Cocaine
Cocaine and its derivative ‘crack’ cocaine provide an example of both the globalization of substance use and the cyclical nature of drug epidemics. Traditionally coca leaves have been chewed by people in the Andean countries of South America for thousands of years. The main alkaloid of the coca leave, cocaine, was isolated relatively recently in about 1860. Cocaine was then used in patent medicines, beverages and ‘tonics’ in developed countries in Europe, North American and in Australia until the early 1900s. Laws restricting the availability of cocaine saw a decrease in consumption in these countries until the 1960s. From that time cocaine use became popular among certain groups of young people in some developed countries and in the producer countries of South America. Cocaine became widely available in North America in the 1970s and Europe in the 1980s.
Prevalence rates for lifetime use of cocaine are typically 1-3% in developed countries, with higher rates in the United States and in the producer countries. Cocaine dependence has become a substantial public health problem, resulting in a significant number of medical, psychological and social problems, including the spread of infectious diseases (e.g. AIDS, hepatitis and tuberculosis), crime, violence and neonatal drug exposure.