The drug isn’t just being used by the usual suspects anymore, experts say.
Australians are increasingly dying from cocaine, as research suggests its popularity is spreading into new demographics.
While the yearly rate of death was relatively stable two decades ago, there was a “marked acceleration” in the last 10 years, according to a study by the National Drug and Alcohol Research Centre.
Starting in 2012, the rates of death due to cocaine began growing 20% each year.
And as cocaine becomes more widely available in Australia, the drug is gaining a “wider footprint” into groups that previously were not using the drug, experts say.
The study in Addiction found there was a significant increase in the proportion of cocaine-related deaths among people with no history of substance abuse or injecting drug use.
Two decades ago, 90% of people who died after taking cocaine had a history of substance abuse problems, but by last year, that proportion had dropped to only half.
Illicit drug researcher and lead author Professor Shane Darke urged doctors not to make assumptions about who was likely to be using cocaine.
“Twenty years ago, it was being soaked up by well-known dependent drug users,” Professor Darke said. “There’s now more of it available, and it’s gone outside those circles.”
Professor Darke and his colleagues analysed coronial data and found that 884 people died after taking cocaine, and 86% of these were male, with a mean age of 33.
Professor Darke said that it wasn’t only young people using the drug either, with one in 10 deaths in people aged over 50, and some even into their 70s.
“And for older males at high risk of heart disease, using a drug that puts pressure on the heart is a recipe for disaster.”
Unintentional drug toxicity caused 70% of deaths, while 18% of deaths involved intentional self-harm or suicide and 12% were traumatic incidents, mainly motor vehicle accidents.
Professor Darke said doctors needed to be aware that cocaine can kill.
He urged GPs to talk to patients when they suspected, or knew, that they were taking cocaine or methamphetamine.
“If you’ve got someone who’s using cocaine, you need to keep an eye on their cardiovascular health.
“We’ve done work in the past and shown that there’s quite staggering levels of heart disease among young recreational users of these drugs. So you’ve got 70-year-old hearts in 30-year-old bodies.”
Professor Darke said that younger cocaine users often presented with chest pains, which may be a trigger to ask about cocaine or methamphetamine use.
It was also important not to assume that a patient in their 50s with heart problems wasn’t a cocaine user, he said. “They might not be, but they just may well be.”
Cocaine, as with methamphetamine, puts pressure on the cardiovascular system and caused progressive cardiovascular damage, including atherosclerosis of the coronary arteries and ventricular hypertrophy.
Heart disease can appear rapidly in cocaine users, he said. “You can get a cardiomyopathy within a couple of years.”
Whether people inject, smoke or snort cocaine, the drug will have the same damaging effect on the heart, he added.
“It doesn’t matter how they use the drug, it will cause heart disease. And that can develop quite rapidly. ”
Professor Darke said one of the reasons for the rise in cocaine use was the perception that it was a safer drug.
While the image of methamphetamine was “pretty dire”, there was a common perception that cocaine was safer, “even though it’s basically, in almost every way, comparable to methamphetamine”, he said.
“There’s a belief that it’s a benign drug.
“Clinically, that image is just wrong. People can die from the use of cocaine, and people do die from the use of cocaine. And they it doesn’t matter how you use it, that is the case.”
The report found that psychoactive drugs were also present in 92% of cases of cocaine-related deaths, while opioids and alcohol were each present in around 50% of cases.
Cocaethylene, a metabolite produced by the body when cocaine and alcohol are ingested and which increases the toxicity of cocaine, was present in 26% of cases.
Levamisole, a parasitic worm treatment, was found in 18% of cases. The drug is commonly used to increase the potency of cocaine, but can induce bradycardia, hypertension and respiratory depression, the authors said. The anaesthetic lignocaine was found in 11% of cases.
