Trends of Cocaine Use and Manifestations in Hospitalized Patients: A Cross-Sectional Study

Abstract

Objective About 41 million people aged ≥18 years reported lifetime use of cocaine, and 5.4 million people reported having used cocaine in 2019. We aim to identify trends of cocaine use, manifestations, concomitant drug use, and financial burden on health care among hospitalized patients. Methods We utilized National Inpatient Sample from years 2006-2018. Patients with age ≥18 years, admitted to the hospital with a diagnosis of cocaine abuse, dependence, poisoning, or unspecified cocaine use were included in the study. We used ICD-9 Clinical Modification (CM) and ICD-10-CM codes to retrieve patient samples and comorbid conditions. The primary outcome was the trend in cocaine use among hospitalized patients from the year 2006 to 2018. Cochran-Mantel-Haenszel test was used to assess the significance of trends. Results In the year 2006, the prevalence of cocaine abuse among hospitalized patients was 10,751 per million with an initial decline to 7,451 per million in 2012 and a subsequent increase to 11,891 per million hospitalized patients in 2018 with p =0.01. The majority of patients admitted were older than 50 years (43.27%), and a greater percentage of patients were males. All ethnicities showed a rising trend in the use of cocaine except for Native Americans. Cardiovascular effects, neuropsychiatric and infectious manifestations in hospitalized patients with cocaine abuse showed a consistent increase from year 2006 to 2018 with p <0.001. Conclusions There is a recent uptrend in cocaine use among hospital admissions in the US from 2006 to 2018 with an increased rate of systemic manifestations. This highlights the impact of cocaine use on the health system and the dire need to address this growing problem.

Cardiovascular Risks of Simultaneous Use of Alcohol and Cocaine—A Systematic Review

“…An in-hospital mortality study performed in a national inpatient sample in the U.S. ( n = 261,000,000; between 2006 and 2018) compared cocaine to cocaine–alcohol positive patients, admitted with a diagnosis of cocaine abuse, dependence, poisoning, or unspecified cocaine use. The results showed a higher rate of in-hospital mortality for cocaine–alcohol compared with cocaine alone (1.36% and 1.07%, respectively; p < 0.001), but this difference was no longer statistically significant ( p = 0.87) after adjustment for a number of covariates, like age, sex, race, and comorbid conditions [ 9 ].…”

“…As a potent sympathomimetic drug, cocaine is associated with considerable cardiovascular complications [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ], including angina pectoris, coronary vasospasm, myocardial ischemia, acute myocardial infarction (AMI), cerebrovascular disease, ventricular arrhythmias, and sudden cardiac death. Therefore, it is no surprise that cocaine is one of the main causes of drug-related emergency department (ED) visits, due to cardiovascular problems [ 11 ], with chest pain mentioned as the most common complaint [ 12 , 13 ].…”

Substance Use Disorders in the Geriatric Population: a Review and Synthesis of the Literature of a Growing Problem in a Growing Population

“…Between 2000 and 2017, older adults showed greater increases in proportions admitted for cocaine/crack relative to younger adults [ 49 ]. Gangu et al found that there has been an uptrend in hospital admissions in the U.S. with a primary diagnosis of cocaine abuse, dependence, poisoning, or unspecified cocaine use from 2016 to 2018, with patients over 50 years old comprising only 21.2% of admissions in 2006 compared to 43.27% in 2018 [ 50 ]. Further research must be done to better understand trends in order to address appropriate screening, diagnosis, and treatment of older patients.…”

Trends in cocaine use among United States females of reproductive age, 2005–2019

“…Compared with the existing literature, this study presents cocaine use trends specific to reproductive age females, with or without other drug use. It is worth noting that other studies examining trends of cocaine use in the US general population have warned of a similar noticeable uptake in use of this drug 18 . As highlighted in a recent study that included responses from all subgroups of US adults, a similar initial decrease in past 12‐month cocaine use prevalence was observed from 2006 to 2011 (2.5% in 2006–2007 to 1.7% in 2010–2011), before an uptake in use was documented in 2018–2019 (2.1%) 5 .…”