Perceived Risk and Prevalence of Crack Use and Among Young People in the US

"Crack cocaine use spread rapidly from the early to mid-1980s. Still, among 12th graders, the use of crack remained relatively low during this period (3.9% annual prevalence in 1987). Clearly, crack had quickly attained a reputation as a dangerous drug, and by the time of our first measurement of perceived risk in 1987, it was seen as the most dangerous of all drugs. Annual prevalence dropped sharply in the next few years, reaching 1.5% by 1991, where it remained through 1993. Perceived risk began a long and substantial decline after 1990 – again serving as a driver and leading indicator of use. (The decline in perceived risk in this period may well reflect generational forgetting of the dangers of this drug.)

"Annual prevalence among 12th graders rose gradually after 1993, from 1.5% to 2.7% by 1999. It finally declined slightly in 2000 and then held level through 2007. Since then, some additional decline has occurred. In 2016, annual prevalence for crack cocaine was at 0.8%.

"Among 8th and 10th graders, crack use rose gradually in the 1990s: from 0.7% in 1991 to 2.1% by 1998 among 8th graders, and from 0.9% in 1992 to 2.5% in 1998 among 10th graders. And, as just discussed, use among 12th graders peaked in 1999 at 2.7% and among young adults at 1.4%. Since those peak years, crack use has declined appreciably -- more than half among 8th, 10th, and 12th graders -- yet it held fairly steady among college students and young adults, at least until 2007, when use among college students finally began to decline. The 2016 prevalence levels for this drug were relatively low – less than 1% in all five groups. Twelfth graders had the highest prevalence. Annual crack prevalence among the college-bound has generally been considerably lower than among those not bound for college. Among 12th graders, the levels of use in 2016 were 0.7% for college-bound and 1.2% for noncollege-bound.

"We believe that the particularly intense and early media coverage of the hazards of crack cocaine likely had the effect of capping an epidemic early by deterring many would-be users and motivating many experimenters to desist use. As has been mentioned, when we first measured crack use in 1987, it had the highest level of perceived risk of any illicit drug. Also, it did not turn out to be “instantly addicting” upon first-time use, as had been widely reported. In some earlier years, 1994 and 1995 for example, 3% of 12th graders reported ever trying crack; however, only about 2% used in the prior 12 months and only about 1.0% used in the prior 30 days. It thus appears that, among the small numbers of 12th graders who have ever tried crack, the majority of those who tried it did not establish a pattern of continued use, let alone develop an addiction."