TY - JOUR
T1 - Decline and Pronounced Regional Disparities in Medical Cocaine Usage in the United States
AU - Armbuster, Youngeun C.
AU - Banas, Brian N.
AU - Feickert, Kristen D.
AU - England, Stephanie E.
AU - Moyer, Erik J.
AU - Christie, Emily L.
AU - Chughtai, Sana
AU - Giuliani, Tanya J.
AU - Halden, Rolf U.
AU - Graham, Jove H.
AU - McCall, Kenneth L.
AU - Piper, Brian J.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: No direct funding was received for this study. Software was provided by the National Institutes of Environmental Health Sciences (T32 ES007060-31A1). BJP is supported by the Health Resources Services Administration (D34HP31025).
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: No direct funding was received for this study. Software was provided by the National Institutes of Environmental Health Sciences (T32 ES007060-31A1). BJP is supported by the Health Resources Services Administration (D34HP31025).
Funding Information:
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: BJP is part of an osteoarthritis research team supported by Pfizer and Eli Lilly. JHG is supported by Pfizer, Eli Lilly, and AstraZeneca. The other authors have no disclosures.
Publisher Copyright:
© The Author(s) 2021.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Cocaine is a stimulant and Schedule II drug used as a local anesthetic and vasoconstrictor. Objective: This descriptive study characterized medical cocaine use in the United States. Methods: Retail drug distribution data from 2002 to 2017 were extracted for each state from the Drug Enforcement Administration, which reports on medical, research, and analytical chemistry use. The percentage of buyers (pharmacies, hospitals, and providers) was obtained. Use per state, corrected for population, was determined. Available cross-sectional data on cocaine use as reported by the Medicare and Medicaid programs for 2013-2017 and electronic medical records were examined. Results: Medical cocaine use decreased by −62.5% from 2002 to 2017. Hospitals accounted for 84.9% and practitioners for 9.9% of cocaine distribution in 2017. The number of pharmacies carrying cocaine dropped by −69.4%. The percentages of hospitals, practitioners, and pharmacies that carried cocaine in 2017 were 38.4%, 2.3%, and 0.3%, respectively. There was a 7-fold difference in 2002 (South Dakota, 76.1 mg/100 persons; Delaware, 10.1 mg/100 persons). Relative to the average state in 2017, those reporting the highest values (Montana, 20.1; North Dakota, 24.1 mg/100 persons) were significantly elevated. Cocaine use within the Medicare and Medicaid programs was negligible. Cocaine use within the Geisinger system was rare from 2002 to 2007 (<4 orders/100 000 patients per year) but increased to 48.7 in 2018. Conclusion and Relevance: If these pharmacoepidemiological patterns continue, licit cocaine may soon become a historical relic. The pharmacology and pharmacotherapeutics education of health care providers may need to be adjusted accordingly.
AB - Background: Cocaine is a stimulant and Schedule II drug used as a local anesthetic and vasoconstrictor. Objective: This descriptive study characterized medical cocaine use in the United States. Methods: Retail drug distribution data from 2002 to 2017 were extracted for each state from the Drug Enforcement Administration, which reports on medical, research, and analytical chemistry use. The percentage of buyers (pharmacies, hospitals, and providers) was obtained. Use per state, corrected for population, was determined. Available cross-sectional data on cocaine use as reported by the Medicare and Medicaid programs for 2013-2017 and electronic medical records were examined. Results: Medical cocaine use decreased by −62.5% from 2002 to 2017. Hospitals accounted for 84.9% and practitioners for 9.9% of cocaine distribution in 2017. The number of pharmacies carrying cocaine dropped by −69.4%. The percentages of hospitals, practitioners, and pharmacies that carried cocaine in 2017 were 38.4%, 2.3%, and 0.3%, respectively. There was a 7-fold difference in 2002 (South Dakota, 76.1 mg/100 persons; Delaware, 10.1 mg/100 persons). Relative to the average state in 2017, those reporting the highest values (Montana, 20.1; North Dakota, 24.1 mg/100 persons) were significantly elevated. Cocaine use within the Medicare and Medicaid programs was negligible. Cocaine use within the Geisinger system was rare from 2002 to 2007 (<4 orders/100 000 patients per year) but increased to 48.7 in 2018. Conclusion and Relevance: If these pharmacoepidemiological patterns continue, licit cocaine may soon become a historical relic. The pharmacology and pharmacotherapeutics education of health care providers may need to be adjusted accordingly.
KW - anesthesiology
KW - cocaine
KW - controlled substances
KW - surgery
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U2 - 10.1177/87551225211035563
DO - 10.1177/87551225211035563
M3 - Article
AN - SCOPUS:85111915755
VL - 37
SP - 278
EP - 285
JO - Journal of Pharmacy Technology
JF - Journal of Pharmacy Technology
SN - 8755-1225
IS - 6
ER -