Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

9. Cocaine and Stimulants 185among the unemployed (3.6%) than among the employed (1.8%). Becausesocioeconomically disadvantaged persons are still a minority population,cocaine users are more often white, employed, and high school graduates(Johanson & Schuster, 1995).Unlike adult levels of use, national-level prevalence studies indicate thatadolescent (ages 12–17) levels of cocaine use appear stable and may be declining.According to NHSDA data, adolescents reported that past year cocaineuse dropped from 1.7% in 2000 to 1.5 % in 2001, while past year crack useremained the same (0.4%). In 2001, the past year prevalence of cocaine useamong youth ages 12–17 years was higher among Hispanic males (0.9%) andwhite females (0.6%) and males (0.4%) than among blacks (0.1%) and femaleHispanics (.1%). The Monitoring the Future study (MTF; Johnston, O’Malley,& Bachman, 2003) demonstrated that past year rates for powder cocaine appearsimilar (1.9% in 2001 and 1.8% in 2002) for eighth graders, 10th graders (3.0%in 2001 and 3.4% in 2002), and 12th graders (4.4% in 2001 and 2002). Crackcocaine use appeared stable for eighth (1.7% in 2001 and 1.6% in 2002) and12th graders (2.1% in 2001 to 2.3% in 2002), but increased significantly for10th graders (1.8% in 2001 to 2.3% in 2002).Consistent with overall growth in cocaine use, the Drug Abuse WarningNetwork (DAWN; Substance Abuse and Mental Health Services Administration,2001a) reports that cocaine continues to be the most frequently mentionedillicit substance reported by hospital emergency departments (EDs)nationwide. The most recent data available regarding the consequences ofcocaine use reveal rising ED mentions and declining treatment admissions.Data from DAWN show that the estimated number of cocaine-related EDmentions increased significantly, from 174,881 in 2000 to 193,034 in 2001. Infact, reports of cocaine were present in 30% of the ED drug episodes during2001 and part of 2002. ED cocaine mentions in 2001 increased 10% from 2000.In a large study conducted in New York City, the rate of overdose deaths forcocaine increased from 1993 to 1998, with cocaine being involved in 69.5% offatal overdoses. The majority of overdose death rates were attributed to drugcombinations of opiates, cocaine, and alcohol. Accidental overdose deaths variedby racial and ethnic group, with overdose deaths among blacks due primarilyto cocaine, and overdose deaths among Latinos and whites due to opiateswith cocaine (Coffin et al., 2003).Treatment Episode Data Set (TEDS; Substance Abuse and Mental HealthServices Administration, 2002) data also reveal the use of cocaine in combinationwith other illegal drugs. Marijuana, methamphetamine, and heroin werethe secondary drugs of abuse most often mentioned in 1999 TEDS admissionsfor which cocaine was identified as the primary substance of abuse. Admissionsfor cocaine taken by routes other than smoking were more likely to be whitemales (29%), followed by black males (23%), white females (18%), and blackfemales (12%). Admissions for smoked cocaine were more likely to be black