That's still triple the number of heroin users, estimated at 435,000 nationwide, but as that drug and other opiates have spread, producing nearly 30,000 overdose deaths annually, the spotlight on cocaine has faded. The drug remains dangerous — 241 ...and more »
About 1,000 recovering addicts came to a convention in Chicago recently to celebrate their sobriety, having survived a highly addictive drug that claims thousands of lives each year and produces untold misery among those caught in its grip.But the drug isn't heroin â€” it's cocaine.
"Heroin is the drug du jour, but crack is still here, cocaine is still here," said Brian T., 57, a Cocaine Anonymous member from Evanston who attended the convention. "It destroys lives. It's a tornado effect that just eats up everybody in its path. Even though it's not in the limelight, it's still here, killing people."Not long ago, cocaine was considered America's No. 1 drug scourge. Cartels smuggled it here by the boatload, street gangs battled over its sale and after politicians surveyed the devastation it caused, they passed harsh sentencing laws that led to a swelling prison population.
Yet for reasons that aren't entirely clear, cocaine use has declined dramatically while heroin use has boomed. There are about 1.5 million cocaine users today, compared with 4 million at its peak in the 1980s, experts say.That's still triple the number of heroin users, estimated at 435,000 nationwide, but as that drug and other opiates have spread, producing nearly 30,000 overdose deaths annually, the spotlight on cocaine has faded.The drug remains dangerous â€” 241 people died from cocaine-related causes last year in Cook County, according to the medical examiner's office â€” and difficult to treat: Though cocaine doesn't cause severe physical dependence, as heroin and other opiate drugs do, cravings for the drug cannot be controlled through pharmaceutical means."We've been looking for medications for a long time, and right now, there is nothing that is proved (effective) for the treatment of cocaine dependence," said Dr. Kyle Kampman, a psychiatry professor at the University of Pennsylvania's Perelman School of Medicine who has researched the subject.
That leaves psychological approaches such as cognitive-behavioral therapy and 12-step programs such as Cocaine Anonymous. The self-help group, formed in California in 1982, has meetings worldwide, following the same tenets of "spiritual awakening" as Alcoholics Anonymous.Some members who came to the Chicago convention lived through cocaine's heyday in the 1970s, when many thought the drug wasn't addictive, as well as the crack plague of the 1980s and 1990s. They vividly recalled the 1986 death of basketball star Len Bias â€” an event some believe led to stiff mandatory sentencing laws passed later that year.But Jim R., 52, of Lemont, said today's 20-somethings have no comprehension of cocaine's hazards."Most of these kids are like, 'We wouldn't do heroin â€” we would die,'" he said. "But the cocaine will show up at their parties. They view it as less dangerous. They don't know anyone who has overdosed from cocaine. They view heroin as a death sentence. They view cocaine as a party drug."The reality, according to Dr. Steven Aks, an emergency room physician at Cook County's Stroger Hospital, is that cocaine can be lethal.Cocaine is a stimulant, he said, and can raise a person's body temperature and create an abnormal heart rhythm, even to the point of rupturing the aorta. It can ultimately cause organ systems to shut down and cast a user into cardiac arrest, he said.The drug has no antidote such as naloxone, a medication that stops a heroin overdose almost instantly. Aks said ER doctors normally try to hydrate and cool the person while using tranquilizers to calm the heartbeat.Such episodes are less common than they used to be, he said, but fatalities still occur regularly."We have to keep all of these things on our radar," he said. "The numbers we've seen (with heroin and other opiates) have been huge, such a rapid rise, but we definitely have to keep focus on cocaine and other stimulants."Cocaine's decline is evident across a range of measurements. According to the Illinois Youth Survey, only 2.7 percent of high school seniors in 2014 had used it, compared with 5 percent a decade earlier. Fewer Chicago arrestees test positive for it, and fewer clients referred to Treatment Alternatives for Safe Communities, an organization that helps people in the criminal justice system get into recovery, list cocaine as their primary drug of choice."What we hear from clients is that cocaine is more expensive than heroin, and that how long they stay high is shorter on cocaine than it is on heroin," said Alicia Osborne, the group's director of operations.Dwindling supply also seems to be playing a role. The U.S. Drug Enforcement Administration says the spraying of herbicide on Colombian coca fields in the mid-2000s helped to cut the amount of cocaine entering the country. So did the cartels' decision to send more cocaine to Europe, which has a growing appetite for the drug.Despite the drop, people with cocaine addictions still regularly seek treatment at rehabilitation centers such as Yellowbrick in Evanston. Dr. David Baron, the center's medical director, said the drug poses unique challenges: While it doesn't produce the excruciating withdrawal symptoms that opiates do, it's often used to mask depression, which must be treated alongside the addiction.Baron said while opiates have eclipsed cocaine in the public eye, people in his line of work still see plenty of damage caused by the drug."A trend doesn't mean a total turnover," he said. "I don't think there's anyone I know who does addiction treatment who would say cocaine is no longer a problem."firstname.lastname@example.orgTwitter @JohnKeilman