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Cocaine use has recently made dozens of eye-catching headlines in Norwegian media. In this article, Professor Thomas Clausen sheds light on the truth behind the cocaine question in Norway, and in the Nordic countries — from media reports to prevalence, harms and treatment demand. This holds true particularly in Western Europe and the Nordic region. Cocaine use is more common among the young 15—30 years , and is a more urban than rural phenomenon. Cocaine is more commonly used among males than females. During the spring and summer of , the Norwegian press reported frequently on cocaine- related matters. There were also reports of an increase in cocaine use among teenagers graduating from high school, as well as among university students. Overall, a concerning stream of reports left news consumers with the impression that cocaine had become more mainstream and normal, with a corresponding massive increase in use. Some facts first: In Europe, cocaine is the second most commonly used illicit drug after cannabis. Cocaine use as well as cocaine-related health problems are steadily increasing. Although cocaine is primary used for its pleasurable and central stimulant effects, cocaine can cause adverse health effects after just a single dose leading to acute intoxication as well as following more long-term chronic use. Acute effects of cocaine include an increase in impulsivity and associated higher risk taking that can lead to accidents and violence. Cocaine also affects the body, with increased pulse rate, higher blood pressure, and sometimes poor temperature regulation and arrhythmias. In severe cases, cocaine use can lead to cardiac infarction, brain hemorrhage or fatal overdose. Chronic cocaine use is associated with reduced mental health, such as higher risk of anxiety, depression and psychosis as well as the high risk of developing cocaine dependence. What is new is that the influx of cocaine into Europe was all-time high in , primarily but not limited to via ports in Spain, Belgium and the Netherlands. Even if we exclude reports of record high cocaine seizures, the stable purity of the drug and its relatively stable price indicate a high influx of cocaine into Europe. However, the recent media frenzy about cocaine use in Norway was sparked by the updated numbers for cocaine use showing an increase to 4. Similarly, a survey among Norwegian University students in early showed that six per cent had used cocaine at least once during the past year. Cocaine use among teenagers and young adults is increasing, shown by the past year use prevalence in the range of five per cent. This means that 95 per cent of young Norwegians have not used cocaine during the past year, and most — 9 out of 10 — Norwegians have never tried it. It is, therefore, important to remember that cocaine use has not become the new normal; on the contrary, cocaine use is a relatively marginal phenomenon in the population. Nevertheless, neither of these arguments are correct. It is not surprising that cocaine availability and use has increased in the Nordics and Norway, as this trend has been seen over some time in Western Europe already. The Nordic markets, although on the fringe of Europe, are generally financially strong, and many young people have enough money to spend on partying using illicit and expensive drugs. Thus, both the supply and the demand for cocaine seems to be increasing. Internationally, calls for drug reform and drug law liberalization have been a trend for some time, with examples of more liberal cannabis approaches from a number of states in the US as well as from some European countries. In Norway, there has also been a drug policy reform debate during the past several years, and many young adults have adapted a more liberal stance towards drug use. The juridical system and the police have recently adapted a slightly less restrictive practice around drug possession and use, primarily towards persons with substance use disorders. Although no real formal drug reform has taken place, many young people may believe that drug use and minor possession is not illegal anymore or at least that it presents less risk of penal consequences. It is hard to imagine that the trend of increases in cocaine use will change without the introduction of strengthened interventions or clear political signals reinforcing the illegal nature of such drug use. Adequate resources for prevention seem important, both for public messaging around the risk associated with both acute and chronic cocaine use, as well as for supply reduction interventions such as border customs control and policing. Both acute intoxications from cocaine and treatment demand for cocaine dependence have been on an increase in Europe. The treatment demand for cocaine use disorder was the second most common reason among first time drug treatment entrants in in Europe. We observe an increase in cocaine availability, use and harmful consequences in Europe. Without strengthened preventive measures, this trend is also likely to become more visible in the Nordics in the coming years. For persons with cocaine use disorders, treatment is available. Often, treatment is offered at both the municipality level and the specialist health services level, but these services vary from country to country. Overall, treatment remains primarily psychosocial and counselling based. The experience from surveys of European treatment demand indicates that among first-time treatment entrants for cocaine use disorder, the mean age at first cocaine use was 23 years, while the mean age for first time treatment was 33 years, leaving a year delay from first use to first treatment. This indicates that even though we see current increases in cocaine use, at present it may take several years before we experience a surge in treatment demand, which will then build over the next decade. There seems to be an opportunity to reduce the development of chronic drug use disorders through the provision of earlier treatment, if such treatment services are available with adequate capacity and a focus on early identification and treatment. However, it is important to focus on primary prevention; keeping the numbers low for cocaine use initiation remains the ideal approach for preventing the development of cocaine-related problems. Cocaine has made headlines in Norway this year, and suddenly it seems like the drug was everywhere and used by everyone. In this article, Thomas Clausen disentangles the truth behind the headlines, and looks into use, consequences and treatment opportunities. What are the facts and what is new? So where do we stand? Is there any hope? Categories Drugs. Related content. Follow us on social media:.

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