Growing up, you're led to believe that one line of cocaine will swiftly lead to full-blown addiction and the loss of money, career and relationships. One of the most surprising things about adult life, then, has to be the sheer number of people who seem to be smashing through bags of the stuff every weekend.
While the dangers of taking drugs are often oversold, it should be obvious that taking them can never be risk-free. Worryingly, the risks of taking coke appear to be dramatically increasing.
VICE analysis of hospital data has revealed the number of in-patients with a primary diagnosis of "mental and behavioural disorders due to use of cocaine" has risen by more than 90 percent in the last four years. Freedom of Information requests submitted by VICE to A&E departments in England also show the number of incidents where cocaine is mentioned in the attendance record have more than doubled over the same period.
According to the annual Crime Survey for England and Wales, cocaine is second only to cannabis in the list of most commonly used illegal drugs. Nevertheless, for the best part of a decade, the percentage of people aged between 16 and 59 who are using the drug has remained relatively stable, fluctuating between 1.9 and 2.4 percent. In the last four years, the percentage has increased slightly, but nowhere near enough to account for the dramatic rise in hospital attendances and admissions linked to the drug.
If use of cocaine has remained stable, why are increasing numbers of the drug's users needing medical treatment?
One theory is that coke is much stronger than it used to be. Only a decade ago, tests on cocaine seized by the police revealed purity levels of around 25 percent. Last year, independent drug testers told VICE that purity levels of 80 percent are now common. Harry Shapiro, director at drug information service Drugwise, says: "If there's more people using stronger coke, then the chances are that more of them will at some point come to grief."
No one knows for sure why coke is getting stronger. Booming production of the drug in South America may have increased supply and therefore purity, but there could also be another factor at play closer to home. In 2014, UK ministers published the Serious Crime Bill, which established "new powers to seize, detain and destroy chemical substances suspected of being used as cutting agents for illegal drugs".
As cutting agents such as benzocaine have become a higher priced commodity, the incentive to dilute the purity of cocaine has fallen. That's right: you can thank MPs for that bang-bang you've been picking up in recent years.
Unfortunately, a crackdown on cutting agents has been about the most significant change in UK drugs policy in recent years; cocaine is just as illegal today as it was four years ago. During that time, the number of cocaine users has risen slightly, while the number of hospital admissions has nearly doubled. Must we say it again? The war on drugs isn't working.
Ed Morrow, drug policy lead at the Royal Society for Public Health, says the rising number of hospital attendances linked to cocaine shows these policies are a problem for all kinds of drug users: "Criminalisation acts as a barrier to those whose use has become problematic finding support, while a lack of evidence-based education or harm reduction services means use typically takes place in ignorance of substance strength, content or risk minimisation strategies."
This should obviously be of concern to anyone who uses drugs, or has friends or relatives who do so. But even if you believe drug users deserve everything that’s coming to them, it should still be clear that something has to change. Because although we can’t stop people from taking drugs, there’s plenty of evidence that we can reduce the associated harms. And reducing the harm from drugs reduces the number of users ending up in hospital – which helps to reduce the burden on our already stretched public services.
Dr Henry Fisher is policy director at drugs policy think-tank Volteface and a senior chemist at harm reduction organisation The Loop. "The main reasons that people are ending up at hospital is for some kind of transient psychosis or acute toxicity, both of which are significant and challenging things to control," he says. "That requires a lot of resources. We’re already hearing that A&E and hospitals are pressured for resources, and this adds significant additional strain."
Today, Volteface and The Loop published a report, Night Lives, calling for measures such as drugs testing services to be adopted across the UK. "Large numbers of the public are ending up in hospital after using drugs or otherwise being adversely affected by poor drug-use practices," says Fisher. "Drug safety testing, and other measures to reduce drug-related harms, provide an opportunity to educate people and reduce those harms before they occur, rather than having to clear up after the fact."