NATIONAL INSTITUTE ON DRUG ABUSE EPIDEMIOLOGIC ...

As a percentage of the total, cocaine admissions have
remained quite stable at 18 to 20 percent for several
CEWG reporting periods (exhibit 4). Alcohol was the
most commonly reported secondary drug problem
among primary cocaine admissions (38 percent) (exhibit
5), followed by marijuana (19 percent). Smoking
is the reported route of administration for 86 percent
of all cocaine admissions, followed by inhalation
(10 percent). When asked whether they had used any
drug intravenously in the year prior to admission,
approximately 5 percent of all primary cocaine admissions
reported that they had used needles to administer
one or more drugs intravenously at least
once during the specified time period (exhibit 6).
Sixty-seven percent of the primary cocaine admissions
reported in the first half of 2004 were male,
identical to the gender breakdown seen in the second
half of 2003. Black non-Hispanics continued to
dominate cocaine admissions (at 57 percent), followed
by Hispanics (21 percent) and White non-
Hispanics (15 percent). In terms of age at admission,
nearly 40 percent were concentrated in the 36–45
year age group; an additional 23 percent of all primary
cocaine admissions were between the ages of
26 and 35.
Primary cocaine treatment admissions are more likely
than treatment admissions for any other substance
(alcohol, prescription medications, or illicit drugs) to
report being homeless at admission (28 percent). The
proportion of cocaine admissions referred to treatment
through the criminal justice system in the first
half of 2004 continued to decrease slightly to 20 percent
of all admissions. More frequently mentioned
referral sources included self-referral (33 percent) or
referral through Proposition 36 (a.k.a. SACPA)
court/probation (29 percent). Although one-third of
primary cocaine admissions had never been admitted
to treatment for a primary cocaine problem, approximately
one-half (47 percent) had one or two prior
treatment episodes. Forty-six percent earned a high
school diploma or GED. At the time of admission,
approximately 15 percent were employed either full-
or part-time.
Preliminary unweighted data accessed from DAWN
Live! for the first half of 2004 indicate that of the
4,688 major substances of abuse reported in the Los
Angeles division, 1,263 (27 percent) were cocaine/crack
(exhibit 7). Cocaine was the second most
likely major substance to be reported, following alcohol.
Seventy percent of the patients reporting cocaine
use were male; 40 percent were Black (followed
by 31 percent Hispanic and 24 percent White);
35 percent were age 35–44; and 60 percent reported
smoking crack. A total of 2,846 chief complaints
EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Los Angeles County
were logged for patients reporting cocaine. The top
three complaints were psychiatric condition (694
complaints), altered mental status (691 complaints),
and intoxication (592 complaints). Cocaine-using
patients were most likely to be discharged home (39
percent) or admitted to a psychiatric inpatient ward
(33 percent).
California Poison Control System calls involving the
use of cocaine/crack by Los Angeles County residents
increased from 69 in 2000 to a high of 97 in
2003. In the first 6 months of 2004 alone, 41 calls
involving cocaine/crack were received (exhibit 8a).
Between January 2003 and June 2004, 68 percent of
the cocaine-exposed callers were male, and 51 percent
were between the ages of 26 and 44 (exhibit 9).
An additional 20 percent were between the ages of 18
and 25.
According to CHKS data for the 2003–2004 school
year (exhibit 10), 7.4 percent of all Los Angeles
County secondary school students (including 7th, 9th,
and 11th graders, and a small sample of nontraditional
students) who responded to the survey had ever
used cocaine (crack or powder), and 3.8 percent were
current cocaine users (defined as any use in the past
30 days). A breakdown of the data by grade level
illustrated that among responding ninth graders, 5.4
percent had ever used cocaine and 3.0 percent were
current cocaine users. A higher percentage of 11th
graders than 9th graders reported current cocaine/crack
use in the past 30 days. Of the lifetime
cocaine users, 55 percent were male and 45 percent
were female. The gender distribution was slightly
wider for past-30-day use of cocaine (63 percent
male vs. 37 percent female). Frequent cocaine use is
defined as 20 or more days of use in the previous 30
days. Twenty-four percent of the current cocaine users
reported frequent use. Among the frequent users,
74 percent were male. When asked about past-6month
use of cocaine (any form), methamphetamine,
or other stimulants, 7.1 percent of 9th graders and 6.5
percent of 11th graders responded in the affirmative
(exhibit 11).
According to long-term trends calculated from CHKS
data spanning over the most recent 5 school years
(exhibit 12), the pattern of past-30-day cocaine
(powder or crack) use among responding secondary
school students was similar to usage patterns for
some of the other licit and illicit drugs, such as lysergic
acid diethylamide (LSD)/other psychedelics and
methamphetamine. Past-30-day cocaine/crack use
decreased consistently from the peak level seen in
1999–2000 (4.9 percent) to 3.8 percent in 2002–
2003. In 2003–2004, current cocaine use remained
stable at 3.8 percent of all respondents.
Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 99