Mark Gold, M.D., an international authority on addiction medicine, and chairman of the University of Florida College of Medicine's department of psychiatry. (Photo by Sarah Kiewel/University of Florida)
Like some drug de jÃ vue, cocaine use is once again on the rise among students and the rich and famous, a trend University of Florida researchers say likely signals a recurring epidemic of abuse.
Once known as the champagne of drugs, cocaine killed "Saturday Night Live" comedian John Belushi and basketball star Len Bias in the 1980s before use declined in the 1990s.
Now new data from UF and the Florida Department of Law Enforcement show that since 2000 cocaine has increasingly been cited as the cause of death in coroner's reports, and that the number of cocaine deaths per hundred-thousand people in the state has nearly doubled in the past five years, from 6.31 in 2000 to nearly 11.4 in 2005. The steepest per capita rise in death rates was in college towns and wealthy, upper-class seaside communities, such as Melbourne, West Palm Beach and the Florida Keys.
What's happening in Florida is likely occurring coast to coast, says Mark Gold, M.D., a distinguished professor of psychiatry, neuroscience, anesthesiology and community health and family medicine at UF's College of Medicine. Gold and colleagues analyzed FDLE data gathered in Florida and presented their findings Oct. 15 at the Society for Neuroscience's annual meeting in Atlanta.
"Our data is closest to real time to any data available in the United States," Gold said. "With death reports, there is no fudge factor. The other states will show the same thing: That we are in the early stages of a new cocaine epidemic that is being led by the rich and famous and students with large amounts of disposable income and that is responsible for more emergency room visits and more cocaine-related deaths than we have seen at any time since the last cocaine epidemic."
Prescription drugs, often abused for the immediate rush of euphoria they trigger, can cause sudden respiratory or cardiac arrest. In contrast, cocaine's cumulative effects - including blood vessel damage that increases the risk of heart attack or stroke over time - can unexpectedly kill years after abuse begins, Gold said.
"Cocaine gives them a feeling of incredible mastery, that they are immune to the laws of nature," said Gold, who is affiliated with UF's McKnight Brain Institute. "But it causes consequences. You can't say you are out of the risk window simply by surviving the use event. Death can come some time in the future." Cocaine temporarily induces a high but depletes the feel-good neurotransmitter dopamine, which in turn triggers a craving for more of the drug. It is this "drive for the drug," he said, that makes it more likely for someone who has used cocaine once to use it a second time.
Gold and his colleagues, including Bruce Goldberger, Ph.D., a professor of pathology, immunology and laboratory medicine at UF's College of Medicine, said models, artists and other celebrities addicted to cocaine have "advertised" the drug, enticing students and others with disposable income, who are now among the most frequent users.
UF experts said the recent spike in deaths should serve as a wake-up call, prompting more drug education in schools and communities nationwide. Gold said such interventions are necessary to avoid another full-fledged cocaine epidemic.
"Hopefully, with warning and prevention we can help users realize that this is a chronic problem without a cure and their longevity is at question," he said.