Trends in cocaine use, markets and harms in Australia, 2003–2019

Abstract

Introduction This paper aims to describe cocaine use, markets and harms in Australia from 2003 to 2019. Methods Outcome indicators comprised prevalence of use from triennial household surveys; patterns of use from annual surveys of sentinel samples who use stimulants; and cocaine‐related seizures, arrests, hospitalisations, deaths and treatment episodes. Bayesian autoregressive time‐series analyses were conducted to estimate trend over time: Model 1, no change; Model 2, constant rate of change; and Model 3, change over time differing in rate after one change point. Results Past‐year population prevalence of use increased over time. The percentage reporting recent use in sentinel samples increased by 6.1% (95% credible interval [CrI95%] 1.2%,16.9%; Model 3) per year from around 2017 (48%) until the end of the series (2019: 67%). There was a constant annual increase in number of seizures (count ratio: 1.1, CrI95% 1.1,1.2) and arrests (1.2, CrI95% 1.1,1.2), and percentage reporting cocaine as easy to obtain in the sentinel samples (percent increase 1.2%, CrI95% 0.5%,1.8%; Model 2). Cocaine‐related hospitalisation rate increased from 5.1 to 15.6 per 100 000 people from around 2011–2012 to 2017–2018: an annual increase of 1.3 per 100 000 people (CrI95% 0.8,1.8; Model 3). While the death rate was low (0.23 cocaine‐related deaths per 100 000 people in 2018; Model 2), treatment episodes increased from 3.2 to 5.9 per 100 000 people from around 2016–2017 to 2017–2018: an annual increase of 2.9 per 100 000 people (CrI95% 1.6,3.7; Model 3). Discussion and Conclusions Cocaine use, availability and harm have increased, concentrated in recent years, and accompanied by increased treatment engagement.

Increasing cocaine use amongst employed Australians: who is most at-risk?

“…Consequently, younger workers may opt to use more accessible drugs rather than make an active choice to delay use of cocaine 27 ) . Recent studies however have shown that cocaine availability is increasing and becoming easier to obtain in Australia 7 ) and elsewhere 29 ) . Thus, uptake among younger workers may increase and should be monitored in the future, particularly given the slight albeit non-significant reduction in age of cocaine initiation between 2016–2019 (23.9 vs 23.6 years) 5 ) .…”

“…Higher cocaine levels have been accompanied by increased health service utilisation, further underscoring concerns about increased use. Cocaine-related harms, and help-seeking behaviour are illustrated in higher hospitalisation and treatment utilisation rates for cocaine as the principal drug of concern, respectively 7 ) . Cocaine-related mortality has also increased elsewhere in-line with increasing cocaine prevalence 3 , 8 , 9 ) .…”

“…Cocaine use can impair concentration, coordination and judgement and produce symptoms of anxiety, paranoia, exhilaration and intolerance to pain/fatigue 10 , 11 ) : factors of considerable relevance to workers and the workplace. Fitness for work can also be compromised as cocaine use can cause vomiting, headaches, hallucinations and delirium; and a range of cardiovascular, cerebrovascular and neurological problems 7 , 11 , 12 ) . People who use cocaine may by a danger to others, especially if operating machinery or driving a vehicle.…”

Trends in methamphetamine use, markets and harms in Australia, 2003–2019

“…However, concern regarding methamphetamine use and harms has persisted, and trends following recent investment in treatment have not been explored. Using an approach similar to our recent work in relation to cocaine [19], we examine trends in methamphetamine use, markets and harms using select national data sources from 2003 until 2019.…”

Moving away from piecemeal trends: The need for multiple data sources in drug use trend analyses

“…However, in this issue of Drug and Alcohol Review , Man et al . [13] present a manuscript in which they estimate trends in cocaine use in Australia between 2003 and 2019 using many sources of indicator data. Specifically, they utilise data from: (i) triennial household surveys; (ii) annual surveys of sentinel samples of people who use stimulants; (iii) seizures; (iv) arrests; (v) hospitalisations; (vi) treatment episodes; and (vii) deaths.…”