Cocaine Use on the Rise Again

The National Institute on Drug Abuse (NIDA) reports overdose-related deaths from cocaine is second only to opioids. However, cocaine’s toll on the general public receives little attention. This is largely due to the lack of remedies for the person addicted to the drug. Unlike opioids, there is no naloxone (narcan), a medication designed to rapidly reverse an overdose, or methadone or suboxone, which help people stop using heroin. For those suffering from a cocaine-fueled substance-use disorder, current options include behavioral therapies and experimental, incentive-based, therapy called contingency management.


Cocaine and the American workforce

Cocaine, classified as a Schedule II drug, is a powerfully addictive substance with a high potential for abuse, potentially leading to severe psychological dependence. Cocaine provides users with a stimulating and energetic high with burst of energy followed by significant crashes in energy levels. According to research from NIDA, adults between the ages of 18-25 years old (approximately 1.2 million people) have a higher rate of cocaine use than any other age group. Employers should be concerned because this age range represents a large portion of new-to-the-workforce employees.



According to the Quest Diagnostics Drug Testing Index™ (DTI) the positivity rate in urine testing for cocaine has increased for four straight years in the general U.S. workforce. In the federally mandated, safety-sensitive workforce, cocaine use has increased for two consecutive years. Drug tests indicating cocaine use increased 12% in 2016, reaching a seven-year high in the general U.S. workforce, and 7% among federally mandated, safety-sensitive workers.

DTI statistics reveal the ongoing threat to workplace safety posed by substance abuse. While most drug related dialogue addresses marijuana and opiate issues, cocaine, a substance with well-established dangers, continues its upward trends in use in the workforce.


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Cocaine, derived from the coca plant is native to South America where many people chew the plant’s leaves to reduce pain, thirst, hunger, while giving a boost of energy. By the 1880s, doctors were studying cocaine as a miracle anesthetic for surgeries. It was also being studied for a variety of health conditions including anxiety and pain. By the turn of the 20th century, fatalities were associated with cocaine and an article in The New York Times by Dr. Edward Huntington Williams warned of the drug’s dangers, calling its effects “cocaine-craze insanity.” In 1914, Congress passed the Harrison Narcotics Tax Act which banned the non-medical use of cocaine in the United States. Today, cocaine is classified as a Schedule II controlled drug with a high potential for abuse, which may lead to severe psychological or physical dependence.


After an analysis of more than ten million workplace drug tests, cocaine made headlines in this year’s Quest Diagnostics Drug Testing Index™ (DTI) report because drug test results indicating cocaine use rose 12 percent in 2016. This increase reflects a seven-year high which has led to a trend of consecutive year increases of cocaine use in the workplace – both in federally mandated, safety-sensitive positions like transportation workers as well as general U.S. workers. Overall, cocaine drug use has fluctuated in the U.S. general workforce with its highest levels in 1998 and its lowest levels in 2012 according to the DTI.


Even more troubling is that positive drug tests indicating cocaine use are twice as high when the test was conducted in a post-accident scenario as compared to pre-employment tests.

While a positive test doesn’t necessarily prove drug use caused the accident, it does raise the question as to whether it played a role in the incident.

The most current findings from the National Survey on Drug Use and Health tell us:

  • An estimated 8.2 percent of adults (aged 26 or older), or 17.1 million people, currently use an illicit drug
  • 580,000 young adults (ages 18-25) and 1.2 million adults currently use cocaine
  • Approximately 31,000 adolescents (ages 12-17), 229,000 young adults, and 637,000 adults suffer from a cocaine use disorder, pointing to dependence and recurrent use that affects health and responsibilities at work, home, or school


Visit for the full report and data.


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