Health consequences of cocaine use
The health consequences of cocaine use are likely to be underestimated. This is due partly to the often unspecific or chronic nature of the pathologies typically arising from long-term use of cocaine, and also to the difficulties in establishing causal links between the illness and the use of the drug (1). Regular use, including by snorting, can be associated with cardiovascular, neurological and psychiatric problems, and the risk of accidents and of transmission of infectious diseases through unprotected sex (Brugal et al., 2009). A study conducted in the United States also showed that about 5 % of cocaine users can become dependent in the first year of use, though not more than about 20 % of users developed dependence in the long term (Wagner and Anthony, 2002).
Studies in countries with high levels of use indicate that a considerable proportion of cardiac problems in young people could be related to cocaine use (Qureshi et al., 2001). In these countries, cocaine use also appears to be involved in a significant proportion of drug-related hospital emergencies; for example, 32 % in the Netherlands, and the majority in Spain and in the United States. A recent study in Spain among 720 18- to 20-year-old regular cocaine users, who were not regular heroin users, found that 27 % had experienced acute cocaine intoxication during the last year. Of these, 35 % presented symptoms of psychosis (hallucinations or delirium) and more than 50 % chest pain (Santos et al., in press).
Cocaine injection and crack use are associated with the highest health risks, including cardiovascular and mental health problems. These are generally aggravated by social marginalisation and additional specific problems, such as the risks associated with injection, including the transmission of infectious diseases and overdoses (EMCDDA, 2007).
Overall, there are indications of a significant and probably increasing health burden related to cocaine use in Europe, which is not yet fully identified and recognised. Concerns have also been recently raised regarding the association between cocaine use and violent crimes in the night-time economy (Measham and Moore, 2009).
(1) See the box ‘Deaths caused by cocaine’ in Drug-related infectious diseases and drug-related deaths.
Brugal, M.T., Pulido, J., Toro, C., de la Fuente, L., Bravo, M.J. et al. (2009), ‘Injecting, sexual risk behaviors and HIV infection in young cocaine and heroin users in Spain’, European Addiction Research 15, pp. 171–8.
EMCDDA (2007), Cocaine and crack cocaine: a growing public health issue, EMCDDA Selected issue, Publications Office of the European Union, Luxembourg.
Measham, F. and Moore, K. (2009), ‘Repertoires of distinction: exploring patterns of weekend polydrug use within local leisure scenes across the English night time economy’, Criminology and Criminal Justice 9, pp. 437–64.
Qureshi, A.I., Suri, M.F., Guterman, L.R. and Hopkins, L.N. (2001), ‘Cocaine use and the likelihood of nonfatal myocardial infarction and stroke: data from the Third National Health and Nutrition Examination Survey’, Circulation 103, pp. 502–06.
Santos, S., Brugal, M.T., Barrio, G., Castellano, Y., Jiménez, E. et al. (in press), ‘Characteristics and risk factors of acute health problems after cocaine use: assessing the effect of acute and chronic use of cocaine’, Drug and Alcohol Dependence.
Wagner, F.A. and Anthony, J.C. (2002), ‘From first drug use to drug dependence; developmental periods of risk for dependence upon marijuana, cocaine, and alcohol’, Neuropsychopharmacology 26, pp. 479–88.