Prevalence and patterns of use
Cocaine use among the general population
Cocaine is, after cannabis, the second most tried drug in Europe, although its use is concentrated in a small number of high prevalence countries, some of which have large populations. It is estimated that about 14.5 million Europeans have used cocaine at least once in their life, on average 4.3 % of adults aged 15-64 years (see Table 9 for a summary of the data). National figures vary from 0.1 % to 10.2 %, with half of the 24 reporting countries, including most central and eastern European countries, reporting low levels of lifetime prevalence (0.5-2.5 %).
About 4 million Europeans are estimated to have used the drug in the last year (1.2 % on average). Recent national surveys report last year prevalence estimates of between zero and 2.7 %. The prevalence estimate for last month cocaine use in Europe represents about 0.5 % of the adult population or about 1.5 million individuals.
Levels of last year cocaine use above the European average are reported by Ireland, Spain, Italy, Cyprus and the United Kingdom. In all of these countries, last year prevalence data show that cocaine is the most commonly used illicit stimulant drug.
Time frame of use
European estimates are computed from national prevalence estimates weighted by the population of the relevant age group in each country. To obtain estimates of the overall number of users in Europe, the EU average is applied for countries lacking prevalence data (representing not more than 3 % of the target population). Populations used as basis: 15–64, 336 million; 15–34, 132 million. As European estimates are based on surveys conducted between 2001 and 2009/10 (mainly 2004–08), they do not refer to a single year. The data summarised here are available under General population surveys in the 2011 statistical bulletin.
|15–64 years||Estimated number of users in Europe||14.5 million||4 million||1.5 million|
|European average||4.3 %||1.2 %||0.5 %|
|Range||0.1–10.2 %||0.0–2.7 %||0.0–1.3 %|
|Lowest-prevalence countries||Romania (0.1 %) |
Malta (0.4 %)
Lithuania (0.5 %)
Greece (0.7 %)
|Romania (0.0 %) |
Greece (0.1 %)
Hungary, Poland, Lithuania (0.2 %)
Malta (0.3 %)
|Romania, Greece (0.0 %) |
Czech Republic, Malta, Sweden, Poland, Lithuania, Estonia, Finland (0.1 %)
|Highest-prevalence countries||Spain (10.2 %) |
United Kingdom (8.8 %)
Italy (7.0 %)
Ireland (5.3 %)
|Spain (2.7 %) |
United Kingdom (2.5 %)
Italy (2.1 %)
Ireland (1.7 %)
|Spain (1.3 %) |
United Kingdom (1.1 %)
Cyprus, Italy (0.7 %)
Austria (0.6 %)
|15–34 years||Estimated number of users in Europe||8 million||3 million||1 million|
|European average||5.9 %||2.1 %||0.8 %|
|Range||0.1–13.6 %||0.1–4.8 %||0.0–2.1 %|
|Lowest-prevalence countries||Romania (0.1 %) |
Lithuania (0.7 %)
Malta (0.9 %)
Greece (1.0 %)
|Romania (0.1 %) |
Greece (0.2 %)
Poland, Lithuania (0.3 %)
Hungary (0.4 %)
|Romania (0.0 %) |
Greece, Poland, Lithuania, Norway (0.1 %)
Czech Republic, Hungary, Estonia (0.2 %)
|Highest-prevalence countries||Spain (13.6 %) |
United Kingdom (13.4 %)
Denmark (8.9 %)
Ireland (8.2 %)
|United Kingdom (4.8 %) |
Spain (4.4 %)
Ireland (3.1 %)
Italy (2.9 %)
|United Kingdom (2.1 %) |
Spain (2.0 %)
Cyprus (1.3 %)
Italy (1.1 %)
Cocaine use among young adults
In Europe, it is estimated that about 8 million young adults (15-34 years), or an average of 5.9 %, have used cocaine at least once in their life. National figures vary from 0.1 % to 13.6 %. The European average for last year use of cocaine among this age group is estimated at 2.1 % (about 3 million) and for last month use at 0.8 % (1 million).
Use is particularly high among young males (15-34 years), with last year prevalence of cocaine use reported at between 4 % and 6.7 % in Denmark, Spain, Ireland, Italy and the United Kingdom (). In 13 of the reporting countries, the male to female ratio for last year prevalence of cocaine use among young adults is at least two to one (2).
Overall, the estimated last year prevalence of cocaine use is lower among young adults in Europe (2.1 %) than among their counterparts in Australia (3.4 % among 14- to 39-year-olds), Canada (3.3 %) and the United States (4.1 % among 16- to 34-year-olds). Spain (4.4 %) and the United Kingdom (4.8 %) report, however, higher figures (Figure 9). It is important to note that small differences between countries should be interpreted with caution.
Cocaine use among school students
Lifetime prevalence of cocaine use among 15- to 16-year-old school students in the most recent surveys available is 1-2 % in over half of the 29 reporting countries. Most of the remaining countries report prevalence levels of 3-4 %, while France and the United Kingdom report 5 %. Where data are available for older school students (17-18 years old), lifetime prevalence of cocaine use is generally higher, rising to 8 % in Spain (3).
Trends in cocaine use
Trends in cocaine use in Europe have followed different patterns. In Spain and the United Kingdom, the countries with the highest prevalence levels, use of cocaine increased greatly in the late 1990s, before moving to a more stable, though generally upward trend. In four other countries (Denmark, Ireland, Italy, Cyprus), the increase in prevalence has been less pronounced and occurred later. All of these countries reported last year cocaine prevalence among young adults (15-34 years) above the EU average of 2.1 % (Figure 9). Four of these six countries reported an overall increase over the past 10 years, though observing a decrease in their most recent survey (Denmark, Spain, Italy, United Kingdom), echoing the trend observed in Canada and the United States (Figure 10). The other two countries report increases in their most recent surveys: Ireland, from 2.0 % in 2003 to 3.1 % in 2007; and Cyprus, from 0.7 % in 2006 to 2.2 % in 2009.
In 17 other countries with repeated surveys, cocaine use is relatively low and, in most cases, stable. Possible exceptions to this include Bulgaria and Sweden, which have reported signs of an increase, and Norway, where the trend appears to be downward. It should be borne in mind, however, that small changes at low prevalence must be interpreted with caution. In Bulgaria, last year use of cocaine among young adults rose from 0.7 % in 2005 to 1.5 % in 2008, and in Sweden from zero in 2000 to 1.2 % in 2008 (4). Norway reported a decrease from 1.8 % in 2004 to 0.8 % in 2009.
Among the four countries that conducted national school surveys in 2009-10 (Italy, Slovakia, Sweden, United Kingdom), only Slovakia reported a change (decrease) of more than one percentage point in lifetime cocaine use among 15- to 16-year-old school students. A recent study among older students in Germany found that the proportion of 15- to 18-year-old students in Frankfurt reporting lifetime experience of cocaine increased slightly to 6 % in 2008 and fell to 3 % in 2009.
Targeted surveys can provide a valuable window on the drug-using behaviour of young people in dance music and other recreational settings. While these surveys generally report relatively high prevalence of cocaine, recent studies in some European countries report a decrease. For example, a study of visitors to 'coffee shops' in Amsterdam reported a drop in lifetime cocaine use from 52 % in 2001 to 34 % in 2009, and a drop in last month use from 19 % to 5 % over the same period (5). Also in the Netherlands, a qualitative trend monitor noted that, compared to earlier generations of 20- to 24-year-olds, people now of this age are less interested in cocaine use. A Belgian study conducted regularly in nightlife settings since 2003 reported an increase in last year cocaine use during the period 2003-07 from 11 % to 17 %, followed by a decrease to 13 % in the 2009 study. Similar studies in the Czech Republic report an increase in lifetime cocaine use from 19 % in 2007 to 23 % in 2009. Such findings, however, need to be confirmed by other data sets.
Patterns of cocaine use
Surveys show that, in recreational settings, cocaine use is strongly linked with the consumption of alcohol. Data from general population surveys in nine countries reveals that the prevalence of cocaine use is between two and nine times higher among heavy episodic drinkers (6) than in the general population (EMCDDA, 2009). Surveys have also shown that cocaine use is associated with the use of other illicit drugs. For example, an analysis of data from the 2009/10 British Crime Survey found that 89 % of adults (16-59 years old) who had used cocaine powder during the past year had also used other drugs, compared with only 42 % of cannabis users (Hoare and Moon, 2010).
In some European countries, a substantial number of people use cocaine experimentally only once or twice (Van der Poel et al., 2009). Among more regular cocaine users, two broad groups can be distinguished. The first group is made up of more socially integrated users, who tend to use cocaine at weekends, parties or other special occasions, sometimes in large amounts. Many of these users report controlling their cocaine use by setting rules, for example, about the amount, frequency or context of use (Reynaud-Maurupt and Hoareau, 2010). Some of these may suffer health problems related to their use of cocaine or go on to develop compulsive patterns of use that require treatment. Studies suggest however, that a substantial proportion of those with cocaine-related problems may recover without formal treatment (Cunningham, 2000; Toneatto et al., 1999).
The second group is composed of intensive cocaine and crack users belonging to more socially marginalised or disadvantaged groups, and may also include former or current opioid users, who use crack or inject cocaine (Prinzleve et al., 2004).
(1) See Figure GPS-13 in the 2011 statistical bulletin.
(3) See Tables EYE-10 to EYE-30 in the 2011 statistical bulletin.
(4) See Figure GPS-14 (part i) in the 2011 statistical bulletin.
(5) It should be noted that trends in Amsterdam are not representative of those in the Netherlands as a whole.
(6) Heavy episodic drinking, also known as binge drinking, is here defined as drinking six glasses or more of an alcoholic beverage on the same occasion at least once a week during the past year.
Cunningham, J.A. (2000), 'Remissions from drug dependence: is treatment a prerequisite?', Drug and Alcohol Dependence 59, pp. 211-3.
EMCDDA (2009), Polydrug use: patterns and responses, Selected issue, Publications Office of the European Union, Luxembourg.
Hoare, J. and Moon, D. (editors) (2010), 'Drug misuse declared: findings from the 2009/10 British Crime Survey', Home Office Statistical Bulletin 13/10.
Prinzleve, M., Haasen, C., Zurhold, H. et al. (2004), 'Cocaine use in Europe: a multi-centre study: patterns of use in different groups', European Addiction Research 10, pp. 147-55.
Reynaud-Maurupt, C. and Hoareau, E. (2010), 'Es carrières de consommation de cocaïne chez les usagers «cachés»', Trends, Observatoire Français des Drogues et des Toxicomanies, Saint-Denis (available online).
Toneatto, T., Sobell, L.C., Sobell, M.B. and Rubel, E. (1999), 'Natural recovery from cocaine dependence', Psychology of Addictive Behaviors 13, pp. 259-68.
Van der Poel, A., Rodenburg, G., Dijkstra, M. et al. (2009), 'Trends, motivations and settings or recreational cocaine use by adolescents and young adults in the Netherlands', International Journal of Drug Policy 20, pp. 143-51.