Epidemiology

In 2019, an estimated 20 million people used cocaine in the past year, corresponding to 0.4% of the global population.[5] Between 1990 and 2016 there was an increased prevalence of cocaine use disorder worldwide from around 4.2 million to 5.8 million people, although it is still far less prevalent than alcohol, cannabis, or opioid use disorders.[6]​ Cocaine use is most common in Oceania, North America, Western and Central Europe, and South and Central America.[5]​ However, many regions and countries do not report the true extent of cocaine use. The output of global cocaine manufacture doubled between 2014 and 2019 to reach an estimated 1784 tons (expressed at 100% purity) in 2019, the highest level ever.[5][7]

In 2023, it was estimated that 5 million people in the US aged 12 years or older used cocaine in the past year.[8]​ A 2013 US survey found that 58% of individuals who used cocaine in the last year did so less than 12 times, while 22% used cocaine at least 50 times.[7]​ In the UK in 2016-2017, an estimated 180,000 people aged 15-64 years used crack cocaine.[9]

Cocaine is the second most commonly used illegal stimulant in Europe. In the European Union, surveys indicate nearly 2.2 million 15-34 year olds used cocaine in the past year.[10] Although decreases in cocaine use have been reported across Europe, in 2017 a number of indicators (wastewater monitoring, drug seizures, and price and purity data) suggested that the availability of cocaine may be increasing.

Three subgroups have shown a higher prevalence than the general population: youth, socially marginalised groups, or people with opioid use disorder in maintenance treatment who additionally use cocaine.[11] 

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