Cocaine use and overdose mortality in the United States: Evidence from two national data sources, 2002–2018

Manuel Cano, Sehun Oh, Christopher P. Salas-Wright, Michael G. Vaughn

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40 Citations (Scopus)


Background: Cocaine-involved overdose mortality has recently risen in the United States (US), yet it is unclear to what extent patterns in cocaine-involved overdose mortality parallel patterns in cocaine use. This study: examined time trends (2002–2018) in past-year cocaine use and cocaine-involved overdose mortality in the US; and compared demographics and drug involvement of adults who reported past-year cocaine use versus adults who died of a cocaine-involved overdose. Methods: Data from two sources were utilized: (1) the National Survey on Drug Use and Health (n = 1,334 adults self-reporting cocaine use in 2018); and (2) the Multiple Cause of Death dataset of the National Center for Health Statistics (N = 14,630 adults who died of a cocaine-involved overdose in 2018). The study examined prevalence of past-year cocaine use, mortality rates for cocaine-involved overdose, 2002–2018 trends, demographic characteristics, and involvement of other drugs. Results: Results of Joinpoint Regression indicated that the prevalence of past-year cocaine use increased after 2011, with an annual percent change of 5.13, while age-adjusted cocaine-involved overdose mortality rates escalated after 2012, with an annual percent change of 26.54. In 2018, prevalence of past-year cocaine use did not significantly differ (p = 0.09) by racial/ethnic group, yet Non-Hispanic Blacks had an age-adjusted cocaine-involved overdose mortality rate more than double the rate in Non-Hispanic Whites and significantly higher (p < 0.001) than in any other group. Conclusions: While the prevalence of cocaine use has increased modestly, cocaine-involved overdose mortality has risen dramatically. Cocaine-involved overdose mortality is disproportionately affecting individuals who are Black, older, or with lower educational attainment.

Original languageEnglish
Article number108148
JournalDrug and Alcohol Dependence
Publication statusPublished - 2020 Sept 1

Bibliographical note

Funding Information:
This work was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health [Award Number K01AA026645 ; Christopher P. Salas-Wright]. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIAAA or the NIH.

Publisher Copyright:
© 2020 Elsevier B.V.

All Science Journal Classification (ASJC) codes

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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