Cocaine, mainly in the form of crack, continues to dominate New York City's illicit drug scene. Trends in cocaine-involved deaths, hospital emergencies, arrest and treatment admissions are reviewed from the late 1980s to the early 1990s. Also, street studies conducted at drug coping areas throughout New York City during this period yield ethnographic insights. At the same time that cocaine trends were showing increases in the 1990s, heroin trends and marijuana trends were also showing decisive increases. An upsurge in heroin activity may be directly related to cocaine activity. Heroin's ameliorative effects for the cocaine user are the most direct association. The sequence-first cocaine, then heroin-has been documented by historians in the field. The association between cocaine trends and marijuana trends is less direct, and may represent the substitution of or a retreat to marijuana, a drug that is perceived as much safer.
Price disparity contributes to a recurrent process whereby irregular users who are able to gain access to cheaper heroin in urban areas, return to the mid-Hudson and sell premium-priced heroin to other users who do not have access to cheaper heroin. This process contributes to the diffusion of heroin abuse.
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