Cocaine use and hospitalisations on the rise

A new report reveals an increase in cocaine availability, prevalence of use and related hospitalisations in Australia.

Led by researchers at the National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, the report published in the Drug and Alcohol Review triangulates cocaine trends in Australia using datasets from 2003–2019.

“The triangulation of these various data sources points to significant shifts in cocaine use, markets and harms in Australia in recent years, and generates renewed attention on treatment and harm-reduction responses for regular and dependent cocaine use,” lead author Dr Amy Peacock said.

According to the National Drug Strategy Household Survey, the percentage of adult Australians reporting past-year cocaine use increased from 2.5% in 2016 to 4.2% in 2019.

Dr Peacock said the NDARC research revealed increases in cocaine use among samples of people who regularly use ecstasy and other stimulants, with these individuals reporting that cocaine is easier to access.

“[The] cocaine-related hospitalisation rate increased from 5.1 to 15.6 per 100,000 people from around 2011–12 to 2017–18: an annual increase of 1.3 per 100,000 people,” Dr Peacock said.

“Whilst the death rate was low, treatment episodes increased from 3.2 to 5.9 per 100,000 people from around 2016–17 to 2017–18: an annual increase of 2.9 per 100,000 people.

“These findings are concerning given the lack of efficacious treatment options for cocaine dependence, and reinforce the need for harm-reduction interventions targeted at reducing overdose, injuries and other harms. Close monitoring of these indicators is warranted given the potential for further elevation in rates of use and harms, particularly if reductions in price occur alongside increased availability and/or increased purity,” Dr Peacock said.

Despite the increase in cocaine prevalence, availability and hospitalisations, frequency of use remains low.

“Cocaine prices in Australia are still some of the highest globally, which may explain why frequency of use remains low despite increased availability,” Dr Peacock explained.

The report findings coincide with results from a University of South Australia (UniSA) study of wastewater samples taken over the New Year period, which reveal that Australians are consuming large quantities of designer drugs, along with seven other countries worldwide.

According to the UniSA wastewater analysis of psychoactive substances (NPS), published in Water Research, the Netherlands, United States, Australia and New Zealand are consuming the highest amounts of designer ‘party’ drugs,

UniSA analytical chemist Dr Richard Bade said samples were collected over the New Year in each country and shipped to South Australia for analysis.

NPS are a range of drugs that have been designed to mimic established illicit drugs, such as cannabis, cocaine, MDMA and LSD. More than 200 synthetic drugs across all countries were monitored and 16 substances found.

“The Netherlands recorded the highest usage, followed by Australia, New Zealand and the United States. Spain, Italy and China had the lowest incidence of designer drug use in cities participating in the study,” Dr Bade said.

N-ethylpentylone, which is known to cause fatalities, was seen in Australia, New Zealand and the US. It has previously been detected in forensic samples and at music festivals in Australia and New Zealand.

Another designer drug called mephedrone (often referred to as drone, M-CAT, White Magic and meow meow) was found only in Australia and New Zealand, with the latter country recording a 20-fold spike in usage on New Year’s Eve.

“It is a very powerful drug that produces effects similar to those of cocaine and MDMA, and is popular among ecstasy and stimulant users in Australia and NZ,” Dr Bade said.

The Netherlands recorded traces of six of 10 quantifiable drugs. Seven additional recreational drugs were also identified in the samples after screening. Of these, ketamine (a human and veterinary anaesthetic) and its metabolite, norketamine, were found in every country.

A newer drug on the market — eutylone — was seen in Australia, New Zealand, the US and the Netherlands. Warnings were issued in 2020 that this designer drug was being incorrectly marketed as MDMA in New Zealand due to its visual similarity to the latter. High doses of it have been linked to intense and particularly dangerous side effects.

“What makes the NPS so dangerous is that they were originally sold as legal alternatives to conventional illicit drugs such as ecstasy and cannabis, suggesting they were safe when, in fact, there was very little information about their toxicity,” Dr Bade explained.

“Governments soon intervened after hospitalisations and fatalities were linked to these class of drugs, with some countries enforcing blanket bans. However, despite these bans, NPS are still synthesised, transported and consumed across the world, often with fatal consequences.”

Dr Bade said he hopes that wastewater samples will help complement hospital, legal and forensic data, along with global surveys, to identify which designer drugs are the most dangerous in the community.

Image credit: ©stock.adobe.com/au/DedMityay