Ethnographers, Epidemiologists, and Ethnographic Sources (Table 4)
Ethnographic reports of powder cocaine/crack use differ across the cities included in this issue of Pulse Check. In 7 of the 15 cities where ethnographic sources were interviewed, powder cocaine/crack use was stable, 3 cities reported use as increasing, while only one reported a decline in cocaine use (Seattle). Sources in Chicago report that although use rates are still lower than their peak of a few years ago, cocaine use has increased over the past 6 months and remains the most frequently used drug in the area. Sources in Honolulu report an increase in treatment admissions relating to cocaine use but a stable number of arrests. In Minneapolis, cocaine-related problems account for more hospital admissions and overdose deaths than any other drug. Austin sources report that cocaine is the primary illegal drug used in the area. Kansas City sources report that cocaine is one of the three most frequently used drugs, along with alcohol and marijuana. In Los Angeles, San Francisco, Denver, Bridgeport, Newark, St. Petersburg, New York, and San Antonio, sources report that cocaine use rates are stable.
Differences between powder and crack cocaine users are consistent with past trends. In two Texas cities, Austin and San Antonio, most powder cocaine users are professionals from upper socioeconomic groups. Newark sources also note an increase in cocaine use among those with higher socioeconomic backgrounds. In contrast, crack use in San Antonio, Miami, St. Petersburg, and Kansas City is primarily found among African-Americans in urban, lower income groups. Sources in Chicago state that crack users are a heterogeneous group, while powder cocaine use is increasing among females. In St. Petersburg, Honolulu, Minneapolis, and Kansas City, sources note that cocaine users are mostly adults, but in other areas (e.g., Austin, Chicago, St. Petersburg, and San Francisco) there is a significant number of young users. For example, San Francisco reports that Caucasian high school and college students comprise most of the powder cocaine user group. In contrast, Kansas City sources report a decline in use among youths.
The prevalence of both smoking and snorting cocaine indicates availability of the drug in both powdered form and as crack. In all 15 cities with the exception of Bridgeport, where snorting predominates, the most prevalent method of ingestion is smoking cocaine as crack. Snorting of cocaine is common in 6 of the cities (i.e., Miami, St. Petersburg, Honolulu, Austin, San Antonio, and Seattle). Injection was cited as a method of ingesting cocaine in the cities of Denver, Miami, New York, Austin, San Antonio, and Seattle. The number of injection users is very small in San Francisco, and Denver reports a decline in the number of injection users. The eastern cities of Newark and New York note injection only in connection with "speedballing." "Shebanging" (squirting a liquid cocaine mixture up the nose), a method of ingestion that has previously been associated with heroin, was reported in Austin. Similarly, San Francisco sources report the practice of injecting crack made soluble in lemon juice.
Ethnographic sources in all of the cities related that cocaine was used in combination with other drugs. Ethnographic sources in Los Angeles, Chicago, Minneapolis, New York, San Francisco, Newark, Miami, and Seattle report "speedballing," or combined use of heroin and cocaine, a continuing trend from prior reports. Contacts in Miami, St. Petersburg, and Honolulu indicate cocaine is often used with other drugs, such as marijuana, MDMA, and LSD. Concurrent cocaine and marijuana use is reported in Los Angeles, San Francisco, Denver, Newark, Miami, St. Petersburg, Chicago, Kansas City, and San Antonio. Sources in Austin and Denver also note concurrent cocaine and methamphetamine use. In Los Angeles, San Francisco, Newark, Miami, Kansas City, New York, and Austin, sources report concurrent use of cocaine and alcohol.
Gangs or organized crime were found to be involved in cocaine/crack sales in Chicago, Minneapolis, Austin, San Antonio, and Seattle. Kansas City, Austin, and Seattle sources note that cocaine sellers are often young. Sources in San Francisco, Newark, Miami, Chicago, Minneapolis, New York, and San Antonio report that many cocaine sellers also sell other drugs.
Most sources report crack prices ranging from $10-$20 per rock or bag, though there is notable variation. In Miami, sources report prices of only $3-$5 per rock, while prices in Honolulu range from $30-$50 per rock. St. Petersburg sources report powder cocaine selling in $20, $30, $40, and $50 units, with powder prices ranging from $20-$100 per gram. Los Angeles, Denver, and Minneapolis sources report prices of about $80-100 per gram. In Chicago, lower quality powder cocaine sells for $50 per gram. San Francisco sources report a dramatic decrease in cocaine prices to $50 per gram of cocaine.
Law Enforcement Sources (Table 5)
Police sources from all areas but Seattle describe cocaine use as stable, but many also comment that it is stable at a high level of use. In Seattle, sources report that there has been a decrease in use, though cocaine use remains very common. Washington, D.C., and San Antonio report widespread cocaine use. In the eastern city of Trenton, powder cocaine use remains stable at a moderate level, while crack cocaine use is stable at a very high level. Yakima sources note that although use is generally stable, there might be a slight increase in use due to a decrease in price in that area. In Cleveland, crack cocaine is much more popular than powder cocaine.
Smoking and snorting are the predominant methods of cocaine use. Only sources in Columbia and Seattle report injection, as well as smoking and snorting. In Seattle, sources note that injection and snorting are much less common than smoking. San Antonio sources report more snorting than smoking.
In San Diego, sources report that cocaine users may also use methamphetamine, as well as prescription drugs to aid sleep. Sources in Columbia note that cocaine use is often combined with heroin, while Boston reports that cocaine and heroin use are only combined occasionally.
Seller characteristics vary widely across the country. In Washington, D.C., sources report that, although sellers primarily sell cocaine, they sell other drugs as well. Sources in Trenton found that cocaine sellers do not usually sell other drugs. In Cleveland and San Antonio, cocaine sellers reportedly may participate in marijuana sales. Sources in Seattle report that cocaine sellers also sell methamphetamine, marijuana, and heroin. Most sources report that cocaine sells in $10-$20 units.
Law enforcement contacts report a variety of unique packaging for cocaine and crack. In Trenton, crack is sold both in ziploc bags and unpackaged; that is, a piece is cut or shaved directly off a larger rock and handed directly to the buyer. Powder is sold in ziplocs or as "twisties" where a small plastic bag is cut and shaped into a cone and tied shut with a twist tie. Many bags are tagged or marked, as has been true in the heroin market for decades. Police in Maryland report that the bags are often tagged with contemporary pop culture names like "Titanic" or "White House."
Treatment Providers (Table 6)
Cocaine use among treatment clients remains fairly consistent with previous Pulse Check reports. In the Northeast region, 23 percent of clients entering drug treatment list cocaine or crack as their primary drug, a decrease from the last issue of Pulse Check, when about one-third of clients in this region designated cocaine as their primary drug. Consistent with the last Pulse Check, in the Mid-Atlantic/South and Midwest regions, 26 percent and 32 percent of clients, respectively, reported cocaine as their primary drug of abuse. In the West and Southwest, the proportion of treatment clients reporting cocaine as their primary drug is lower at 15 percent.
The majority of drug treatment facilities report no change in the proportion of clients entering treatment for cocaine use over the 6-month period reported in this issue. Also, most clients reportedly snort or smoke cocaine as opposed to injecting it in all regions.
Alcohol abuse frequently accompanies cocaine use, and marijuana use is also high in all regions among cocaine users. Concurrent use of heroin and cocaine among treatment populations was high in the Mid-Atlantic (20 percent) and West/Southwest (23 percent) regions.
In all regions, most clients entering treatment for cocaine abuse are in their twenties and thirties. The percentage of younger clients (under 20) ranges from 17 percent to 20 percent in the Northeast, Mid-Atlantic/South, and Midwest regions. In the West/Southwest region, only 9 percent of cocaine using clients are under 20 years old, while 17 percent are over 40. The majority of clients in all regions are Caucasian males.
In the West/Southwest region, 50 percent of clients receiving treatment for cocaine abuse have received drug treatment previously. In the other regions, this rate is even higher, ranging from 58 percent to 63 percent.
