Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids.
OBJECTIVE
To assess trends in cocaine overdose deaths and examine the role opioids play in these deaths.


METHODS
We used data on drug overdose deaths in the United States from 2000 to 2015 collected in the National Vital Statistics System to calculate annual rates and numbers of cocaine-related overdose deaths overall and deaths both involving and not involving opioids. We assessed statistically significant changes in trends with joinpoint regression.


RESULTS
Rates of cocaine-related overdose deaths increased significantly from 1.26 to 2.50 per 100 000 population from 2000 to 2006, declined to 1.35 in 2010, and increased to 2.13 in 2015. Cocaine-related overdose deaths involving opioids increased from 0.37 to 0.91 from 2000 to 2006, declined to 0.57 in 2010, and then increased to 1.36 in 2015. Cocaine-related overdose deaths not involving opioids increased from 0.89 to 1.59 from 2000 to 2006 and then declined to 0.78 in 2015.


CONCLUSIONS
Opioids, primarily heroin and synthetic opioids, have been driving the recent increase in cocaine-related overdose deaths. This corresponds to the growing supply and use of heroin and illicitly manufactured fentanyl in the United States.
Christopher McCall Jones is with the Division of Science Policy, Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC. Grant T. Baldwin is with the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Atlanta, GA. Wilson M. Compton is with the National Institute on Drug Abuse, National Institutes of Health, Rockville, MD.
Christopher
C
McCall Jones
Christopher McCall Jones is with the Division of Science Policy, Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC. Grant T. Baldwin is with the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Atlanta, GA. Wilson M. Compton is with the National Institute on Drug Abuse, National Institutes of Health, Rockville, MD.
Grant T
GT
Baldwin
Christopher McCall Jones is with the Division of Science Policy, Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC. Grant T. Baldwin is with the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Atlanta, GA. Wilson M. Compton is with the National Institute on Drug Abuse, National Institutes of Health, Rockville, MD.
Wilson M
WM
Compton
D000701:Analgesics, Opioid / Q000506:poisoning*; D003042:Cocaine / Q000506:poisoning*; D062787:Drug Overdose / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D000701:Analgesics, Opioid; D003042:Cocaine