"• Throughout the study period, the rates of drug overdose deaths involving cocaine were highest for the non-Hispanic black population, followed by non-Hispanic white and the Hispanic population (Figure 3).

"• In 2018, the rate of drug overdose deaths involving cocaine in the non-Hispanic black population (9.0 per 100,000) was nearly twice that of the non-Hispanic white population (4.6) and three times that of the Hispanic population (3.0).

"• In 2018, there were 14,666 drug overdose deaths involving cocaine in the United States for an age-adjusted rate of 4.5 per 100,000 standard population (Figure 1)."

"• The age-adjusted rate of drug overdose deaths involving cocaine remained stable from 2009 through 2013 ranging from 1.3 to 1.6 per 100,000, then increased on average by 27% per year from 2013 through 2018.

"Deaths involving cocaine and psychostimulants have increased in the United States in recent years; among 70,237 drug overdose deaths in 2017, nearly a third (23,139 [32.9%]) involved cocaine, psychostimulants, or both. From 2016 to 2017, death rates involving cocaine and psychostimulants each increased by approximately one third, and increases occurred across all demographic groups, Census regions, and in several states. In 2017, nearly three fourths of cocaine-involved and roughly one half of psychostimulant-involved overdose deaths, respectively, involved at least one opioid.

"Nationwide, 4.8% of students had used any form of cocaine (e.g., powder, crack,†† or freebase§§) one or more times during their life (Supplementary Table 114).

"In 2018, an estimated 5.5 million people aged 12 or older were past year users of cocaine (Figure 10), including about 757,000 users of crack. Stated another way, about 2.0 percent of the population in 2018 used cocaine (Figure 13), and 0.3 percent used crack (2018 DT 7.2).

"As in recent years, the second most commonly used drug in the last year among adults aged 16 to 59 was powder cocaine (2.3% in the 2016/17 survey, equating to around 760,000 people). Powder cocaine was also the second most commonly used drug among young adults aged 16 to 24 (4.8% or around 297,000 young adults) after cannabis. Both proportions remained similar to the previous year (2.2% of 16 to 59 year olds and 4.4% of 16 to 24 year olds in the 2015/16 survey). This trend is illustrated in Figure 1.3.

"The positivity rate in urine testing for cocaine increased for the fourth consecutive year in the general U.S. workforce and for the second consecutive year in the federally-mandated, safety-sensitive workforce. Cocaine positivity increased 12 percent in 2016, reaching a seven-year high of 0.28 percent, compared to 0.25 percent in 2015 in the general U.S. workforce, and seven percent among federally-mandated, safety-sensitive workers to 0.28 percent, compared to 0.26 percent in 2015."

"Surveys suggest that around 18 million adults aged 15-64 in the European Union (5.4 %) have used cocaine at least once in their lifetime. Of those aged 15-34, nearly 3 million (2.4 % of this age group) are estimated to have used the drug in the last year.

"In the Americas, the primary cocaine trafficking flow is from Colombia to the United States. The analysis of cocaine seizure samples in the United States mainland suggests that 90 per cent of that cocaine originated in Colombia and 6 per cent originated in Peru, while the origin of the rest was unknown.⁴⁰

Estimated Past Year Prevalence of Cocaine and Crack Use Among Young People in the US: "Past-year cocaine use in 2015 among 12th graders has been essentially the same across regions and varied between 1.8% and 2.3%, with the exception that the West stood out and climbed to 4.4% in 2015 (Figure 5-10b; also Tables 36-38 and Figure 81 in Occasional Paper 86). In past years regional variation in cocaine use was the largest observed for any of the drugs.