Cocaine users in medical practice: a five-year follow-up

Prompted by the discontinuity between the number of estimated cocaine users in epidemiologic studies and the small number entering the substance abuse treatment system in the early 1980s, Weinstein et al. surveyed physicians practicing in a variety of specialties and found sizable numbers of cocaine-using patients being seen by physicians not in the substance abuse treatment system. Since the number of cocaine abusers has steadily increased during the decade, a 5-year follow-up of that research was conducted to determine if physicians in private practice have continued to see increasing numbers of cocaine-using patients. A survey of Philadelphia area physicians indicates that these physicians have continued to see growing numbers of cocaine-using patients, and that those numbers have increased dramatically. While an average of 0.61 patients per physician was noted in the early 1980s, by 1987 that value had increased over 200% to 1.84. Since physicians outside the traditional substance abuse system have continued to see increasing numbers of cocaine-using patients, a need remains for increased physician education in the recognition, referral, and treatment of drug-dependent patients.