Cocaine production has been reportedly increasing exponentially in the last decade, resulting in a surge in its availability and an increase in overdose and health implications. Understanding the associated risks and available treatment can help reduce or prevent serious consequences of cocaine use.
Cocaine use trends: What the data shows
Figures from the Centers for Disease Control and Prevention (CDC) compiled by the National Institute on Drug Abuse (NIDA) show that all drug overdose deaths began to increase significantly from 2015 to 2022, reaching 107,941 reported deaths, with a slight decrease in 2023 to 105,007. [1]
Cocaine-related overdose deaths also significantly increased during this time. Of the total overdose deaths in 2023, 29,449 (28%) involved cocaine, while synthetic opioids (particularly fentanyl) remain the highest cause of overdose deaths. [1][2]
A report from the United Nations Office on Drugs and Crime (UNODC) shows that, in 2023, 2.27% of the US population (aged 15-64) used cocaine, with a higher prevalence among males (2.82%) than females (1.56%). [3]
A study (Gangu et al, 2022) showed that the prevalence of individuals admitted to hospital who had a diagnosis of cocaine dependence, abuse, or poisoning increased dramatically, from 270,790 in 2014 to 422,481 in 2018. This suggests an increase in cocaine use and in serious outcomes of cocaine use. [4]
Why cocaine is making a comeback
Reports from UNODC show dramatic increases in cocaine production in Colombia between 2015 and 2023, from 499 metric tons to a record-high of 2664 tons, an increase of over 400%. Coca bush cultivation in Colombia has also grown from 96,000 to 252,600 hectares during this time. [3] Reportedly, this is due to changes in production techniques, the expansion of coca-growing land, and improved coca plant resilience, which have resulted in significant increases in production. [2]
Much of this cocaine is then trafficked into the US, and figures show increases in Europe, East Asia, and Australia, with trafficking routes across Africa and the Middle East. These trafficking networks are believed to be incorporated into pre-existing fentanyl and methamphetamine routes, leading to massive expansion of cocaine and other drug supplies across the world. [2][3] Around 92% of the illicit cocaine in the US was produced in Colombia, which produces the majority of the world’s cocaine. [2][3]
With increased production, cocaine becomes more readily available, prices are reduced, and purity increases. This can increase use among those already using cocaine, as well as potentially increasing the likelihood of new use.
Health risks from the surge
Chronic cocaine use is associated with higher risks of cardiovascular issues, neurocognitive impairments, psychosis, and mood disorders. In overdose, cocaine can cause serious cardiac risks, seizures, or stroke, and can be fatal. An increase in cocaine availability potentially increases these risks among the US population and worldwide. [2][4]
Research indicates that people who use cocaine are likely to use other substances concurrently. Alcohol, cannabis, and opioids have historically and consistently been found among polysubstance users. Additionally, figures show significant increases in people using other stimulants alongside cocaine, increasing from 5.95% in 2014 to 11.46% in 2018 among hospitalized patients with cocaine abuse. [4]
Implications of the cocaine surge include risks associated with: [2][4][5]
- Increased purity: New users or people who have consistently used lower-purity cocaine may be at increased risk of adverse effects or overdose if they suddenly use a more potent product.
- Polysubstance use with opioids: Using cocaine (or another central nervous system stimulant) with an opioid (CNS depressant) can create dangerous risks. Cocaine can mask or delay the recognition of serious CNS depressant effects, such as respiratory depression, which could be fatal. Healthcare professionals may also struggle to identify polysubstance use in overdose cases such as this, delaying the implementation of potentially life-saving treatment.
- Polysubstance use with other stimulants: Combining stimulants, such as cocaine and methamphetamine, can significantly increase risks related to overstimulation, such as serious heart complications.
- Contamination: Cocaine may be cut or mixed with other substances before being sold to increase profits. This can create significant risks, particularly if it is cut with fentanyl.
Who is most affected by rising cocaine use?
With the increase in availability and purity of cocaine, a wide spectrum of the population is affected. In particular, certain demographics are more likely to use cocaine and are more affected by these changes, including: [4]
- Young adults
- Caucasian and African American people
- Males
Additionally, people with underlying health issues can be significantly affected by the rise in use, availability, and purity of cocaine, particularly those with cardiovascular issues, mental health conditions, or neurological conditions, as well as those with a history of substance use disorder.
Implications for public health, prevention, and personal steps
The US has designated drug cartels as terrorist organizations and is attempting to reduce the trafficking and distribution of drugs, including cocaine. Reports from the US Coast Guard indicate annual seizures of around 167,000 pounds of cocaine, which increased to over three times this amount in the 2025 fiscal year. [2][6]
While efforts to fight the ‘war on drugs’ may help to address the cocaine surge, there is some argument that this may only temporarily disrupt production and sale. For example, arresting or intervening in cartel operations could lead to higher prices, lower purity, and greater contamination, increasing risks to consumers. [2]
People who do not feel ready to stop cocaine use or seek professional help can implement harm reduction strategies to prevent or reduce their potential risks. For example:
- Avoid sharing equipment, such as pipes and mouthpieces, tubes and notes, or needles.
- Utilize safe consumption sites where professionals can monitor for overdose or dangerous effects.
- Utilize needle exchange programs.
- Be aware of the signs of overdose and how to seek professional help.
- Avoid using cocaine with other substances.
- Start with small doses to check new batches for strength and contamination.
Treatment options for cocaine use disorder
Cocaine is an extremely addictive substance, so people can struggle to reduce their use without professional support. Various options are available to help people with cocaine use disorder, and it can be most beneficial to utilize a combination of treatments, including: [7]
- Individual, group, and family therapies.
- Behavioral therapies, such as contingency management (CM) and cognitive behavioral therapy (CBT).
- 12-step meetings.
- Medications can be helpful, although there are currently no approved medications for this treatment.
People might benefit from inpatient rehabilitation services to help with detoxification and recovery from cocaine. Available rehab centers can be viewed on the Recovered Directory.
A doctor can advise about suitable treatment options and make a referral to a specialist provider.
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