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Sudden death in cocaine abusers

Richard A. Lange, L. David Hillis
DOI: http://dx.doi.org/10.1093/eurheartj/ehp503 271-273 First published online: 13 January 2010

Cocaine is the second most widely trafficked drug in the world, trailing only cannabis in this regard. Over the past decade, its recreational use has increased in most European countries (Figure 1). At present, it is estimated that ∼1.2% of Europeans used cocaine in the last year, with the prevalence varying from 0.7% in Romania and Lithuania to 12.7% in the UK.1 However, due to the absence of standardized survey and reporting procedures, it is likely that the prevalence of cocaine abuse is under-reported in many European countries. Cocaine use is concentrated among young adults, aged 15–34 years: of the 4 million Europeans who used it in the last year, almost 90% were in this age group.1

Figure 1

Trends in prevalence of cocaine use among young adults (aged 15–34 years). Source: http://www.emcdda.europa.eu

Among European countries, Spain ranks second to the UK in the prevalence of cocaine abuse, with 7% of the population estimated to have used it at least once and 3% to have done so in the past year. Among those aged 15–34 years, 10% are estimated to have used it.1 The higher prevalence of recreational cocaine use in Spain when compared with most other European countries is due, at least in part, to the fact that it is a major European port of entry for the drug from South America.

Several factors account for the increasing abuse of cocaine, including its ease of administration [i.e. it can be administered intravenously, intranasally, or by inhalation (smoking)], its availability and purity, its relatively modest cost (i.e. ∼€40–€80/g), and the misperception that recreational cocaine use is safe. In a recent survey conducted by the US Department of Health and Human Services, only 50% of young people expressed the belief that monthly cocaine ingestion carries a great …

*Corresponding author. Tel: +1 210 567 4812, Fax: +1 210 567 4654, Email: langera{at}uthscsa.edu