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Cocaine and Cocaine Substances

3.1 Use

General Population

  • In 2015, 1.6% of Ontario adults (aged 18+) reported cocaine use in the past year and 8.3% reported a lifetime history of cocaine use. Men (11.5%) had higher (lifetime) rates than women (5.4%) (CAMH Monitor, n=5,013).2 Estimates of lifetime cocaine/crack-cocaine use in Ontario were similar (6.8%; 7.5%) based on Ontario sub-samples from  the national representative surveys Canadian Tobacco Alcohol and Drugs Survey (CTADS; n=1,451; aged 15+; 2015) and CADUMS (n=1,011; aged 15+), respectively.1,80

Youth and Young Adults

  • Cocaine use (past-year) was more common (5.9%) among ages 18-29 than among older adults (0.6% among ages 30+), however lifetime cocaine use did not differ substantially among young adults (12.2%) and older adults (7.5%) in Ontario in 2015. Lifetime cocaine use among young adults has more than tripled since 1996 (4.0%), according to the CAMH Monitor (2015, n=5,013).2
  • Cocaine use (past-year) was reported by 2.5% of grade 9-12 students in Ontario in 2015 (3.2% lifetime use), with the highest rate (4.5%) of past-year use among grade 12 students. Among all students, rates of (past-year) cocaine use peaked in 2003 (5.7%) and have been declining since. Crack-cocaine use (past-year) was <0.5% among grade 9-12 students in 2015 (OSDUHS, n=10,426).3
  • Among a sample of Ontario postsecondary students, 1% reported past-month cocaine/crack-cocaine use and 4.4% reported lifetime use (2013 NCHA survey, Ontario sub-sample n=16,123).6

Special Populations

Indigenous Populations

  • Past-year cocaine/crack-cocaine use was reported by 5.7% of adults (aged 18+) in Ontario First Nations communities (2008-10). Rates were highest (11.0%) among 18-29 year olds and have increased from 4.0% among all adults (aged 18+) in 2002-03, according to the 2008-10 Regional Health Survey (n=1,500) representative of Ontario First Nation adults living on reserve.8,9

Racialized Populations

  • There are no publicly available provincial data on cocaine use among racialized populations. 

Homeless and Street-Involved Populations

  • Over one quarter (27%) of homeless adults in Toronto reported cocaine use (past two years) based on a stratified random sample of (n=1,191) in 2004-05.12 30% of a random sample (n=368) of Toronto homeless adults used cocaine and almost half (49%) used crack-cocaine regularly (3+ times/week) in the past year (2006-07).11
  • Among a sample of Toronto's 'street-entrenched' adults who use drugs, 62% reported cocaine use and 78% reported crack-cocaine use in the past year (2012-13). Among a sample of 'street-involved' youth who use drugs, 44% reported cocaine use and 19% reported crack-cocaine use in the past year (2012-13 Health Canada High Risk Populations study).13
  • 69% of male and 74% of female homeless youth in Toronto reported cocaine use (past-month); similar rates (68%; 71%) of crack-cocaine use were found among males and females, respectively. 26% of the respondents who had used crack-cocaine reported at least daily use among a convenience sample of (n=100) substance-using homeless youth (aged 16-24) in Toronto (Drugs, Homelessness and Health survey, 2008-09).14

Correctional Populations

  • Two in five (37.8%) incarcerated adult (aged 18+) males in Ontario reported cocaine use and 29.1% reported crack-cocaine use in the year prior to incarceration according to a (2009) representative sample (n=499) from a provincial detention centre.44

Pregnant and Parenting Women

  • There is no publicly-available provincial data on women’s cocaine use during pregnancy. 

People Living with HIV

  • One in ten (10.3%) of a sample of HIV-positive men who have sex with men reported (past 6-month) cocaine use based on a sample (n=1,997) recruited from HIV clinics across Ontario (2010-13; Ontario HIV Treatment Network Cohort Study).81

Opioid Users

  • Almost half (46.1%) of a sample of Toronto-based regular illicit opioid users (age 18+) reported past-month cocaine use; 62.4% reported past-month crack-cocaine use among a convenience sub-sample (n=141) from the pan-Canadian OPICAN study (2002).68,82

Injection Drug Users

  • The majority (61.9%) of a sample of IDUs in Ontario sites reported (past 6 month) cocaine use and 55.5% reported crack-cocaine use (2007 Ontario Harm Reduction Distribution Program Evaluation).17 Similarly, 56.9% and 59.9% of IDUs in select Ontario sites reported (past 6 month, non-injection) use of cocaine and crack, respectively, among an Ontario sub-sample of (n=775) IDUs from the national I-Track survey (2005-08).18

Recreational Drug Users

3.2 Risks and Harms

Cocaine and Driving

  • One in five (18.9%) Ontario adults (aged 18+) who reported (past year) cocaine use were involved in a MVC, compared to 7.4% among those who did not report cocaine use, according to self-reported data from the CAMH Monitor (n=8,107; 2002-08).84
  • Cocaine was detected in 8% of drivers involved in fatal MVCs in Ontario who tested positive for drugs, among (n=229) samples submitted for toxicological testing between 2011 and 2012.19

Morbidity and Mortality

Burden of Disease

  • There were 12,278 Health-Adjusted Life Years Lost due to an estimated 17,282 new cases of cocaine use disorder in Ontario in 2009. The burden of cocaine use disorders was highest among adults aged 25-44 years, according to diverse data sources.59


  • Hospital separations related to cocaine increased from ~16 to ~24/100,000 population in Ontario between 2000 and 2005 based on administrative health records (Canadian Institute for Health Information's Hospital Morbidity Database).24

3.3 Interventions

Safer Crack Use Kits

  • Ontario's 36 Needle Syringe Programs reported distributing 263,888 glass stems in 2014, (+29% from 2013) (Ontario Harm Reduction Distribution Program).85
  • In Ottawa, the needle exchange program (NEP) distributed a total of 1,633 safer crack use kits (SCUKs), 49,952 individual glass stems, 18,566 rubber mouthpieces and 81,667 brass screens in the first year of distributing safer smoking supplies (2005-06).86
  • In Toronto, an estimated 2,000 SCUKs were handed out monthly by The Safer Crack Use Coalition in 2005.87
  • In London, Ontario, approximately 740 SCUKs were distributed between September and January 2015, according to a local news report.88
  • The majority (87%) of a sample of Ottawa-based IDUs who also smoked crack-cocaine accessed safer smoking supplies from Ottawa's NEP within the first year of the initiative (2005-06). Following the introduction of SCUKs, there was a significant decrease in the proportion of IDUs reporting (past month) injection (from 96% to 78% at 12 month follow-up). Among those who reported sharing crack-cocaine pipes, the proportion who shared 'every time' declined from 37% to 13%, based on self-reported data from a sub-sample of (n=550) Ottawa-based I-Track  participants (a street-recruited convenience sample of active IDUs).86
  • 61% of a sub-sample of homeless youth in Toronto who used crack-cocaine (past 6 months) had shared a pipe. Two thirds (64%) reported getting an SCUK from an on-site NEP while one in three (29%) reported never having done so, based on a convenience sample of (n=71) homeless youth (aged 16-24) who used crack-cocaine (Drugs, Homelessness and Health survey, 2008-09).14


  • Cocaine was reported as a problem substance by 16.3% (16,387 admissions) of patients presenting to Ontario publicly-funded substance abuse treatment in 2012-13; 13.6% (13,380 admissions) reported crack-cocaine. Since 2007, these numbers have decreased from 29% and 35%, respectively (DATIS).25
  • Approximately 10 per 10,000 children and youth (aged 0-24) in Ontario were in treatment for stimulant use, including cocaine and crack-cocaine in 2011-12, which was the third most common drug category for which youth received treatment. These rates were highest among ages 20-24 (Mental Health of Children and Youth in Ontario Baseline Scorecard).26