The bitter lessons about the dangers of cocaine from the disco era in the 1970s may be lost on a new generation of drug abusers.
A phenomenon known as “generational forgetting” may be one of the reasons for the deadly uptick in cocaine deaths that the federal Centers for Disease Control and Prevention reported this week, experts said.
“Certain drugs seem to go in and out of style,” Daniel Raymond, deputy director of the Harm Reduction Coalition, said. “Right now we’re seeing an uptick in cocaine use, and we’re hitting that point in the cycle where we’re starting to see more fatal overdoses.”
“Absolutely, there is a generational piece to this,” said Hans Breiter, a Northwestern University psychiatry professor and one of the world’s leading experts on how cocaine stimulates the human brain.
Today’s narcotics abusers may be turning to cocaine in part “because there’s been a lot of bad press about other drugs,” Breiter said.
Just like the generation that dealt with the horrors of AIDS was followed by another that was less afraid of the scourge and thus more likely to have unprotected sex, today’s drug users aren’t afraid of cocaine like they should be, he said.
“We see this kind of forgetting in politics all the time, for example,” he said. “People resurrecting ideas like trickle-down economics, even though it’s been pretty much invalidated.”
On Thursday, the CDC reported that overdose deaths involving cocaine began rising around 2012 and jumped by more than a third between 2016 and 2017.
CDC researchers also found that almost three-quarters of the deaths involving cocaine in 2017 were among people who had also taken opioids.
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But deaths involving cocaine alone also increased, said the CDC’s Lawrence Scholl, who was one of the study’s authors.
That could be because there’s more cocaine on the streets, Raymond, of the Harm Reduction Coalition, said.
“We have a greater supply of cocaine now than we did 10 years ago,” he said. “My understanding is production had fallen off in Colombia and it has been increasing again.”
Sheila Vakharia of the Drug Policy Alliance wrote in an email “there is definitely something to be said for cyclical theories of drug use because when we focus a lot of time/energy/resources on restricting the ‘drug du jour’ it opens the market for alternative drugs and encourages suppliers to diversify.”
Of late, the drug du jour wreaking havoc across America has been opioids, which have killed tens of thousands nationwide, with the addiction cutting like a scythe through states such as West Virginia, Ohio, Pennsylvania, Kentucky and the District of Columbia, according to the CDC.
But the Drug Enforcement Administration also reported in its National Drug Threat Assessment last year that cocaine availability has increased steadily in the United States since 2012, especially on the East Coast and in the South.
According to the CDC report, 10,131 out of the 13,942 cocaine-involved deaths (almost 73 percent) also involved an opioid.
Heroin is an opioid made from morphine. But drug dealers have been boosting profits by cutting their drugs with synthetic opioids like fentanyl, which is 25 to 50 times more powerful than heroin.
Breiter said drug addicts often get high on something known on the street as a “speedball,” which is a combination of cocaine and heroin.
“People will use heroin to blunt the severity of coming down from the high of cocaine,” he said. “It can be quite severe.”
The problem is that when the heroin is cut with an opioid, it can make this drug cocktail even more lethal, the experts said.
Vakharia said there have been reports of drug dealers cutting cocaine with opioids and “cocaine users naïve to opioids are overdosing because they have no tolerance.” But neither she nor her colleagues at Drug Policy are convinced that is the case.
“It makes little sense,” she wrote. “Why would a seller want to kill off a customer.”
Raymond agreed that he didn't believe that fentanyl-contaminated cocaine was intentional, given the opposing effects of the two drugs.
“We’re not seeing a huge trend of cocaine intentionally mixed with opioids like fentanyl,” he said. “Why? I think that’s probably because fentanyl is very sedating, cocaine is very stimulating.”