Memorandum submitted Independent Drug
Monitoring Unit (IDMU Ltd)
1. BACKGROUND
TO IDMU SURVEYS
1.1 The Independent Drug Monitoring Unit
(IDMU Ltd) is a small independent research consultancy specialising
in the study of drug consumption patterns and drug markets in
the UK, as well as monitoring changes of attitudes towards drugs
and other aspects of drug-related behaviours. We are funded predominantly
via our legal casework as expert witnesses in the Criminal Courts,
in most cases instructed by defence solicitors but also on occasion,
giving evidence for the Crown. In addition we have been commissioned
by organisations such as GW Pharmaceuticals, the BBC and the Advisory
Council on the Misuse of Drugs to conduct research and/or reanalyse
existing data for specific projects.
1.2 Our original research consists of anonymous
surveys targeted at drug users recruited primarily at pop festivals
and other outdoor events (eg pro-cannabis rallies), these occurred
in 1984, 1994 and each year since 1997, since 2004 this has been
supplemented with an online user-completed survey, to provide
a total database of over 20,000 drug users.
1.3 The survey carries a number of core questions
on usage of specific drugs, as well as allowing write-in options,
other questions (eg re driving, drug education, health problems/benefits,
political affiliations etc) have appeared in one or more surveys.
1.4 For this paper, data from surveys between
1997 and 2008 have been consolidated into a single data file and
analysed to monitor long term trends, with specific emphasis on
changes in the demographics of cocaine users, and differences
in usage and attitudes between different socioeconomic groups.
2. COCAINE AND
CRACK
2.1 General comments on cocaine
2.1.1 Cocaine is a white crystalline powder
extracted from the leaves of the plant—Erythroxylon coca—with
organic solvents from which the solid is precipitated, normally
in the hydrochloride form. Typical cocaine hydrochloride purities
in the UK were, until recently 40-60% for cocaine powder, and
80-100% in freebase, or "crack". Cocaine freebase use
has been described since the 1970s, although the term "crack"
and wider public perception of the phenomenon arose during the
late 1980s. The hydrochloride powder is commonly snorted into
the nostrils through a tube, frequently a rolled-up banknote,
where it is absorbed by the nasal mucosa. Less commonly, it may
be injected.
2.1.2 Cocaine is a stimulant drug with effects
similar to amphetamine, but which are generally of shorter duration.
Cocaine stimulates the release of noradrenalin from synaptic terminals,
and inhibits the reuptake of noradrenalin, dopamine and serotonin,
thus prolonging the effects of these neurotransmitters. It has
been described as "the most powerful reinforcing drug known".1
The prevalence of cocaine use in the UK has never
escalated to US levels, quite probably due to the availability
of cheap amphetamine powders, which produce similar effects lasting
several hours.
2.1.3 While the general view is that physical
dependence is not normally found, there can be a powerful psychological
dependence such that a heavy user will fall from a euphoric state
to a severe depression within a relatively short time. Repeating
the dose can stave off the depression. There is evidence that
tolerance develops to the desired effects, such that an increased
dose is required to produce the same psychological effect. This,
combined with the depression caused by abstinence, can lead the
user to consume ever larger amounts, leading the a substantial
risk of overdose and cardiac failure2, 3, 4, or to a paranoid
psychotic state, mimicking some forms of schizophrenia, if the
user has been on an excessive cocaine "binge" for several
days.5
2.1.4 There are few quantitative or statistical
studies specifically investigating the amounts of cocaine used
by individuals. Most studies are of small samples of users, many
of whom have already sought counselling or treatment for their
dependency. Larger scale UK studies of the general population
or of poly-drug users6, 7, 8, 9, 10, 11, 12, 13, 14 have shown
that although daily use is not the norm, and occasional or recreational
use is common, the heaviest use tends to occur in binges lasting
up to several days, followed by a period of abstinence and recuperation.
A heavy user who indulges in a binge every weekend could consume
a prodigious amount.
2.2 "Crack" cocaine
2.2.1 Cocaine in freebase form, commonly
known as "crack", is prepared specifically for smoking,
as the free base form melts at a lower temperature than the base
cocaine hydrochloride. As it forms a crystalline structure the
purity remains fairly constant at around 88%, compared to 40-60%
for cocaine hydrochloride powder. Cocaine use in this form has
been described since the 1970s, although the term "crack"
and wider public perception of the phenomenon arose during the
late 1980s.
2.2.2 When smoked, the cocaine vapourises and
may be inhaled by the user, either in the form of a cigarette,
pipe, or by inhaling fumes from a heated rock by a similar method
to that of heroin users who "chase the dragon". I have
witnessed cocaine users (in Berlin during 1983) smoking cannabis
and freebase cocaine as a "cocktail" in a rolled cigarette,
a practice which has also been reported by Arif,15 Bean,16 Negrette17
and Siegel.18 Smoking cocaine in cannabis cigarettes is not an
efficient method of delivery. Much cocaine is wasted by this method,
as it may be oxidised (burned), lost in the side smoke of a cigarette,
or may condense out on to the cooler surfaces of a cardboard filter
or a pipe. Siegel indicates that only 5% of available freebase
(crack) cocaine is normally obtained from smoke in tobacco-based
cigarettes or in pipe, although techniques may improve this yield.
This effectively means more cocaine has to be smoked to deliver
the same "high" as snorting or intravenous use.
2.2.3 There is some debate as to whether
crack cocaine produces a physical addiction. Stutman19 the Drug
Enforcement administration official who first warned the UK about
the dangers of crack cocaine, stated that 75% of people who tried
it three times become addicted. Few experts would now support
that view.
2.2.4 As the effects of crack cocaine are
so transitory, usually lasting approximately 10 minutes, the temptation
to repeat the dose on a regular basis can be great. A common pattern
of use is the binge, where the user maintains the stimulation
over a period of 24-48 hours, or longer in some cases, followed
by exhaustion and a prolonged sleep. During a binge, all the available
stimulant can be used in a single session.
2.3 Literature Review—Cocaine and Crack
Usage
2.3.1 Note that this review is now dated,
there is insufficient time available to produce an updated review
at the present time.
2.3.2 The Institute for the Study of Drug Dependence
(now Drugscope), in their audit of Drug Misuse in 199220 stated
the following in respect of cocaine and crack:
"The typical weekend (cocaine) users
might sniff 1/4 gram over a weekend, heavy users might consume
one or two grams a day."
"Crack ... is available in major cities
at around £25 a rock weighing 150mg and 88% pure."
"Users can get through several grams
at a stretch."
"... doses may have to be repeated as
often as every 20 minutes."
2.3.3 In a study of individual crack users
in Nottingham,21 respondents describe the compulsive nature of
crack use:
"if the rock is there I can't leave it",
and the frequently solitary nature of use
"I take crack alone now, I prefer it
because I know there's not going to be any hassle. I want more
and I don't want to share".
Several respondents described episodes of heavy
crack use, spending £300 to £1,000 per week, commonly
£400 to £600. Nottingham had a thriving crack market
by 1991-92, priced at £30 to £25 per rock. Generally
imported in hydrochloride form and converted to crack locally.
2.3.4 A 1989 study of crack use in Liverpool22
reports daily crack users taking an average of 11 "hits"
per day (range 1-30), spending an average £118 per day (range
£30 to £300). A report of the Scottish Cocaine Research
Group23 contains little quantitative data, although it is a relatively
large sample. The most extreme category of use referred to more
than 100mg/day, which was reported by 49% of users during "heaviest
period". As 100mg is less than one rock of crack cocaine,
the study is of little value in assessing the consumption of heavy
users.
2.3.5 A national study24 involving anonymous
questionnaires completed by 412 cocaine and crack users compared
the results from respondents recruited from community drugs teams
and voluntary agencies with users recruited by researchers in
the wider community. When those who had used cocaine "in
the last four weeks" were asked to estimate their consumption
on an "average day" researchers found that 57% of agency
clients and 31% of the community sample reported using over one
gram per day.
2.3.6 A survey based on interviews with
150 cocaine users not in contact with law enforcement or treatment,25
found that the overall average amount consumed was 1.2g per day.
The 60 crack smokers studied (40%) averaged 1.01g per day. Only
3% of injectors of cocaine were black, compared to 16% of snorters
and 23% of smokers of the drug. 41% of the cocaine smokers were
in employment, compared to 63% of snorters and 22% of injectors.
In a personal Communication, Dr John Marks, consultant psychiatrist
and former director of the Widnes drug dependency clinic, stated
that crack cocaine users who were referred to the clinic for maintenance
prescriptions were prescribed from 200mg to 1000mg (1g) per day
free base cocaine.
3. IDMU SURVEYS—COCAINE
AND CRACK
USAGE
3.1 Initiation to Cocaine/Crack
3.1.1 Only 10% of adults using cocaine or
crack started using the drugs before age 16, the peak ages of
initiation fall in young adulthood—between 16 and 27 for
cocaine and between 16 and 32 years for crack cocaine.
AGE OF INITIATION TO COCAINE/CRACK
|
| Percentile | Cocaine
| Crack |
|
| 1% | 13
| 12 |
| 5% | 15 |
15 |
| 10% | 16 |
16 |
| 25% | 18 |
18 |
| 50% | 20 |
21 |
| 75% | 22 |
25 |
| 90% | 27 |
32 |
| 95% | 30 |
35 |
| 99% | 37 |
44 |
|
3.1.2 Use of cocaine or crack by secondary-age schoolchildren
is unusual. The median age of initiation for cocaine use is 20
years, with only 10% starting at age 16 or under.
3.2 Lifetime Prevalence
3.2.1 Overall, 35% of survey respondents had used cocaine
at least once, and 8% had used crack at some point in their lives,
although the proportions of respondents admitting having ever
used cocaine fell from 60% in 1998 to 20% in 2005. Dividing the
surveys into three periods, 1997-99, 2000-03 and 2004-08 the overall
proportion of resp6ondents reporting lifetime use of cocaine has
fallen from 50% to just over 25%, similarly the proportion reporting
lifetime crack use has fallen from 9% to 4% over the same period.
USAGE OF COCAINE BY YEAR—1997-2008
|
| Year | Base
| Ever Used Cocaine?
| Ever Used Crack?
|
| n |
Total | %
| Total | %
|
|
| 1997 | 1,136
| 507 | 44.6
| 89 | 7.8
|
| 1998 | 1,153
| 693 | 60.1
| 128 | 11.1
|
| 1999 | 2,173
| 1,032 | 47.5
| 202 | 9.3
|
| 2000 | 2,352
| 938 | 39.9
| 175 | 7.4
|
| 2001 | 681 |
286 | 42.0
| 86 | 12.6
|
| 2002 | 2,825
| 1,176 | 41.6
| 223 | 7.9
|
| 2003 | 2,910
| 919 | 31.6
| 158 | 5.4
|
| 2004 | 2,960
| 912 | 30.8
| 152 | 5.1
|
| 2005 | 2,713
| 551 | 20.3
| 78 | 2.9
|
| 2006 | 3,004
| 657 | 21.9
| 115 | 3.8
|
| 2007 | 507 |
187 | 36.9
| 32 | 6.3
|
| 2008 | 328 |
124 | 37.8
| 21 | 6.4
|
| Total | 22,742
| 7,982 | 35.1
| 1,459 | 6.4
|
| 1997-99 | 4,462
| 2,232 | 50.0
| 419 | 9.4
|
| 2000-03 | 8,768
| 3,319 | 37.9
| 642 | 7.3
|
| 2004-08 | 9,512
| 2,431 | 25.6
| 398 | 4.2
|
|
3.2.2 The vast majority of crack users also used powder
cocaine, only 7% of crack users had never used cocaine powder,
but 82% of powder users had never tried crack.
USAGE OF COCAINE AND CRACK
|
| n
| % of total | % of Either
|
|
| Neither Drug | 14,658
| 64.45% | n/a
|
| Cocaine Only | 6,641
| 29.20 | 82.15
|
| Crack Only | 105
| 0.46 | 1.30
|
| Cocaine + Crack | 1,338
| 5.88 | 16.55
|
| Total Either Drug | 8,084
| 35.55 | 100.00
|
|
3.3 Frequency of Use
3.3.1 The results show that 48% of respondents who have
tried cocaine, but only 20% of those who have tried crack, use
the drug on a continuing basis.
3.3.2 The vast majority of users of cocaine do so on an experimental
or occasional basis, 38% of cocaine users and 60% of crack users
had not progressed beyond experimental use (less than 10 occasions),
however one in five cocaine users and 11% of crack users took
the drug on a regular basis.
3.3.3 Daily use of both drugs was rare, only 2.4% of cocaine
users and 3.2% of crack users claimed to use the drugs on a daily
basis. The most common pattern among regular users is weekend
or unspecified binge use.
Table 1
FREQUENCIES OF USE 1997-2008
|
| Cocaine
| Crack |
| Frequency | n
| % total | % users
| n | % total
| % users |
|
| Experimental | 3,000
| 13.2 | 38.3
| 1,136 | 5.0
| 60.5 |
| Occasional | 2,113
| 9.3 | 26.9
| 176 | 0.8
| 9.4 |
| Regular* | 1,656
| 7.3 | 21.1
| 201 | 0.9
| 10.7 |
| Daily | 187 |
0.8 | 2.4
| 60 | 0.3
| 3.2 |
| Ex-Users | 1,072
| 4.7 | 13.7
| 365 | 1.6
| 19.4 |
| Never Used | 14,888
| 65.5 | n/a
| 20,852 | 91.7
| n/a |
| Total Ever Used | 7,841
| 34.5 | 100.0
| 1,878 | 8.3
| 100.0 |
| Base | 22,730
| 100.0 | n/a
| 22,730 | 100.0 | n/a
|
|
| * "Regular" includes daily users.
|
3.3.4 Market Saturation—When non-users were
asked whether they might try the drug or would never consider
using it, approximately 18% of non-users of cocaine, and 6% of
non-crack users who expressed a preference stated they would try
the drug if offered. Deeming market saturation to be current users
as a percentage of current users plus those who might use in the
future, the cocaine market is 94% saturated and the crack market
82% saturated.
3.4 Amounts Used
3.4.1 Since 2001 the IDMU surveys have asked respondents
how much cocaine and/or crack they use per week, along with monthly
spending on cocaine and average prices for grams and ounces. When
usage reports are ranked in order of lowest to highest, the amount
used at different percentiles of usage can be determined (Table
2). The spending can be converted into quantities by dividing
by the average gram and ounce prices in the relevant year (Use
equiv figures). The results suggest that respondents underestimate
spending relative to weekly use, but that the heaviest users (7g
per week or more) are more likely to buy in bulk.
Table 2
COCAINE USAGE PERCENTILES (1997-2008)
|
| Cocaine
| Crack |
| Percentile | Monthly Spend
| Use Equiv | Weekly Use
| Monthly Spend | Use Equiv
| Weekly Use |
|
| 10% | £10
| 0.283g | 0.25g
| £10 | 0.130g
| 1g |
| 25% | £20
| 0.667g | 0.5g
| £20 | 0.286g
| 1g |
| 50% | £50
| 1.53g | 1.0g
| £50 | 0.726g
| 3g |
| 75% | £100
| 2.76g | 2.0g
| £200 | 2.60g
| 6g |
| 90% | £200
| 5.67g | 5.0g
| £600 | 9.72g
| 20g |
| 95% | £300
| 9.24g | 10.0g
| £1,200 | 15.0g
| 28g |
| 99% | £1,000
| 32.1g | 30g
| £4,000 | 44.5g
| 30g |
| 99.5% | £2,000
| 48.1g | 47g
| £8,000 | 114.6g
| 60g |
| Base | 1,462
| 1,462 | 692
| 137 | 137
| 81 |
|
3.4.2 The results show 95% of users consuming an average
of one gram or less per day. In most cases the weekly usage would
all take place at the weekend—thus a user bingeing on 1/4oz
at the weekend would average one gram per day if taken over the
whole week. The heaviest users of cocaine would consume on average
between 4 and 7 grams per day, the heaviest users of crack would
consume an average of 4-9g per day.
3.4.3 Defendants in Custody—Police officers
frequently claim that persons arrested in possession of significant
quantities of drugs will exaggerate their level of use in order
to claim the drug was possessed for personal use rather than for
dealing. A trawl of IDMU cases up to November 2008 found that
those defendants who admitted levels of cocaine use in custody
virtually all reported usage within the top 25% of survey-derived
levels with 10% reporting what must be considered as excessive
usage levels. For crack this effect was less marked, however these
were both small samples. By comparison, for cannabis 50% of defendants
reported usage within the top 5-10% of survey responses.
REPORTED DAILY USE BY DEFENDANTS IN CUSTODY vs SURVEY
USAGE LEVELS
|
| Usage | Defendants in Custody
| Survey (weekly use)
|
| Percentile | Cocaine
| Crack | Cocaine
| Crack |
|
| Median | 2.0g
| 0.9g | 0.143g
| 0.429g |
| 75% | 3.5g
| 1.0g | 0.286g
| 0.857g |
| 90% | 7.0g
| 3.5g | 0.714g
| 2.86g |
| 95% | 9.0g
| 4.0g | 1.43g
| 4.00g |
| 99% | 28.0g
| 4.0g | 4.28g
| 4.29g |
| Mean | 3.21g
| 1.54g | 0.393g
| 0.859g |
| Base | 28 |
10 | 692
| 81 |
|
3.5 Use of other Drugs by Cocaine Users
3.5.1 Amphetamines—The use of cocaine should
not be viewed in isolation, rather it often occurs within a pattern
of wider use of stimulants. Just over three in five stimulant
users would use either or both amphetamine and cocaine when available,
only one in six stimulant users would use cocaine and/or crack
exclusively.
COCAINE AND AMPHETAMINE—LIFETIME USE
|
| Drug | n
| % of either |
|
| Only Cocaine | 1,703
| 16.5 |
| Only Amphetamines | 2,232
| 21.6 |
| Both Drugs | 6,381
| 61.9 |
| Total | 10,316
| 100.0 |
|
3.5.2 Crack & Heroin—The proportion of heroin
and crack users who combine the drugs is around 40% of their respective
user-bases. However whilst crack use among heroin users has remained
stable, use of heroin by crack users has declined from 56% in
the late 1990s to 34% over the past five years, with the proportion
of "crack only" users rising from 23% to 44%, and heroin-only
use declining from 49% to 34% over the same period. This suggests
an increase in crack usage relative to heroin.
LIFETIME PREVALENCE—CRACK & HEROIN
|
| Year | 1997-99
| 2000-03
| 2004-08
| Overall
|
| Drug(s) | n
| % Either | n
| % Either | n
| % Either | n
| % Either |
|
| Crack + Heroin | 225
| 28.6 | 282
| 26.8 | 161
| 22.1 | 667
| 26.0 |
| Crack Only | 179
| 22.7 | 355
| 33.9 | 318
| 43.8 | 852
| 33.3 |
| Heroin Only | 384
| 48.7 | 412
| 39.3 | 248
| 34.1 | 1,043
| 40.7 |
| Either | 788
| 100 | 1,049
| 100 | 726
| 100 | 2,562
| 100.0 |
| % Her use Crack | 37.0
| 40.6 | 39.3
| 39.0 |
| % Crack use Her | 55.7
| 44.2 | 33.5
| 43.9 |
|
4. ATTITUDES TO
COCAINE
4.1 User-Ratings
4.1.1 Survey respondents have been asked to rate different
drugs using marks out of 10, with 10 being the best ever and 0
the worst imaginable, taking everything into account.
4.1.2 We have found that user-ratings to be a valuable
predictor of intention to use, with the lowest ratings given by
those who would never consider using a particular drug, and the
highest by regular (but not necessarily daily) users.
USER RATINGS BY FREQUENCY OF COCAINE USE
|
| Frequency | Cocaine Rating
| Cocaine Spending
| Crack Rating
|
| Of Use | n
| Rating | n
| Spending | n
| Rating |
|
| Experimental | 2,062
| 5.73 | 345
| £16.77 | 750
| 1.72 |
| Occasional | 1,549
| 6.75 | 488
| £39.13 | 632
| 2.80 |
| Regular | 1,149
| 7.53 | 769
| £138.31 | 453
| 4.00 |
| Daily | 102 |
7.30 | 74
| £562.03 | 44
| 4.38 |
| Ex-Users | 646
| 4.35 | 76
| £158.09 | 355
| 1.62 |
| Never/Blank | 1,903
| 3.38 | 134
| £83.85 | 1,638
| 1.50 |
| Total | 7,309
| 5.49 | 1,812
| £85.26 | 3,828
| 2.06 |
| Total Ever | 5,406
| 6.24 | 1,678
| £85.37 |
2,190 | 2.49
|
|
4.1.3 Year on year ratings are influenced by a number
of external factors such as the nature of the sample population
(some festivals are more attractive to drug users than others),
and due to technical problems with the online survey ratings were
not collected for respondents who had never used the drug in question.
USER-RATINGS BY YEAR AND LIFETIME USE
|
| Year | Non-User
| User |
Total |
| n |
Rating | n
| Rating | n |
Rating |
|
| COCAINE |
| 1997 | 93 |
3.18 | 331
| 6.89 | 424
| 6.07 |
| 1998 | 102 |
3.01 | 551
| 6.20 | 653
| 5.70 |
| 1999 | 118 |
2.79 | 711
| 6.73 | 829
| 6.17 |
| 2000 | 109 |
2.91 | 563
| 6.10 | 672
| 5.58 |
| 2001 | 108 |
2.03 | 275
| 6.23 | 383
| 5.04 |
| 2002 | 647 |
2.33 | 1,114
| 5.50 | 1,761
| 4.34 |
| 2003 | 57 |
3.95 | 450
| 6.28 | 507
| 6.02 |
| 2004 | 46 |
4.22 | 440
| 6.15 | 486
| 5.96 |
| 2005 | 111 |
5.97 | 432
| 6.73 | 543
| 6.81 |
| 2006 | 325 |
3.04 | 429
| 6.83 | 754
| 5.20 |
| 2007 | 7 |
3.71 | 171
| 6.50 | 178
| 6.39 |
| 2008 | 5 |
4.60 | 116
| 6.31 | 121
| 6.24 |
| Total | 1,728
| 3.02 | 5,583
| 6.26 | 7,311
| 5.5 |
| 1997-99 | 313
| 2.98 | 1,593
| 6.58 | 1,906
| 5.99 |
| 2000-03 | 921
| 2.46 | 2,402
| 5.87 | 3,323
| 4.93 |
| 2004-08 | 494
| 3.83 | 1,588
| 6.54 | 2,082
| 5.96 |
| |
| | | |
| |
| CRACK COCAINE |
| 1997 | 160 |
1.61 | 52
| 5.81 | 212
| 2.64 |
| 1998 | 250 |
0.87 | 92
| 4.39 | 342
| 1.82 |
| 1999 | 248 |
1.15 | 125
| 5.26 | 373
| 2.53 |
| 2000 | 239 |
1.37 | 94
| 4.57 | 333
| 2.27 |
| 2001 | 223 |
0.98 | 83
| 4.94 | 306
| 2.05 |
| 2002 | 1,247
| 0.93 | 204
| 4.15 | 1,451
| 1.39 |
| 2003 | 68 |
1.16 | 72
| 5.08 | 140
| 3.18 |
| 2004 | 55 |
0.93 | 78
| 5.01 | 133
| 3.32 |
| 2005 | 32 |
3.12 | 60
| 6.25 | 92
| 5.16 |
| 2006 | 309 |
0.84 | 75
| 6.17 | 384
| 1.88 |
| 2007 | 10 |
1.40 | 29
| 6.72 | 39
| 5.36 |
| 2008 | 11 |
0.91 | 14
| 5.57 | 25
| 3.52 |
| Total | 2,852
| 1.05 | 978
| 5.03 | 3,830
| 2.06 |
| 1997-99 | 658
| 1.16 | 269
| 5.07 | 927
| 2.29 |
| 2000-03 | 1,777
| 1.00 | 453
| 4.53 | 2,230
| 1.72 |
| 2004-08 | 417
| 1.04 | 256
| 5.86 | 673
| 2.88 |
|
4.1.4 Cocaine powder has a relatively even number of users
giving different ratings, with a tendency for either generally
positive or highly negative user-ratings. The vast majority of
users give a highly negative rating to crack cocaine.
5. DEMOGRAPHIC FACTORS
5.1 Gender Differences
5.1.1 A slightly higher proportion of male respondents
had used cocaine and/or crack compared to female respondents,
however the patterns of cocaine and crack use were fairly similar
between the sexes. Of males, 37.2% had used powder cocaine compared
to 33.2% of females, the figures for crack were 7.2% of males
and 4.9% of females.
LIFETIME PREVALENCE BY SEX
|
| Ever Used? | Male
| Female | Not Stated
| Total |
|
| Neither | 7,684
| 5,543 | 1,420
| 14,647 |
| Cocaine Only | 3,743
| 2,392 | 505
| 6,640 |
| Crack Only | 61
| 33 | 11
| 105 |
| Cocaine + Crack | 836
| 378 | 124
| 1,338 |
| Either/both | 4,640
| 2,803 | 640
| 8,083 |
| Totals | 12,324
| 8,346 | 2,060
| 22,730 |
| Neither | 62.3%
| 66.4% | 68.9%
| 64.4% |
| Cocaine Only | 30.4%
| 28.7% | 24.5%
| 29.2% |
| Crack Only | 0.5%
| 0.4% | 0.5%
| 0.5% |
| Cocaine + Crack | 6.8%
| 4.5% | 6.0%
| 5.9% |
| Either/both | 37.7%
| 33.6% | 31.1%
| 35.6% |
|
5.1.2 Both sexes gave similar ratings of cocaine and
crack if they had used the drug, however female non-users gave
significantly lower ratings than males to both forms of the drug.
USER RATINGS OF COCAINE & CRACK BY SEX & LIFETIME
USE
|
| User Status | Male
| Female |
Not Stated |
Total |
| n |
Rating | n
| Rating | n
| Rating | n
| Rating |
|
| Used Cocaine | 3,329
| 6.25 | 1,873
| 6.25 | 380
| 6.39 | 5,582
| 6.26 |
| Non-User | 904
| 3.36 | 691
| 2.54 | 133
| 3.26 | 1,728
| 3.02 |
| Total | 4,233
| 5.63 | 2,564
| 5.25 | 513
| 5.59 | 7,310
| 5.5 |
| Used Crack | 624
| 4.98 | 279
| 4.93 | 75
| 5.84 | 978
| 5.03 |
| Non-User | 1,553
| 1.11 | 1,111
| 0.89 | 187
| 1.47 | 2,851
| 1.05 |
| Total | 2,177
| 2.22 | 1,390
| 1.7 | 262
| 2.72 | 3,829
| 2.06 |
|
5.2 Socioeconomic Status
5.2.1 The socioeconomic status of respondents was coded
according to their stated occupation, those in employment were
coded AB, C or DE, with separate categories for students, the
unemployed (includes sick/disabled, retired and self-confessed
drug dealers), and those who gave no details as to occupation.
5.2.2 Lifetime Prevalence—Lifetime use of both
cocaine and crack was highest amongst the unemployed and lowest
among students. There were only minor differences in prevalence
of cocaine between different SE groups in employment, however
professional and managerial classes had slightly lower levels
of lifetime use than clerical or manual workers. For crack, use
amongst employed persons was highest among manual workers.
LIFETIME PREVALENCE OF COCAINE/CRACK USE BY SE STATUS
|
| SE Status | Total
| Cocaine
| Crack |
| | n
| % | n
| % |
|
| AB | 3,924 |
1,498 | 38.2
| 220 | 5.6
|
| C | 6,892 |
2,707 | 39.3
| 483 | 7.0
|
| DE | 2,739 |
1,084 | 39.6
| 243 | 8.9
|
| Students | 5,466
| 1,430 | 26.2
| 178 | 3.3
|
| Unemployed | 1,142
| 508 | 44.5
| 149 | 13.0
|
| Unknown | 1,645
| 516 | 31.4
| 131 | 8.0
|
| Total | 21,808
| 7,743 | 35.5
| 1,404 | 6.4
|
|
5.2.3 User-Ratings—There were negligible
differences between employment groups in the overall rating of
cocaine, however again the unemployed gave the highest ratings
and students the lowest. For crack there were more dramatic differences
in crack ratings, with manual workers and the unemployed giving
higher ratings and AB groups and Students giving the lowest ratings.
USER-RATINGS OF COCAINE/CRACK BY SE STATUS
|
| SE Status | Cocaine
| Crack |
| n
| Rating | n
| Rating |
|
| AB | 1,269
| 5.55 | 581
| 1.82 |
| C | 2,460 |
5.58 | 1,351
| 1.96 |
| DE | 952 |
5.56 | 484
| 2.43 |
| Students | 1,523
| 5.38 | 757
| 1.80 |
| Unemployed | 430
| 5.77 | 246
| 2.84 |
| Unknown | 545
| 4.98 | 373
| 2.14 |
| Total | 7,179
| | 3,792
| |
|
5.3 Annual Income
5.3.1 Respondents were asked how much and how often they were
paid, allowing annual income to be calculated. Annual incomes
were divided into low (under £15k), middle (£15-£35k)
and high (>£35k) income groups.
5.3.2 Lifetime Prevalence—Lifetime use of cocaine
was highest among middle and low income groups, and significantly
lower among the highest earners. Use of crack was highest amongst
those with the lowest incomes and lowest among high earners.
LIFETIME COCAINE/CRACK USE BY INCOME
|
| Income | Total
| Cocaine
| Crack |
| Group | | n
| % | n
| % |
|
| Unknown | 7,957
| 2,308 | 29.0
| 438 | 5.5
|
| Low | 7,843 |
3,033 | 38.7
| 613 | 7.8
|
| Middle | 5,468
| 2,132 | 39.0
| 345 | 6.3
|
| High | 1,474
| 509 | 34.5
| 63 | 4.3
|
|
5.3.3 User Ratings—The user-ratings for cocaine
were significantly higher from those on middle incomes, whereas
those on high, low and unstated incomes gave similar ratings.
For crack the highest ratings came from low-income groups, with
middle-income groups giving the lowest ratings.
COCAINE/CRACK USER-RATINGS BY INCOME
|
| Income | Cocaine
| Crack |
| Group | n
| Rating | n
| Rating |
|
| Unknown | 2,081
| 5.43 | 1,105
| 2.09 |
| Low | 2,846
| 5.43 | 1,545
| 2.23 |
| Middle | 1,950
| 5.67 | 988
| 1.77 |
| High | 434
| 5.42 | 192
| 2.05 |
|
6. THE COCAINE
MARKET IN
THE UK
6.1 UK Cocaine Prices
6.1.1 Since 1994, IDMU has conducted large scale surveys of
drug users monitoring consumption patterns and prices. Average
Cocaine gram and crack rock prices, in each year are shown below.
UK COCAINE/CRACK RETAIL PRICE TRENDS 1997-2008
|
| Year | 1997
| 1998 | 1999
| 2000 | 2001
| 2002 | 2003
| 2004 | 2005
| 2006 | 2007
| 2008 |
|
| Coc gram | £50.52
| £51.92 | £50.55
| £49.38 | £46.20
| £47.95 | £47.06
| £45.27 | £44.62
| £42,45 | £42.83
| £42.70 |
| n | 208
| 307 | 406
| 317 | 90
| 410 | 487
| 475 | 516
| 449 | 137
| 105 |
| Crack Rock | £21.69
| £24.85 | £23.65
| £20.48 | £18.91
| £22.23 | £22.34
| £16.70 | £25.74
| £17.20 | £15.33
| £13.00 |
| n | 35
| 33 | 57
| 47 | 19
| 57 | 57
| 54 | 43
| 51 | 15
| 10 |
|
6.1.2 Cocaine prices have fallen consistently since the mid-1990s
but have remained relatively stable since 2006. The fall in crack
rock prices is even more dramatic, however this is likely to reflect
the greater availability of £10 rocks containing 80-150mg
crack.
6.2 Regional Price Variations
6.2.1 There are significant regional variations in cocaine
and crack prices, with cocaine being cheapest in the North and
Midlands, and most expensive in London and the South West, with
regional prices varying by as much as 10% compared to the UK average.
For crack the variation is wider, possibly reflecting differences
in the sizes of rock available, with much higher prices in Yorkshire
and Scotland, with prices significantly cheaper than average in
Wales and the North West.
REGIONAL COCAINE GRAM PRICES 1997-2008
|
| Cocaine Gram | 1997-99
| 2000-02
| 2003-05
| 2006-08
| Overall
|
| Region | n
| Avg | n
| Avg | n
| Avg | n
| Avg | n
| Avg % |
|
| London | 274
| £54.85 | 258
| £48.86 | 357
| £47.32 | 87
| £43.53 | 976
| 104 |
| Southeast | 132
| £50.15 | 117
| £49.27 | 195
| £45.88 | 148
| £44.06 | 592
| 101 |
| Southwest | 165
| £51.59 | 115
| £50.44 | 189
| £46.96 | 78
| £44.49 | 547
| 103 |
| East Anglia | 56
| £49.77 | 39
| £47.70 | 65
| £47.00 | 36
| £44.91 | 196
| 101 |
| Midlands | 75
| £45.93 | 70
| £45.68 | 127
| £43.73 | 73
| £40.49 | 345
| 94 |
| Wales | 35 |
£49.72 | 28
| £48.93 | 53
| £44.97 | 28
| £43.22 | 144
| 100 |
| Yorks/Humbs | 42
| £51.43 | 41
| £46.71 | 99
| £43.79 | 42
| £39.12 | 224
| 96 |
| North West | 47
| £46.53 | 54
| £45.74 | 120
| £42.21 | 92
| £38.68 | 313
| 92 |
| North East | 8
| £44.06 | 17
| £41.41 | 46
| £41.49 | 15
| £42.00 | 86
| 90 |
| Scotland | 37
| £52.16 | 46
| £48.94 | 125
| £44.92 | 35
| £39.72 | 243
| 99 |
| Other | 50 |
£44.18 | 21
| £45.78 | 119
| £48.90 | 57
| £46.13 | 247
| 99 |
| Total | 921
| £51.00 | 817
| £48.31 | 1,478
| £45.63 | 691
| £42.56 | 3,907
| 100 |
|
REGIONAL CRACK COCAINE ROCK PRICES 1997-2008
|
| Crack Rock | 1997-99
| 2000-02
| 2003-05
| 2006-08
| Overall
|
| Region | n
| Avg | n
| Avg | n
| Avg | n
| Avg | n
| Avg % |
|
| London | 29 |
£35.26 | 44
| £16.98 | 32
| £17.13 | 10
| £16.90 | 115
| 104 |
| Southeast | 12
| £22.75 | 14
| £27.67 | 27
| £19.71 | 16
| £16.88 | 69
| 106 |
| Southwest | 24
| £17.81 | 12
| £19.59 | 18
| £22.45 | 9
| £15.56 | 63
| 92 |
| East Anglia | 9
| £29.44 | 11
| £19.54 | 8
| £18.13 | 3
| £18.33 | 31
| 104 |
| Midlands | 19
| £19.21 | 9
| £20.00 | 15
| £21.00 | 8
| £16.88 | 51
| 95 |
| Wales | 7 |
£15.00 | 6
| £19.17 | 11
| £16.36 | 1
| £10.00 | 25
| 73 |
| Yorks/Humbs | 10
| £19.00 | 7
| £29.29 | 13
| £31.92 | 4
| £17.50 | 34
| 119 |
| North West | 7
| £15.72 | 5
| £20.00 | 8
| £16.25 | 9
| £17.78 | 29
| 87 |
| North East | 1
| £10.00 | 7
| £18.14 | 3
| £30.00 | 1
| £20.00 | 12
| 98 |
| Scotland | 3
| £31.33 | 4
| £47.50 | 8
| £32.38 | 2
| £20.00 | 17
| 159 |
| Other | 4 |
£16.25 | 3
| £9.17 | 15
| £19.97 | 13
| £12.95 | 35
| 72 |
| Total | 125
| £23.42 | 123
| £21.05 | 154
| £21.31 | 76
| £16.28 | 478
| 100 |
|
6.3 Price Distributions
6.3.1 Cocaine Powder—The overall range cocaine
prices in 2007-08 can be compared with the 12-year total below.
Average retail cocaine hydrochloride (powder) prices have been
declining within a range of £40-£60 per gram for the
past few years, purity had until recently been increasing but
from 2006 very low purity cocaine started to appear with increasing
numbers of price reports in the range of £20-£35 per
gram. Prices of ounces and larger quantities can vary considerably
according to quality/purity, with a typical range of £500-£,1200,
quarter kilos from £2,000-£10,000.
Figure 2
UK COCAINE POWDER PRICE RANGES
6.3.2 Crack Cocaine—The range of UK crack
"rock" prices from the 2004-08 surveys are similar to
the overall distribution since 1997, rocks are most commonly £20
with 30-40% going for £10, although they can be as low as
£5 or as high as £80, dependent on size. Crack gram
prices vary between £40 and £100, with ounce prices
varying from £500-£1,200.
Figure 3
UK CRACK COCAINE PRICE DISTRIBUTIONS
6.4 Cocaine Kilogram Prices
6.4.1 IDMU did not collect kilogram price data for cocaine
via surveys prior to 2005, however we do encounter documentary
evidence of kilo prices in drugs cases (dealer lists, computer
records or intercept transcripts). As a general rule of thumb,
there would tend to be an approximate 25%-30% discount for each
10 fold increase in quantity of drugs. We have received only 4x
kilo price reports in our surveys, ranging from £14,000 to
£32,000 (2005-06).
6.4.2 Crack Cocaine is normally produced within the UK distribution
networks, or by end-users, from powder cocaine, importation is
rare and tends to be small-scale. It is rarely available in kilogram
quantities, and we have yet to encounter a case involving kilograms
of crack, or kilogram price reports.
6.5 Other Price Sources
6.5.1 NCIS (April 2004) quote single kilo prices between
£18,000 and £32,000, with multi-kilo prices between
£15,000 and £30,000 per kilo. I note on the (undated)
list provided recently kilos of cocaine are quoted between £22,000
and £30,000.
6.5.2 In a recent case in the South West of England,26 numerous
accounts and dealer lists were seized which indicated the following
prices in 2006-07:
Kilo—£19,500-£20,500 (£19.50-£20.50
per gram equiv)
9oz/250g—between £4,995 and £6,525 (£19.88-£26.10
per gram equiv)
1oz/28g—£690-£1,200 (£555 if bought
in bulk)—£24.64 to £42.86 per gram equiv.
1/2oz/14g—£375-£475—£26.79-£33.93
per gram equivalent
10g pellet—£400-£525—£40-£52.50
per gram equivalent (import purity)
1/8oz/3.5g—£200—£57.14 per gram equivalent
(import purity)
2 grams—£70-£80
1 gram—£40
6.6 EFFECT OF
PURITY
6.6.1 Cocaine kilos (and other bulk quantities) will
be worth much more (£25-£32k) if obtained at imported
purity (typically 70% plus) than at street purity (30-50% for
around £15-£20k), thus a kilogram of imported cocaine
is usually doubled in volume/halved in purity before it reaches
the end-user. I have dealt with a number of cases where blocks
of imported cocaine have been cut at wholesale (multi-kilo) level.
6.6.2 Since 2006, I have encountered a number of cases involving
cocaine of purities far lower than would have previously been
considered merchantable (in the range of 8-20% purity). This reduction
in purity is also associated with the emergence of "budget"
cocaine,27 with three grades of the drug now on offer.
(a) "Peruvian" which is essentially uncut from importation,
and has typical purities in excess of 60% with street prices of
£50-£60 per gram.
(b) "Street"—the bulk of cocaine, typically
30-50% purity with typical street price of £40-£50 per
gram.
(c) "Budget"—low purity cocaine (under 25%)
sold at a discounted price (between £20 and £40 per
gram)
6.7 Cocaine Purchase Behaviour
6.7.1 Frequency of Purchase—In our 1997-99
surveys respondents were asked how often they bought cocaine,
how much they bought at one time and what percentage they used
themselves. The modal purchase frequency was monthly, with fewer
than 4% of buyers purchasing more than once a week.
FREQUENCY OF COCAINE PURCHASE
|
| Frequency | Count
| Percent | Cumulative %
|
|
| £1x a year | 24
| 4.9% | 4.9
|
| <1x per month | 67
| 13.7% | 18.6%
|
| Monthly | 256
| 52.4 | 71.0
|
| >1x per week | 94
| 19.2 | 90.2
|
| Weekly | 30
| 6.1 | 96.3
|
| >1x per week | 15
| 3.1 | 99.4
|
| Daily | 3 |
0.6 | 100.0
|
| Total | 489
| 100.0 |
|
|
6.7.2 Social Supply—The majority of cocaine
users would share at least a proportion of the cocaine they buy
with other users and hence be guilty of supply offences, often
one member of a couple will buy for the use of both, however over
90% of buyers would use 50% or more of the cocaine they purchase,
suggesting small-scale social supply to be far more common than
people buying with the intent of selling the majority on to others
on a commercial basis.
PERCENTAGE OF PURCHASED COCAINE FOR OWN USE
|
| % own use | Count
| Percent |
|
| <25% | 9
| 1.9 |
| 25-49 | 36
| 7.5 |
| 50-74 | 159
| 33.0 |
| 75-99 | 93
| 19.3 |
| 100 | 185 |
38.4 |
| Total | 482
| 100.0 |
|
6.7.3 Deals Purchased—The gram deal is overwhelmingly
the most common purchase quantity, only 16% of users buying smaller
amounts, with 15% buying between 1/16 and 1/4oz, and 3.6% buying
½ ounce or more at a time. The average (mean) deal size was
just under 2 grams.
PURCHASE QUANTITY (COCAINE POWDERS)
|
| Deal | Nominal Size (g)
| Count | Percent
|
|
| Gram | 1 |
343 | 65.0
|
| Half-Gram | 0.5
| 73 | 13.8
|
| 2 Grams | 2
| 39 | 7.4
|
| Eighth Ounce | 3.5
| 25 | 4.7
|
| Qtr Gram | .25
| 11 | 2.1
|
| Qtr Ounce | 7
| 10 | 1.9
|
| Ounce | 28
| 7 | 1.3
|
| Tenth (1/16oz) | 1.75
| 6 | 1.1
|
| Half Ounce | 14
| 6 | 1.1
|
| Under ¼ gram | <0.25
| 3 | 0.6
|
| Over 1 oz | > 28g
| 3 | 0.6
|
| ¾ gram | .75
| 2 | 0.4
|
| Total | | 528
| 100.0 |
| Average Deal | 1.98g
| | |
|
7. COCAINE/CRACK
PURITIES
7.1 Cocaine Powder
7.1.1 Average street purities in the UK have typically varied
between 40-60% for cocaine powder, with typical purities at import
level of around 70%. Until recently the range of typical street
purities would vary from around 20% up to 60%, with instances
of very high or very low purities at end user level. Street level
cocaine is typically around 50% of the purity at import.
7.1.2 However since 2006 (more recently than shown by available
national figures) we have noticed increasing numbers of cases
involving very low purity cocaine, in the range of 5-20%, which
would previously have been considered unmerchantable (without
the risk of violent injury).
7.1.3 Typical adulterants in cocaine powders include
caffeine (another stimulant) and sugars such as glucose and mannitol
for bulking agents, increasingly drugs which exert similar physical
(local anaesthetic) effects such as lignocaine, procaine and benzocaine
have been common, along with painkillers such as phenacetin, diltiazem
and paracetamol. Although caffeine exerts a stimulant effect,
the amount found in a typical line would be far less than in a
typical cup of coffee. Use of "***caine" drugs as adulterants
would tend to mimic the mouth-numbing effects of the genuine drug.
7.2 Crack Cocaine
7.2.1 Crack cocaine purities have fallen steadily over
the years, from around 90% in the early-mid 1990s to around 60-70%
since 2002, as dealers have found ways of maintaining combustibility
at lower purity levels. Import purities have consistently fallen
at around 80% with odd quarterly variations influenced by individual
seizures. A relatively small proportion of crack is imported ready-washed,
the majority being produced in the UK from imported cocaine powder.
7.2.2 We have no information as to other substances present
in deals of low-purity crack, forensic analyses have not reported
the nature of such adulterants as in most cases these are not
an issue. However adulterants of crack would presumably need to
have similar physical properties to crack cocaine, in terms of
appearance (crack is normally a waxy solid) and reaction to applied
heat (sublimation).
7.2.3 Note that more recent purity data will be available
from the Forensic Science Service, the Laboratory of the Government
Chemist and other forensic laboratories (eg Scientifics, Forensic
Access, Keith Borer Consultants) providing analyses for different
police forces or for defence solicitors. Labs should as a matter
of priority be tasked with determining the nature and incidence
of adulterants in low-purity crack-cocaine seizures.
7.3 IDMU Purities
7.3.1 An initial trawl of previous cases has found purity/quantity
data for 186 seizures in cases dealt with since late 2004—time
has precluded a full analysis back to the mid 1990s.
7.3.2 Purities of small seizures—There is
wide variation in the purities at street level and the lower wholesale
level, however before 2007 very low purities (under 10%) were
isolated incidents (the 1% sample in 2007 was actually under 1%
and is likely to represent contaminated cutting agent). Although
very high purity powders can be sold in small deals, the majority
of street powders contain under 40% purity, consistent with the
emergence of the two-tier or 3-tier market first described by
Drugscope.
PURITIES OF COCAINE—SMALL SEIZURES UNDER 350g
|
| Year | n
| Mean | Min
| Max |
|
| 2004 | 3 |
28.3% | 16%
| 37% |
| 2005 | 17 |
32.3% | 4%
| 60% |
| 2006 | 22 |
21.2% | 12%
| 77% |
| 2007 | 16 |
27.4% | 1%
| 79% |
| 2008 | 16 |
31.4% | 7%
| 82% |
| 2009 | 4 |
3.75% | 2%
| 5% |
| Total | 78
| 26.4% |
| |
|
PURITIES OF COCAINE—LARGE SEIZURES OVER 400g
|
| Year | n
| Mean | Min
| Max |
|
| 2004 | 8 |
83.8% | 16%
| 98% |
| 2005 | 5 |
49.4% | 25%
| 84% |
| 2006 | 9 |
73.0% | 38%
| 87% |
| 2007 | 6 |
73.3% | 67%
| 78% |
| 2008 | 1 |
25.0% | 25%
| 25% |
| Total | 29
| 70.3% |
| |
|
7.3.3 Purities of small seizures—There is
less variation in the purities at the higher wholesale and import
market, the majority of seizures containing powder of 70% purity
or higher, with a small number of bulk seizures of lower quality
powders.
7.3.4 Crack Cocaine—It is difficult to form
any conclusions from the 5x recent reports of crack purities,
however the two lowest purities were found in 2007-08.
8. SUMMARY AND
CONCLUSIONS
8.1 Cocaine has ceased to be, if indeed it ever was,
a drug for the upper classes, it might now better be described
as an "aspirational" drug, used mostly by those who
would like to be rich and famous rather than those who actually
are. Contrary to expectations, those of high SE status or incomes
are slightly less likely to use cocaine, and much less likely
to use crack, than other employed users. Use of both cocaine and
crack is highest amongst unemployed drug users, and lowest amongst
students.
8.2 Usage of cocaine most commonly occurs within a pattern
of general stimulant abuse whereby users can switch between cocaine
and amphetamine depending on what is available. The aftermath
of "Operation Pirate" which in the late 1990s significantly
disrupted the amphetamine market in the UK led to a significant
decline in amphetamine use mirrored by a similar increase in regular
use of cocaine.
8.3 There are potential lessons to be learned from the
"Pirate" experience in the late 1990s. Amphetamine usage
has recovered slightly and purities are now back to pre-Pirate
levels, however should the cocaine market become so disrupted
as to produce a prolonged drought, such that the purity of street
cocaine becomes unacceptably low, there is a danger that users
of stimulants may switch to potentially more dangerous substances
such as methamphetamine (crystal meth). At present, use of crystal
meth is restricted to niche markets in the UK, notably the gay
club scene with some localised markets (eg Isle of Wight). Given
that the chemicals needed to produce crystal meth are available
in household cleaning products and over-the-counter medicines
and are effectively un-monitored, any explosion of crystal meth
use would be difficult to counter through conventional law-enforcement
methods.
8.4 The vast majority of users of both cocaine and crack
never progress beyond experimental use, with a tiny proportion
of users of either drug taking the drug on a daily basis. The
most common pattern of regular use is the weekend binge when users
can consume several grams at one time. For most users a couple
of lines on a weekend night out is the typical pattern. However
a small minority of users become psychologically dependent, developing
significant tolerance to the effects, and may consume several
grams per day on a regular basis.
8.5 Prices of both cocaine and crack have fallen significantly
over the course of the survey period. Crack rocks are sold for
either £10 or £20 depending on size, cocaine gram prices
can vary between £20 and £60 depending on the purity
and honesty of the seller, with the most common price being £40.
Most users would buy a weeks or months supply at one time, daily
purchase of cocaine is unusual.
8.6 Purities of both cocaine and crack have fallen sharply
in recent years, where it was unusual to find purities below 25%
before 2005-06 it is now common to find "budget" cocaine
at between 5% and 20% purity. A "line" of 5% purity
cocaine is unlikely to produce significant effects beyond mild
stimulation, such as after a cup of tea or coffee. Further research
is urgently required into adulterants found in low-purity samples
of crack cocaine and the potential health risks from inhaling
such smoked materials.
8.7 Although legalisation, or regulation and taxation
of cocaine, could bring fiscal benefits, some control would have
to be maintained on availability, and the psychological effects
of excessive cocaine use (increased propensity for violence and/or
cocaine psychosis) should preclude the drug ever being on general
sale. However low-purity products, such as coca leaf or "tonic"
beverages such as the original Coca-Cola, where overdose would
be physically impractical, could possibly be considered for sale
to adults as an alternative to caffeine-based products.
June 2009
REFERENCES 1 Arif A (Ed)
(1987) Adverse health consequences of cocaine abuse. World Health
Organisation: Geneva.
2 Benowitz How Toxic is Cocaine? In Bock, G R & Whelan,
J op cit.
3 Siegel RK (1982) op cit.
4 Spotts J V & Shontz F C (1980) Cocaine Users—A
Representative Case Approach. New York, The Free Press (Macmillan).
5 Siegel R K (1982) op cit.
6 Atha M J (1987). op cit.
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