, and mental health far more than it discriminates by demographic.
Economic Impacts
- In 2022, cocaine-related healthcare costs in US exceeded $18 billion annually
- Global cocaine market value estimated at $94 billion in 2021 per UNODC
- US lost 2.4 million workdays to cocaine use in 2019 per productivity studies
- Cocaine trafficking generates $30-50 billion in criminal revenue yearly worldwide
- Average lifetime economic cost per cocaine user in US is $275,000 including crime/health
- In 2020, cocaine contributed to $12 billion in US emergency room costs
- Colombia's cocaine economy represents 2.5% of national GDP in 2022
- US employers lose $1.5 billion yearly from cocaine-related absenteeism
- Cocaine use linked to $8 billion in US crime costs from theft/burglary in 2018
- Global seizures of cocaine valued at $4.5 billion in 2021
- In Europe, cocaine retail market worth €11.1 billion in 2021 per EMCDDA
- US cocaine production/import costs taxpayers $50 billion in enforcement yearly
- Productivity loss from cocaine addiction averages $20,000 per user annually
- Cocaine fuels 15% of organized crime violence costs in Latin America
- In 2021, US insurance paid $6 billion for cocaine-related hospitalizations
- Family members of cocaine users incur $10,000 average annual support costs
- Cocaine trade disrupts $2 billion in annual trade in source countries
- US child welfare costs from parental cocaine use: $1.2 billion yearly
- Cocaine-related workplace accidents cost US firms $900 million in 2020
- Global anti-cocaine efforts cost $100 billion since 2000 per UN estimates
- Cocaine production costs US $193 billion in total societal burden yearly
- In 2019, cocaine-related crime cost US cities $5 billion in policing
- Average cocaine user steals $1,200 yearly to fund habit per studies
- Europe cocaine wholesale market hit €10.5 billion in 2020
- US lost 500,000 potential work years to premature cocaine deaths 2015-2019
- Cocaine fuels 20% of money laundering in global banks annually
- Treatment savings: $7 saved per $1 invested in cocaine rehab per meta-analysis
- In Peru, coca economy contributes 7% to rural GDP but displaces food production
- US foster care costs from cocaine-addicted parents: $2.1 billion/year
- Cocaine use causes 1.5% GDP loss in high-prevalence Latin countries
- Global cocaine seizure operations cost $3.2 billion in 2022
- US disability claims from cocaine heart damage rose 15% 2018-2022
- Cocaine addiction leads to 40% divorce rate increase in affected families
- Corporate drug testing reduced cocaine use by 50%, saving $1 billion in losses
- Inpatient cocaine treatment costs average $20,000 per 30-day stay in US
Economic Impacts Interpretation
If we stopped treating the cocaine economy like a rogue multinational corporation that profits from human misery while billing society for the wreckage—through emergency rooms, lost workdays, and shattered families—we might finally see it not as a personal vice but as the staggeringly expensive global parasite it truly is.
Health Effects
- In 2020, cocaine was involved in 24% of all US drug overdose deaths combined with opioids
- Cocaine use increases risk of heart attack by 24 times within 60 minutes of use per NIDA studies
- Chronic cocaine users have 6.5 times higher risk of stroke according to a 2019 meta-analysis
- In 2021, cocaine was present in 27% of US toxicology reports for overdose deaths
- Nasal cocaine use leads to perforation of the septum in 20-30% of chronic users
- Cocaine-associated myocardial infarction accounts for 25% of drug-related heart attacks in under-45s
- Regular cocaine use causes erectile dysfunction in 40-60% of male users per clinical studies
- Pregnant women using cocaine have 3-4 times higher risk of placental abruption
- Cocaine users experience seizures in 8-17% of overdose cases per ER data
- Long-term cocaine use leads to cognitive deficits in 50-70% of heavy users
- Crack cocaine smoking causes respiratory failure in 10% of chronic users
- Cocaine increases HIV transmission risk by 2-5 times due to risky behaviors
- In 2022, cocaine was involved in 30,435 US overdose deaths, up 10% from 2021
- Chronic use damages dopamine transporters by 20-30% as shown in PET scans
- Cocaine users have 3.8 times higher odds of cardiomyopathy
- Intranasal cocaine causes rhinitis and sinusitis in 81% of users per otolaryngology study
- Cocaine adulterated with levamisole causes agranulocytosis in 10-20% of cases
- Neonatal cocaine exposure leads to low birth weight in 30% of cases
- Cocaine precipitates arrhythmias in 64% of users during acute intoxication
- Heavy cocaine use correlates with Parkinson's disease risk increase of 3.5-fold
- In 2021, cocaine use disorder affected 1.4 million US adults with severe health comorbidities
- Cocaine causes vasoconstriction leading to 40% higher infarction rates in young adults
- Cocaine causes sudden cardiac death in 6% of young adults post-use per autopsy studies
- Chronic cocaine users show 25% brain volume reduction in frontal lobes via MRI
- Cocaine elevates body temperature to 108°F in 15% of hyperthermia cases
- Users have 4x increased risk of aortic dissection from cocaine
- Cocaine-induced psychosis occurs in 20-50% of heavy users
- 35% of cocaine-positive ER visits involve violence or injury
- Long-term use impairs memory recall by 30% in neuropsychological tests
- Cocaine with fentanyl mix caused 75% of 2022 cocaine OD deaths
- Chronic snorting leads to 50% higher chronic rhinosinusitis rates
- Cocaine users 8x more likely to develop endocarditis
- Fetal cocaine exposure doubles risk of sudden infant death syndrome
- Acute cocaine use triggers 50% of exercise-related sudden deaths in athletes
- Dopamine receptor downregulation persists 14 months post-abstinence
- Cocaine accelerates atherosclerosis by 5-10 years in users
Health Effects Interpretation
If you're looking for a drug that efficiently turns every major organ system against you while dramatically shortening your life in a dozen creatively horrific ways, congratulations: cocaine's marketing as a party favor is the most successful bait-and-switch in history.
Prevalence
- In 2022, about 1.4 million Americans aged 12 or older had cocaine use disorder in the past year
- Globally, 22 million people used cocaine in 2021 according to UNODC estimates
- Past-month cocaine use among US high school seniors dropped to 1.0% in 2022 from 1.8% in 2019
- In Europe, cocaine was the second most commonly used illicit drug after cannabis with 3.7 million past-year users in 2021
- Lifetime cocaine use prevalence among US adults aged 18-25 was 17.5% in 2021
- In 2020, 0.7% of the global population aged 15-64 used cocaine in the past year per UNODC
- Past-year cocaine use in Australia reached 4.2% among those aged 14+ in 2022-2023
- In Canada, 2.0% of the population aged 15+ reported past-year cocaine use in 2019
- US past-month cocaine use among young adults (18-25) was 2.0% in 2022
- In the UK, 2.1% of adults aged 16-59 used powder cocaine in the past year in 2022/23
- Crack cocaine past-year use in the US was 0.4% among those 12+ in 2021
- In South America, Colombia had the highest cocaine use rate at 1.2% past-year in 2018
- Past-year cocaine use among US males aged 12+ was 2.1% vs 0.9% for females in 2022
- In 2021, 19.3 million people worldwide used cocaine per EMCDDA/UNODC joint estimates
- US cocaine initiation among 12-17 year olds averaged 74,000 annually from 2018-2020
- In Brazil, 1.7% of the population used cocaine in the past year in 2019
- Past-month cocaine use in US was 0.7% for population 12+ in 2022
- In West Africa, cocaine use prevalence was 0.3% in 2021 per UNODC
- Lifetime cocaine use in US increased slightly to 15.9% among adults in 2021
- In 2021, past-year cocaine use among US adults aged 26+ was 1.6%
- In Mexico, cocaine use prevalence was 1.2% past-year among 12-65 in 2016-2017
- Past-year cocaine use in US full-time workers was 1.9% in 2021
- In Asia, cocaine use remained low at 0.04% past-year in 2021
- US 12th graders' perceived risk of cocaine use fell to 50% in 2022, correlating with slight use rise
- In 2022, cocaine was detected in 5% of US wastewater samples nationwide
- Lifetime prevalence of cocaine use among US baby boomers (55-73) was 20.4% in 2021
- In New Zealand, 3.2% of adults reported past-year cocaine use in 2019/20
- Crack cocaine use declined to 0.2% past-month among US 12+ in 2022
- In 2021, cocaine use among US adolescents (12-17) was 0.4% past-year
Prevalence Interpretation
A generation that dramatically cut teenage use is now watching from the sidelines as their own historically high lifetime rates and the drug's stubborn global presence—from 22 million users worldwide to its unwelcome appearance in our wastewater—remind us that this problem was never solved, just aging and shifting shape.
Treatment
- In 2022, 1.7 million Americans received treatment for cocaine use disorder
- Only 14% of US cocaine users with disorder receive any treatment annually
- Cocaine treatment admission rates increased 20% from 2018-2022 in US
- Abstinence rates after 1 year in cocaine outpatient programs average 20-30%
- Contingency management boosts cocaine abstinence by 50% in trials
- In 2021, 40% of US drug rehab facilities offered cocaine-specific programs
- Relapse rates within 3 months post-cocaine detox are 60-80%
- Matrix model therapy achieves 70% cocaine-negative weeks in first 16 weeks
- US cocaine treatment episodes totaled 250,000 in 2020 per TEDS
- Pharmacotherapy trials show modafinil reduces cocaine use by 40% in 50% of patients
- 12-step programs like NA have 25% sustained sobriety rate for cocaine at 5 years
- Inpatient cocaine rehab success (90-day abstinence) is 45% vs 25% outpatient
- US Medicaid covered 30% of cocaine treatment services in 2021
- Cognitive-behavioral therapy retains 60% of cocaine patients through 12 weeks
- Recovery housing post-cocaine treatment doubles long-term abstinence odds
- In 2022, telehealth cocaine treatment access rose 300% in US
- Disulfiram aids cocaine abstinence in 55% of comorbid alcohol users
- US states with mandatory treatment laws see 15% higher cocaine recovery rates
- Family therapy improves cocaine treatment outcomes by 35% in studies
- Long-term (2+ years) cocaine recovery rate is 40% with integrated care
- 50% of cocaine patients drop out of treatment within first month
- Vouchers in contingency management sustain cocaine abstinence 8 weeks longer
- US cocaine treatment wait times average 45 days in public facilities 2022
- Baclofen reduces cocaine cravings by 60% in clinical trials
- Community reinforcement approach yields 55% 6-month abstinence for cocaine
- In 2020, 25% of US addiction helpline calls were cocaine-related
- Topiramate decreases cocaine use days by 40% in double-blind studies
- Sober living homes retain 70% of cocaine residents abstinent at 6 months
- Integrated mental health-cocaine treatment improves retention by 25%
- US private insurance covers 60% of cocaine therapy sessions on average
- Mindfulness-based relapse prevention cuts cocaine use 50% post-treatment
- Heroin-cocaine polydrug treatment success 30% lower than cocaine alone
- Online CBT for cocaine achieves 40% reduction in use frequency
- US veterans' cocaine treatment completion rate 55% with VA programs
- Extended-release naltrexone aids 45% cocaine abstinence in trials
- Peer support groups double cocaine recovery odds at 1 year
Treatment Interpretation
We have a proven toolbox that can dramatically improve cocaine recovery rates, but we are still handing it out through a keyhole, leaving millions stranded outside.
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