Is Cocaine Coming Back? A Commentary

Background: This commentary considers the potential return of cocaine and the need for intervention and treatment responses. Objectives: To show historical and contemporaneous epidemiological data on indicators of the expected increase in cocaine use. Methods: Data on increases in acreage of cocaine cultivation are presented, along with increases in treatment admissions, toxicological laboratory identifications of cocaine, poison center episodes, and overdose deaths. Characteristics of those entering treatment for problems with cocaine now are compared to the characteristics of those in treatment 23 year ago. Conclusions: There is a need to target prevention and intervention programs based on characteristics of users, and given the lack of FDA-approved medication-assisted treatment for cocaine, attention should be shifted to this epidemic before it reaches the severity as seen om the 1990s.