TY - JOUR
T1 - Trends in cocaine use, markets and harms in Australia, 2003–2019
AU - Man, Nicola
AU - Chrzanowska, Agata
AU - Price, Olivia
AU - Bruno, Raimondo
AU - Dietze, Paul M.
AU - Sisson, Scott A.
AU - Degenhardt, Louisa
AU - Salom, Caroline
AU - Morris, Leith
AU - Farrell, Michael
AU - Peacock, Amy
N1 - Funding Information:
Thanks to Lauren Moran and Nathan Bonamy of the Australian Bureau of Statistics for their assistance with the Australian Bureau of Statistics Cause of Death Data Collection data. We would also like to acknowledge the Australian Institute of Health and Welfare and jurisdictional data custodians for their provision of data from the National Hospital Morbidity Database and the AODTS NMDS. We would like to thank the Chief Investigators and the broader Drug Trends team, past and present, for their contribution to the EDRS. We would also like to thank the thousands of participants who have shared their experiences and expertise with us over the years. Drug Trends and the National Drug and Alcohol Research Centre is funded by the Australian Government Department of Health under the Drug and Alcohol Program. AP has a National Health and Medical Research Council Investigator Fellowship (#1174630). LD is supported by a National Health and Medical Research Council Senior Principal Research Fellowship (#1135991). LD is supported by National Institute of Health grants National Institute on Drug Abuse (R01DA1104470).
Funding Information:
Thanks to Lauren Moran and Nathan Bonamy of the Australian Bureau of Statistics for their assistance with the Australian Bureau of Statistics Cause of Death Data Collection data. We would also like to acknowledge the Australian Institute of Health and Welfare and jurisdictional data custodians for their provision of data from the National Hospital Morbidity Database and the AODTS NMDS. We would like to thank the Chief Investigators and the broader Drug Trends team, past and present, for their contribution to the EDRS. We would also like to thank the thousands of participants who have shared their experiences and expertise with us over the years. Drug Trends and the National Drug and Alcohol Research Centre is funded by the Australian Government Department of Health under the Drug and Alcohol Program. AP has a National Health and Medical Research Council Investigator Fellowship (#1174630). LD is supported by a National Health and Medical Research Council Senior Principal Research Fellowship (#1135991). LD is supported by National Institute of Health grants National Institute on Drug Abuse (R01DA1104470).
Publisher Copyright:
© 2021 Australasian Professional Society on Alcohol and other Drugs
PY - 2021/9
Y1 - 2021/9
N2 - Introduction: This paper aims to describe cocaine use, markets and harms in Australia from 2003 to 2019. Methods: Outcome indicators comprised prevalence of use from triennial household surveys; patterns of use from annual surveys of sentinel samples who use stimulants; and cocaine-related seizures, arrests, hospitalisations, deaths and treatment episodes. Bayesian autoregressive time-series analyses were conducted to estimate trend over time: Model 1, no change; Model 2, constant rate of change; and Model 3, change over time differing in rate after one change point. Results: Past-year population prevalence of use increased over time. The percentage reporting recent use in sentinel samples increased by 6.1% (95% credible interval [CrI95%] 1.2%,16.9%; Model 3) per year from around 2017 (48%) until the end of the series (2019: 67%). There was a constant annual increase in number of seizures (count ratio: 1.1, CrI95% 1.1,1.2) and arrests (1.2, CrI95% 1.1,1.2), and percentage reporting cocaine as easy to obtain in the sentinel samples (percent increase 1.2%, CrI95% 0.5%,1.8%; Model 2). Cocaine-related hospitalisation rate increased from 5.1 to 15.6 per 100 000 people from around 2011–2012 to 2017–2018: an annual increase of 1.3 per 100 000 people (CrI95% 0.8,1.8; Model 3). While the death rate was low (0.23 cocaine-related deaths per 100 000 people in 2018; Model 2), treatment episodes increased from 3.2 to 5.9 per 100 000 people from around 2016–2017 to 2017–2018: an annual increase of 2.9 per 100 000 people (CrI95% 1.6,3.7; Model 3). Discussion and Conclusions: Cocaine use, availability and harm have increased, concentrated in recent years, and accompanied by increased treatment engagement.
AB - Introduction: This paper aims to describe cocaine use, markets and harms in Australia from 2003 to 2019. Methods: Outcome indicators comprised prevalence of use from triennial household surveys; patterns of use from annual surveys of sentinel samples who use stimulants; and cocaine-related seizures, arrests, hospitalisations, deaths and treatment episodes. Bayesian autoregressive time-series analyses were conducted to estimate trend over time: Model 1, no change; Model 2, constant rate of change; and Model 3, change over time differing in rate after one change point. Results: Past-year population prevalence of use increased over time. The percentage reporting recent use in sentinel samples increased by 6.1% (95% credible interval [CrI95%] 1.2%,16.9%; Model 3) per year from around 2017 (48%) until the end of the series (2019: 67%). There was a constant annual increase in number of seizures (count ratio: 1.1, CrI95% 1.1,1.2) and arrests (1.2, CrI95% 1.1,1.2), and percentage reporting cocaine as easy to obtain in the sentinel samples (percent increase 1.2%, CrI95% 0.5%,1.8%; Model 2). Cocaine-related hospitalisation rate increased from 5.1 to 15.6 per 100 000 people from around 2011–2012 to 2017–2018: an annual increase of 1.3 per 100 000 people (CrI95% 0.8,1.8; Model 3). While the death rate was low (0.23 cocaine-related deaths per 100 000 people in 2018; Model 2), treatment episodes increased from 3.2 to 5.9 per 100 000 people from around 2016–2017 to 2017–2018: an annual increase of 2.9 per 100 000 people (CrI95% 1.6,3.7; Model 3). Discussion and Conclusions: Cocaine use, availability and harm have increased, concentrated in recent years, and accompanied by increased treatment engagement.
KW - cocaine
KW - dependence
KW - epidemiology
KW - injecting drug use
KW - stimulant
UR - http://www.scopus.com/inward/record.url?scp=85101015760&partnerID=8YFLogxK
U2 - 10.1111/dar.13252
DO - 10.1111/dar.13252
M3 - Article
C2 - 33626201
AN - SCOPUS:85101015760
SN - 0959-5236
VL - 40
SP - 946
EP - 956
JO - Drug and Alcohol Review
JF - Drug and Alcohol Review
IS - 6
ER -