Global Prevalence of Cocaine Use

"Data on people in drug treatment who mentioned cocaine products as their primary drug are limited to 26 countries, 20 of them in Europe, and show an increasing trend over the past decade. However, 70 per cent of the countries reported a decrease in the number of such patients in 2020, compared with the previous year, possibly confirming the general decrease in treatment delivery during the pandemic rather than a decrease in the number of people with cocaine use disorders.

"Wastewater-based epidemiology offers an additional source of information on trends in consumption of cocaine,^d although this method is limited to a relatively small number of cities, concentrated in Europe, followed by Oceania and Asia.⁴⁰ Long-term trend data with relatively good subregional coverage is only available for Western and Central Europe, although there were available paired data points for 2019 and 2020 for 66 cities across various regions. On average, the standardized quantity of findings of benzoylecgonine, the metabolite that signals the passing of cocaine through the human body, in wastewater dropped by 13 per cent from 2019 to 2020. However, the number of cities witnessing increased benzoylecgonine levels was almost identical to the number of cities experiencing decreases. As data became available for 2021, the trend seems to have returned to its pre-pandemic increasing trajectory. Overall, a 17 per cent increase in average loads was observed in 66 locations with available paired measurements. While 19 locations have recorded a decline and 9 locations a stable situation,^e 38 locations witnessed increases between 2020 and 2021.^f"