New patterns of cocaine use: changing doses and routes.

The history of coca and cocaine use is reviewed in terms of medical and nonmedical patterns of use. Use of coca leaves and coca extract products involved daily use of no more than 200 mg to 500 mg of cocaine. When cocaine became available after 1860, daily doses increased to as much as 1,620 mg and the oral route of administration became supplemented by intranasal, injection, topical, and smoking administration. Contemporary patterns of use between 1970 and 1978 involved social-recreational intranasal doses of 1 to 4 grams per month. From 1978 to 1982, doses increased to 1 to 3 grams per week with increased use of smoking cocaine freebase. Between 1982 and 1984, episodes of concentrated binding became more common, as did the development of experimental practices including intranasal cocaine freebase and the smoking of coca paste. These patterns are discussed in terms of several variables, including purity, dosages, dose regimes, routes of administration, paraphernalia, and changing perceptions of cocaine.