How common is cocaine toxicity in the US?

Updated: Dec 31, 2020
  • Author: Lynn Barkley Burnett, MD, EdD, JD; Chief Editor: Sage W Wiener, MD  more...
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The ancient Incas of Peru believed the coca plant to be a gift from the gods. However, cocaine, derived from coca leaves, is a modern-day curse to the emergency physician. [3] Aside from alcohol (and not including tobacco-related illnesses), cocaine has been the most common cause of drug-related ED visits in the United States, accounting for 505,224 ED visits in 2011, according to the Drug Abuse Warning Network (DAWN). [4] Marijuana or hashish constituted the second leading cause at 455,668 visits. Heroin-related visits accounted for 258,482 visits.

Patients who present to the ED with cocaine toxicity often have also taken other drugs; in fact, the combined use of alcohol and cocaine may be the major cause of drug-related deaths.

Across the spectrum of acute and chronic effects, nearly every organ system can be affected. Trauma is often associated with cocaine use. Even the absence of cocaine, after a cocaine binge, may precipitate an ED visit due to withdrawal symptoms.

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