The cocaine epidemic: a comprehensive review of use, abuse and dependence.

Surveys from the National Institute on Drug Abuse found that the number of people who had tried cocaine at least once increased from 5.4 million in 1974 to 25 million in 1985. Current use, defined as use in the past 30 days, rose from 1.6 million in 1977 to 6 million in 1985. By 1985, 3 million Americans were dependent on cocaine. The re-emergence of cocaine as an epidemic drug of abuse and dependence is a painful reminder of the cocaine epidemic present in the United States at the turn of the century. This time, however, health care providers are challenged with intricate assessment problems. These are proving problematic in their possible solutions, due to the wide spectrum of consequences, the chronicity of the disease and the necessary lifelong commitment to recovery. This article describes the cocaine epidemic by surveying the effects of its use, abuse and dependence. Because this disorder is multidimensional, the health care provider must examine the physical, psychological, family/social, personal and spiritual domains of health. Viewing cocaine addiction in this way provides an accurate appraisal of cocaine's destructiveness for individuals, the family system and society as a whole.