Cocaine users seen in medical practice

Cocaine use and the public's awareness of cocaine abuse problems have escalated sharply in the past several years and yet little is known of the users direct contact with medical providers. A questionnaire was designed, mailed to 2,422 physicians in general and family practice, internal medicine, emergency medicine, and psychiatry. The results indicated that many more cocaine users were presently being seen than had been seen in the same month in the previous year. Most of the cocaine patients were seen by psychiatrists, and contrary to popular myth, only a small percentage had high incomes. Most were young male, polydrug users who had been using for more than several months. Few seemed to want treatment. The responding physicians who saw cocaine patients almost always commented on how they managed such patients. Physician involvement varied from almost none (drug use was seen as incidental) to brief advice, referral, or direct treatment. Physician's comments provide a mirror of problems and feelings surrounding this patient population. Contrasts and similarities with hotline data are discussed. The growth of physician recognition of this problem population clearly indicates a treatment need.