Cocaine use is declining among emerging adults in the United States: Trends by college enrollment

Background The difference in cocaine use between student and non-student emerging adults is not well understood, despite the longstanding assumption that college is protective against use. Objective To describe trends in cocaine use among emerging adults by college enrollment. Methods Using cross-sectional, nationally-representative data from the National Survey on Drug Use and Health (2002–2016), we estimated the prevalence of four cocaine use indicators by year among emerging adults (ages 18–22) and stratified by college enrollment. We tested for linear and quadratic trends over time. Results From 2002 to 2016, 11.7% reported lifetime cocaine use, 5.8% reported past 12-month use, 1.7% reported past 30-day use, and 1% had a use disorder in the past 12-months. We observed significant linear decreases in all four use indicators over time (Lifetime: β = −0.20, Past 12-months: β = −0.17, Past 30-days: β = −0.22, Past 12-months disorder: β = −0.37). Students had lower rates of cocaine use than non-students, although prevalence estimates were more similar between groups for past 12-month (Students:5.3%, 95% CI:5.0–5.5; Non-students:6.3%, 95% CI:6.1–6.5) and past 30-day use (Students:1.6%, 95% CI:1.4–1.7; Non-students:1.8%, 95% CI:1.7–1.9) than for lifetime use (Students:9.4%, 95% CI:9.1–9.7; Non-students:13.8%, 95% CI:13.5–14.1). Conclusions Cocaine use has declined among emerging adults since the early 2000s. The college environment appears compensate for early life differences in cocaine use risk between students and non-students, closing the gap between groups for recent indicators of cocaine use. Given the severe health consequences associated with cocaine use, more public health attention to this issue is needed.