Residents of cities in the Rocky Mountain and Southwestern US have the most cocaine usage nationwide, a new study found.
Phoenix, Arizona, topped the American Addiction Centers’ list of highest cocaine use in the country, with over 23 percent of adult residents there having tried the drug before.
Mesa, also in Arizona, took the number two spot, with about 22.5 percent of people saying they had taken the drug at some point. Both cities also topped the 10 cities with the highest percentage of residents who had used marijuana.
Every city on the list reported cocaine use rates exceeding 21 percent, though all except Phoenix have populations under 632,000.
Cocaine is a Schedule Two drug, according to the Drug Enforcement Administration, in the same category as morphine and amphetamines, including those for ADHD, which means it has a high potential for abuse but also some medical applications.
Cocaine saw a boom in the 1980s, especially among the affluent and the upper-middle class, with illegal production and trafficking spiking during that decade.
Usage dipped in the early 2010s with the meteoric rise of opioids overtaking it in the illicit drug market as well as dipping coca prices in Colombia, but public health researchers have warned that the stimulant is making a roaring comeback.
Cocaine was involved in about 27 percent of 105,000 overdose deaths in 2023, the most recent year for which comprehensive data is available
Behind Mesa for most cocaine usage came Omaha, Nebraska, with 22.2 percent reporting use at some point, followed by Oklahoma City, Oklahoma, with 22 percent, and Las Vegas, Nevada, with 21.9 percent.
The list also features Tulsa, Oklahoma; Wichita, Kansas; Colorado Springs, Colorado; Tucson, Arizona; and Fresno, California, all with 21.8 percent of their populations having tried cocaine.
Researchers did not elaborate on what could be driving the widespread use of the drug in those cities, but most of them are close to common drug trafficking routes.
Arizona cities’ proximity to the southern border makes it a major transit point for cocaine smuggled into the US.
Meanwhile, cities like Fresno and Tulsa have higher poverty rates and economic instability, which correlate with substance abuse.
Many states, like Oklahoma and Arizona, have been hit especially hard by the opioid epidemic, which has led to a lot of cross-contamination with cocaine and other drugs, such as fentanyl in the drug supply.
The team from American Addiction Centers analyzed drug use data from 51 major metropolitan areas, ranking each city by the percentage of residents who reported using specific substances like cocaine.
Researchers did not elaborate on what could be driving the widespread use of the drug in those cities, but most of them are close to common drug trafficking routes
They then created a weighted composite score combining usage rates across all drugs to determine overall substance abuse rankings.
This method revealed cities with the highest prevalence of drug use.
Among the growing population of cocaine users are working-age adults, according to Rutgers University researchers, who reported: ‘Recent surveys show a resurgence in cocaine use, particularly among employed men aged 25 to 45.’
And in 2023, a study in the journal Brown Hospital Medicine found that even older adults use the drug at higher levels.
‘Both lifetime and current cocaine use appear to be more prevalent among members of the “Baby Boomer generation” than older cohorts,’ the researchers concluded.
The cities included on the list also have high Baby Boomer and retiree populations, often overlooked when it comes to illicit drug use but, according to research, no less likely to take the drug.
A significant portion of the cocaine on the US illicit drug market has been contaminated with fentanyl, often without drug users’ knowledge, which has driven up cocaine-linked drug overdoses.
While overdoses attributed only to cocaine have remained steady since the late 90s, at less than 10,000 annually, overdoses involving cocaine and an opioid like fentanyl have risen precipitously starting in 2015.
Many of the drug overdoses over time, according to the CDC, involve more than one drug, such as cocaine and fentanyl. Fentanyl contamination is a major driver of rising cocaine and methamphetamine deaths
Cocaine was involved in about 27 percent of 105,000 overdose deaths in 2023, the most recent year for which comprehensive data is available.
Cocaine-related deaths have more than tripled since 2010 (1.3 per 100,000) and are now at record highs. And adults 55 and up saw the most significant increases.
Researchers at Virginia Tech zeroed in on rising use in their state and reported that the number of cocaine-related overdoses has been increasing since 2013, with 968 fatal overdoses in 2022, a 20 percent increase over 2021.
Warren Bickel, a biomedical researcher at Virginia Tech and director of the Addiction Recovery Research Center, said: ‘Stimulants are coming back. Cocaine use and addiction has been rising for more than a decade with no robust treatment.’
Cocaine is the second-most common drug used in the US after marijuana, with roughly 41 million Americans admitting to having used it at some point in their lives and 5.4 million reporting having used it in the past year.
