PHARMACIST STEVE

WASHINGTON — Cocaine use in the United States has “rebounded” buoyed by a boost in supply, and the increasing prevalence of potent synthetic opioids such as fentanyl mixed into the product is “accelerating cocaine involved overdose deaths,” the Drug Enforcement Administration said in the 2018 National Drug Threat Assessment released today.

Both use and availability of the drug continued a sharp climb between 2016 and 2017 and “increased availability levels and concurrent lowered domestic prices will likely propel this trend through the near-term” thanks to “record levels of coca cultivation and cocaine production in Colombia.” Ninety-three percent of cocaine tested by authorities last year turned out to be of Colombian origin, and “the overall trend of lower prices but higher purity suggests demand has not fully caught up to supply — resulting in a cheaper, more pure product than five years ago.”

There were 10,375 cocaine-involved deaths in the country in 2016, a 52.9 percent increase from the previous year. A further increase in cocaine overdose deaths is expected this year, the report said, as use of both the powder and crack forms of cocaine continues to grow. The most cocaine deaths have been in Washington, D.C., Rhode Island, Ohio, Massachusetts, and West Virginia.

“The mixture of cocaine with fentanyl and other synthetic opioids remains a dangerous trend in an expanding number of markets. Previously, the threat was primarily concentrated in traditional cocaine markets, such as Florida, New York, Massachusetts, and Maryland; however, it has now moved beyond cocaine dominated areas into states with high opiate proliferation, such as Ohio and West Virginia,” the report states. “Additionally, examples of cocaine and fentanyl mixtures have been analyzed in states with neither a high synthetic opioid presence nor a high cocaine presence, such as Arkansas, Washington, and Missouri, extending the reach of both drugs outside of their traditional markets.”

The DEA noted that “fentanyl/cocaine mixtures often target a user base that is typically unaware it is consuming fentanyl and thus more likely to have an adverse reaction than one who intentionally sought out the opioid… the expansion of fentanyl-contaminated cocaine is fueling a surge in cocaine-related overdose deaths.”

The spike in cocaine production in Colombia between 2016 and 2017 is attributed to “a variety of factors, to include decreases in aerial and manual eradication.”

In 2016, an average of 174 people died each day from drugs. Since then, the opioid threat — which includes prescription drugs, synthetic opioids, and heroin — “has reached epidemic levels and currently shows no signs of abating, affecting large portions of the United States,” while “the methamphetamine threat remains prevalent; the cocaine threat has rebounded; new psychoactive substances (NPS) are still challenging; and the domestic marijuana situation continues to evolve.”

The report noted that as abuse of prescription drugs has increased significantly, traffickers are now “disguising other opioids” as those prescriptions “in attempts to gain access to new users.”

“Illicit fentanyl and other synthetic opioids — primarily sourced from China and Mexico — are now the most lethal category of opioids used in the United States. Traffickers — wittingly or unwittingly — are increasingly selling fentanyl to users without mixing it with any other controlled substances and are also increasingly selling fentanyl in the form of counterfeit prescription pills. Fentanyl suppliers will continue to experiment with new fentanyl-related substances and adjust supplies in attempts to circumvent new regulations imposed by the United States, China, and Mexico.”

Acting DEA Administrator Uttam Dhillon said that “the trafficking and abuse of illicit drugs poses a severe danger to our citizens and a significant challenge for our law enforcement and health care systems.”

“Through robust enforcement, public education, prevention, treatment, and collaboration with our partners, we can protect our citizens from dangerous drugs and their dire consequences,” he said.