Part II: Cocaine
Reports on cocaine use vary widely between cities. In particular, it appears that crack is still failing to attract new users the way it did a few years ago. Current crack users continue to use, but new user rates are dropping. However, in a few areas, powder cocaine use seems to be on the rise among more affluent user groups, a trend consistent with the last Pulse Check. On the West Coast, both ethnographers and treatment providers report that cocaine users also tend to use methamphetamine. Cocaine prices remain stable, and purity levels vary in most regions.
Ethnographers, Epidemiologists, and other Ethnographic Sources
Ethnographic reports of cocaine and crack differ across areas. Only the Seattle source reports an overall rise in use, while the San Francisco source reports a slight increase in powder use, but few new crack users. Similarly, New York and Miami sources report that cocaine is still popular with some users, but there appear to be fewer new users. The Chicago source reports that the level of cocaine use is stable, although at a high level. Sources in Denver, Bridgeport, Newark, Miami, and Atlanta all report a stable level of use.
San Diego and Baltimore ethnographers report an overall decrease in cocaine use in their areas. Notably, the San Diego source attributes the decrease to a concomitant rise in methamphetamine use in the area. In sum, crack is continuing to decline in popularity and is failing to attract new users. However, a smaller, established cohort of users continue to use both powder cocaine and crack.
Throughout regions, most ethnographic sources note that crack and powder cocaine users have categorically distinct profiles. This is attributed to the price differences between these two types of cocaine. Because powder cocaine is more expensive, users tend to be older and more economically advantaged, and live in different neighborhoods than crack users. For example, sources in Bridgeport note that most cocaine powder is sold in the suburbs where "users have responsibilities and financial means to buy." The San Diego ethnographer notes that powder users in that area tend to be affluent, and the Newark source also notes a slight increase in use of cocaine powder by a professional/white-collar group 30 years and older.
San Diego, San Francisco, and Chicago sources cite both snorting and smoking as the predominant routes of cocaine administration, indicating the presence of both powder and crack cocaine users. Miami and Atlanta ethnographers add injection as a third method of use; however, the Atlanta source reports that snorting is becoming more popular. In Bridgeport, users are primarily snorting cocaine, with some injection occurring. Finally, in New York and Seattle, smoking and injection are noted as the primary routes of cocaine administration.
Poly-drug use, involving several drugs in various combinations, is common in all areas. The most prominent form of poly-drug use is speedballing -- combined cocaine andheroin use -- which reportedly occurs in all areas and is rising in at least one area, San Francisco. Concurrent use of cocaine and marijuana is reported in San Diego, San Francisco, Denver, and Bridgeport. In Newark, users combine amphetamine and cocaine, which allegedly "lengthens the effect." MDMA and Rohypnol are used with cocaine in the Miami club scene.
Double-breasting continues in many areas, including San Francisco, Newark, and Miami. The source in Miami reports that cocaine imported from Colombia may come with five kilograms of heroin (known as a "rider") at no extra cost with every 100 kilograms of cocaine purchased. Many other sources also report the continuation of double-breasted dealing, though not necessarily in the same manner as in Miami.
In terms of street-level sales, in many areas, cocaine sellers are described as very diverse. In New York, one source reports that "a little of everybody" is selling. The Bridgeport sources notes that there are now more teenage crack dealers, and this has contributed to highly visible detrimental effects on the community (e.g., increased violence, teen pregnancy, spread of HIV). Sources in Chicago, Seattle, and Denver state that gang involvement in cocaine distribution is still common in their areas.
The majority of sources report no change in cocaine prices over the last six months. One exception is Chicago where prices have risen due to a recent shortage in supply. One New York source also notes an increase in price for cocaine that includes delivery; this delivered cocaine also tends to be of higher quality. New York, Denver, Miami, Atlanta, and Baltimore sources report typical rates of $10 to $20 per bag, and most sources report variable purity.
Law Enforcement Sources
Police sources report varied levels of cocaine use. Police in Birmingham, Boston, Cleveland, Austin, and San Antonio report increased use. Notably, in Birmingham, there appears to be increased crack use among middle-class users. In this area, there also are reportedly more young users. Both of these trends are inconsistent with trends in other parts of the country. In Boston, there is more powder in the suburbs. Reports from Denver, Miami, Chicago, Baltimore, Columbia, New York, Eugene, and San Antonio indicate stability in use.
A decrease in use is reported by sources in Los Angeles and Bridgeport. In Washington D.C., use is reportedly stable or decreasing. However, the practice of bag markings, to indicate a particular type of product, continues in this area, indicating a fairly organized market. In Trenton, crack use is up slightly while powder cocaine use is stable. The majority of sources report a wide variety of cocaine users, and many describe that "everyone" is doing it.
Smoking and snorting are the predominant methods of use in most areas. Only sources in Columbia and Eugene report injection as a method of use, though these areas also report smoking and snorting.
Seller characteristics vary widely both within and across source locations. In areas of the West (Denver, Eugene, Austin), sales are dominated by Mexican nationals, while in the Mid-Atlantic and South there are reportedly young African-American males involved in cocaine sales. However, in New York, Cleveland, Austin, and Boston, sellers defy such characterizations; sources say that "everyone" is selling. In Miami, Eugene, Austin, Seattle, and Yakima, sellers reportedly participate in sales of other drugs. However, sources in New York and San Antonio report that cocaine sellers do not usually sell other drugs.
Treatment Providers
In the Northeast and Mid-Atlantic/South regions, about one third of clients entering drug treatment list cocaine or crack as the primary drug of abuse. In the Midwest and West/Southwest regions, these rates are lower (20% and 18%, respectively).
The majority of drug treatment facilities in all regions report no change in levels of cocaine abuse since the last Pulse Check. Also, across all regions, most clients in treatment snort or smoke cocaine as opposed to injecting it.
Many people in treatment for cocaine abuse also have problems with other licit and illicit drugs. In all regions, cocaine abuse coincides with alcohol abuse at very high levels (83-100%). Rates of marijuana abuse are also high in all regions for cocaine users. In the West/Southwest region, about 40 percent of clients receiving treatment for cocaine abuse also report using amphetamines. This is consistent with the reported popularity of methamphetamine in the West/Southwest region. In the Northeast region, nearly 20 percent of cocaine abuse treatment clients report having problems with heroin, while in the Mid-Atlantic & South, this figure is less than 15 percent. Notably, in the Midwest and West/Southwest regions, this figure is zero. That is, in this region, no cocaine abuse treatment clients report concurrent problems with heroin abuse.
In all regions, most clients entering treatment for cocaine abuse are over the age of 21. The percentage of clients younger than 21 ranges from 13 percent to 18 percent across regions. Again, most clients are Caucasian males.
In the Northeast, more than 70 percent of clients receiving treatment for cocaine abuse report having received drug treatment previously. In the other regions, this figure is about 50 percent.
