Cocaine and crack cocaine – Overview

Introduction/Background

Cocaine, or cocaine hydrochloride, is an alkaloid extract from coca leaves. A powerful central nervous system stimulant, this molecule acts on the dopaminergic, serotoninergic, and adrenergic systems. It is found in the form of a white powder, most frequently consumed through the nasal routes (snorting), sometimes into the lungs (inhalation of smoke or vapour orally or nasally) or intravenously (injection).

Cocaine base, which is known as “crack cocaine” or “free base”, is derived from cocaine hydrochloride, resulting from the addition of bicarbonate or ammonia. This transformation enables crystallisation of the powder into little granules, intended to be smoked and, more rarely, injected. The effects of cocaine base are very much more powerful than those of hydrochloride. Their appearance is more rapid (1 to 2 minutes compared with 15 to 30 minutes), but their duration is much shorter (10 to 15 minutes as against one hour), which leads users to taking it multiple times.

Production/Supply

Seizures

Over the last thirty or so years, seizures of cocaine have continued to increase in France. In the 1990s, seizures averaged more than 1.8 tonnes per year, and rose to 5.3 tonnes in the 2000s and to more than 11 tonnes in the 2010s. In 2022, seizures achieved a record with 27.7 tonnes compared to 26.5 tonnes in 2021 and 13.1 tonnes in 2020. This development results of several factors.

1. The extremely strong growth of the production of cocaine in Latin America (mainly Peru, Columbia and Bolivia) from where a major part of hydrochloride consumed in France originates. Since the start of the 2010s, production in that country has tripled increasing from 384 tonnes in 2011 to 1 400 tonnes in 2022.
2. The diversification of cocaine routes with the important role of the French Antilles as transit zones to metropolitan France and more recently, of French Guyana as a direct source through trafficking by mules. In 2022, 55% of the cocaine seized whose origin was known came from the Antilles and French Guiana.

Potency and price

There has been a marked increase in the purity of cocaine over the last ten years, with the average rate in France reaching 66.1% in 2021, compared with 45.8% in 2011 (SNPS 2021 data). The cocaine sold frequently contain cutting agents that also have psychoactive effects (levamisole, paracetamol, caffeine, hydroxyzine, lidocaine).

The price per gram of cocaine hydrochloride has increased since 2010 but has decreased since 2018. The current price has risen to €70 per gram from €65 (OFAST data). The accessibility of cocaine is facilitated by split sales (for a half-gram at €30 or €40 or for small amounts such as “pouches” sold for €15 or €20).

The price of a “rock” of crack cocaine (enough for 3 to 5 uses) varies between €10 and €20. Cocaine base (crack cocaine) is exclusively consumed in the Paris region and in the French Antilles. In metropolitan France, sales of crack cocaine occur in Paris in the north-east of the capital and in Seine-Saint-Denis.

• Psychoactive substances, users and markets in France in 2022. Tendances n°160, 2023, 8 p.
• See also: European Drug Report 2023: Trends and Developments. EMCDDA, 2023

Use

In the adolescent population

In 2022, among young people aged 17 years, cocaine lifetime use is at 1.4% (1.3% among girls and 1.5% among boys). In the same population group, lifetime use of crack cocaine is marginal at 0.4%.

At the regional level, it should be noted that lifetime use of cocaine is more frequent in Brittany and in Provence-Alpes-Côte-d’Azur and less in the regions Hauts-de-France, Île-de-France and Centre-Val de Loire. With regards to crack cocaine, young people most frequently experiment with crack in the Auvergne-Rhône-Alpes and less so in the Hauts-de-France region.

In the adult population

Cocaine, in its hydrochloride form, is the most consumed illegal substance in France after cannabis. The number of people experimenting with cocaine in France among people aged 11-75 is estimated at 2.1 million people in 2017. The portion of 18-64-year-olds having experimented with cocaine has quadrupled in the last two decades (from 1.2% in 1995 to 5.6% in 2017).

600 000 people declared having used it in the last year. Current use, as lifetime use, are still two to three times more common among men than women. Use over the course of the year is highest among those aged 18-25 (2.8%) and those aged 26-34 (3.4%), then declines and finally disappears at about the age of 55. In 2021, there were at least 139 000 users of cocaine hydrochloride and 48 000 users of crack cocaine in the last month.

At the European level, among young adults (aged 15 to 34 years), the prevalence of cocaine use over the course of a lifetime varied greatly from one country to another, from 0.7% to 13.6%, with a weighted European average of 6.1%. According to estimates, about 2.5 million (1.9%) of young Europeans used cocaine during the previous year.

• Drug use in French 17-year-olds: analysis of the 2022 ESCAPAD survey. Tendances n°155, 2023, 8 p.
• Levels of illicit drug use in France in 2017. Tendances, n°128, 2018, 6 p.
• Drugs at 17: regional analyses of the 2022 ESCAPAD survey. OFDT report, 2024, 66 p.

Impacts

The consumption of cocaine and crack cocaine, whether occasional or long-term use, may have an impact on the physical and psychological health of users. These impacts may persist regardless of the routes of administration, the quantity, and frequency of use.

In terms of the effects, cocaine is often described as having disinhibiting properties which induces sensation of being all-powerful and hyperactivity. The effects described also include emotions such as excitement and a feeling of euphoria. The transcending of self and the feeling of joy are also among the effects sought by consumers.

Somatic complications most frequently encountered are cardiac or neurological (strokes, seizures, etc.). Pulmonary complications also occur almost exclusively among crack cocaine users, as a result of the route of consumption (inhalation of smoke).

Snorting cocaine causes lesions in the nasal septum, sometimes rapidly in the case of intensive consumption, and can also cause numbness of the mouth. Finally, the risky practices associated with the injection or sharing of material (cocaine straws, crack pipes) may give rise to bacterial infections (local cutaneous abscesses, septicaemia) or viral infections (HIV, Hepatitis B, and above all Hepatitis C).

Furthermore, in the hours following taking cocaine, there may be episodes of paranoia, anxiety, aggression, and violence sometimes associated with auditory, visual, and sensory hallucinations. Cocaine-induced paranoia may be accompanied by a compulsive syndrome of looking for product, especially among crack users.

Snorting cocaine does not lead to physical dependence but leads to a strong psychological dependence.

Seeking care

The Common data collection on addictions and treatments (RECAP) of the OFDT enables to study trends in requests for treatment from drug users taken into care at national level as well as their characteristics in the specialised drug treatment centres (CSAPA). In 2021, almost 41 000 people consulted a CSAPA for use of an illegal substance other than cannabis. Among these patients, cocaine and crack cocaine were used by 30% and 7% of people respectively.

• Statistics on people receiving care in specialised drug treatment centres in 2021. OFDT briefing paper, 2024, 21 p.

Morbidity and mortality

The impact of cocaine, even partially, in drug and substance abuse-related deaths has increased in the last few years, increasing from 9% to 22% of deaths between 2013 and 2021, of which 141 died in 2021 (DRAMES 2021 study, CEIP-A Grenoble-ANSM data).

Perceptions/Opinions

According to the Survey on representations, opinions and perceptions regarding psychoactive drugs (EROPP), more than three-quarters of French people (76%) aged 15 to 75 consider cocaine to be a dangerous drug as soon as it is tried, just behind heroin. The proportion of people sharing this opinion has fallen for the first time since 1999 (85% held this view in 2013).

Despite its widespread presence and the fairly positive image it still has in some circles, opinions on this drug, as on other substances (particularly licit ones), have hardened in recent years. As a result, 82% of French people consider that cocaine users are dangerous to their loved ones and many refuse to excuse them from their responsibilities, on the pretext that it is an illness or due to previous family problems.

• Drugs: perceptions of substances, public policies and users. Tendances n°131, 2019, 8 p.

Legal framework and recent public guidelines

Cocaine, whether snorted or smoked, in the form of powder (cocaine hydrochloride) or base (crack, free base), is a product classified as a narcotic and its use is prohibited. The purchase, consumption, possession, provision, resale, production, transport, or driving after consumption of cocaine are all considered offences under the law, liable to heavy penalties before the courts, whatever the quantity of the substance concerned.

The law provides for a crackdown on drug trafficking and the profits made from it, which have been strengthened by about thirty laws since the end of the 1990s. The sentences stipulated have been increased, with some drug trafficking offences carrying up to life imprisonment and heavy fines (up to €7.5 million for the production, manufacture, import, transport, or sale of narcotic substances).