Cocaine-Related Health Emergencies in Europe: A Review of Sources of Information, Trends and Implications for Service Development

Abstract

Background: Cocaine-related health consequences are difficult to observe. Data on drug users in health-emergency settings may be a useful source of information on consequences that are not visible via other information sources. Methods: Thirty European countries submit an annual national report on the drug situation to the EMCDDA. All reports for the period 2007–2010 were analyzed, with particular attention given to auditing cocaine-related mentions. Analysis was also performed in order to identify sources and case definitions, assess coverage, audit cases and, where possible, to identify long-term trends. Results: Considerable heterogeneity existed between countries in their approach to recording drug-related emergencies, with only Spain and the Netherlands having established formal indicators. The highest annual numbers of cocaine-related episodes were reported by the UK (3,502), Spain (2,845) and the Netherlands (1,211). A considerable (2- to 3-fold) increase in the numbers of cocaine-related episodes has been reported since the end of the 1990s in these countries; these increases peaked in Spain and England around 2007/08. Conclusions: The analysis reported here suggests the need to develop more standardized approaches to monitoring drug-related emergencies. It points to the potential value of developing effective referral links between the emergency and specialized drug services working with cocaine users.

Acute cocaine-related health problems in patients presenting to an urban emergency department in Switzerland: a case series

“…Most patients were men who chronically abused cocaine and had no employment. Of note, 53% of the patients were over 30 years old in line with increases in age of patients with cocaine-related health problems in other European countries [1]. The patients who abused more than one drug did so most commonly by combining cocaine with ethanol, opioids or cannabis, as reported by others [12,29].…”

“…After cannabis, cocaine is the most-used illicit drug in Europe [1-3]. In Europe, 4.3% of adults aged 15–64 have used cocaine at least once in their lifetime [4].…”

“…EDs may be important sources of information about drug-related health consequences [1,23]. Reports from 30 European countries regarding cocaine-related health emergency episodes have recently been summarized for the period from 2007 to 2010 [1]. However, most of these reports concerned calls to poison centers, or admissions to general hospitals, psychiatric hospitals or toxicology clinics.…”

“…However, most of these reports concerned calls to poison centers, or admissions to general hospitals, psychiatric hospitals or toxicology clinics. Only 7 reports used EDs as information sources and detailed case descriptions were not presented [1]. The present study aimed to describe in more detail the demographics, clinical findings, management, and short-term outcome of patients with analytically-confirmed acute cocaine use presenting to an urban ED in Switzerland.…”

Inflammation and infection in human cocaine addiction

“…Many cocaine-related medical complications lack specificity, and may only be recognized once they deteriorate into medical emergencies. However, at this late stage a direct link with cocaine is difficult to establish [4]. A common adverse health consequence in cocaine-addicted individuals is the increased transmission and progression of infectious diseases [4].…”