Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-19T05:29:26.392Z Has data issue: false hasContentIssue false

Cocaine: Patterns of Use, Route of Administration, and Severity of Dependence

Published online by Cambridge University Press:  02 January 2018

Michael Gossop*
Affiliation:
National Addiction Centre, Maudsley Hospital, 4 Windsor Walk, London SE5 8AF
Paul Griffiths
Affiliation:
National Addiction Centre, Maudsley Hospital, 4 Windsor Walk, London SE5 8AF
Beverly Powis
Affiliation:
National Addiction Centre, Maudsley Hospital, 4 Windsor Walk, London SE5 8AF
John Strang
Affiliation:
National Addiction Centre, Maudsley Hospital, 4 Windsor Walk, London SE5 8AF
*
Correspondence

Abstract

We contacted and interviewed 150 cocaine users in south London community settings. Most were taking cocaine regularly, but not daily, and in substantial doses. Three main routes of administration were used: smoking (40%), intranasal (32%), and injecting (24%). Injectors reported having used cocaine more frequently, in higher doses and for longer periods of time. Despite their frequent and extensive use of cocaine, the overall level of dependence was low for the great majority of the sample. Two-thirds (66%) of the full sample (and two-thirds (65%) of the crack smokers) reported only minor signs of dependence during the year prior to interview. Route of drug administration was related to severity of dependence. Cocaine taken by injection was associated with the highest levels of dependence; intranasal use was associated with the lowest levels, and crack smoking was intermediate between the two. There had been substantial changes in the initial route by which cocaine was used, with a clear trend away from injection on the first occasion of use. Those who first used cocaine before 1986 were more likely to have used the drug either intranasally or by injection. Cocaine users who first tried the drug after 1987 were increasingly likely to take it by smoking crack. Women and black (predominantly Afro-Caribbean) subjects were more evident in this sample of cocaine users than has previously been reported in many UK studies.

Type
Papers
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bouknight, L. G. & Bouknight, R. R. (1988) Cocaine - a particularly addictive drug. Postgraduate Medicine, 83, 115131.Google Scholar
Closser, M. (1992) Cocaine epidemiology. In Clinician's Guide to Cocaine Addiction (eds Kosten, T. & Kleber, H.). New York: Guilford Press.Google Scholar
Dackis, C. & Gold, M. (1990) Addictiveness of central stimulants. In Addiction Potential of Abused Drugs and Drug Classes (eds Erickson, C., Javors, M. & Morgan, W.). New York: Haworth Press.Google Scholar
Drugs Intelligence Laboratory (1991) Drug Abuse Trends. Aldermaston: Home Office.Google Scholar
Erickson, P. & Alexander, P. (1989) Cocaine and addictive liability. Social Pharmacology, 3, 249270.Google Scholar
Erickson, P., Javors, M. & Morgan, W. (eds) (1990) Addiction Potential of Abused Drugs and Drug Classes. New York: Haworth Press.Google Scholar
Gawin, F. & Kleber, H. (1986) Abstinence symptomatology and psychiatric diagnosis in cocaine abusers. Archives of General Psychiatry, 43, 107113.Google Scholar
Gold, M. (1987) Crack abuse: its implications and outcomes. Medical Times, 115, 2732.Google Scholar
Goldsmith, M. (1988) Sex tied to drugs = STD spread. Journal of the American Medical Association, 260, 2009.Google Scholar
Gossop, M., Griffiths, P. & Strang, J. (1988) Chasing the dragon: characteristics of heroin chasers. British Journal of Addiction, 83, 11591162.Google Scholar
Gossop, M., Griffiths, P., Powis, B., et al (1992) Severity of dependence and route of administration of heroin, cocaine and amphetamines. British Journal of Addiction, 87, 15271536.Google Scholar
Gossop, M., Griffiths, P. & Strang, J. (1994) Sex differences in patterns of drug taking behaviour: a study at a London community drug team. British Journal of Psychiatry, 164, 101104.Google Scholar
Griffiths, P., Gossop, M. & Strang, J. (1993) Chasing the dragon: the development of heroin smoking in the UK. In The British System: Responding to Drug Misuse (eds Strang, J. & Gossop, M.). London: Oxford University Press.Google Scholar
Griffiths, P., Gossop, M., Powis, B., et al (1993) Reaching hidden populations of drug users by Privileged Access Interviewers: methodological and practical issues. Addiction, 88, 16171626.Google Scholar
Home Office (1992) Statistical Bulletin on the Misuse of Drugs (1991). London: HMSO.Google Scholar
ISDD (1991) Drug Abuse Briefing. London: Institute for the Study of Drug Dependence.Google Scholar
Jeri, F. (1984) Coca-paste smoking in some Latin American countries: a severe and unabated form of addiction. Bulletin on Narcotics, 36, 1531.Google Scholar
Jones, R. (1987) Psychopharmacology of cocaine. In Cocaine: A Clinician's Handbook (eds Washton, A. & Gold, M.). New York: Wiley.Google Scholar
Maden, A., Swinton, M. & Gunn, J. (1992) A survey of pre-arrest drug use in sentenced prisoners. British Journal of Addiction, 87, 2733.Google Scholar
Murphy, S., Reinarman, C. & Waldorf, D. (1989) An 11 year follow-up of a network of cocaine users. British Journal of Addiction, 84, 427436.Google Scholar
Strang, J. & Edwards, G. (1989) Cocaine and crack. British Medical Journal, 299, 337338.Google Scholar
Strang, J., Griffiths, P. & Gossop, M. (1990) Crack and cocaine use in south London drug addicts: 1987-1989. British Journal of Addiction, 85, 193196.Google Scholar
Strang, J., Griffiths, P., Powis, B., et al (1992) First use of heroin: changes in route of administration over time. British Medical Journal, 304, 12221223.Google Scholar
Strang, J., Johns, A. & Caan, W. (1993) Cocaine in the U.K. - 1991. British Journal of Psychiatry, 162, 113.Google Scholar
Sutherland, G., Edwards, G., Taylor, C., et al (1988) The measurement of opiate dependence. British Journal of Addiction, 81, 485494.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.