Cocaine remains one of the most widely used illegal stimulants in the world. In the United States alone, nearly a million people try it for the first time each year, and millions more use it at least occasionally. While usage rates are lower than cannabis or alcohol, cocaine occupies a significant place in global drug trends, and its presence in overdose statistics has grown sharply over the past decade.
How Many Americans Use Cocaine
The best national snapshot comes from the annual National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration. In 2015, the survey counted roughly 968,000 new past-year cocaine users aged 12 or older. That figure represents people who used cocaine for the first time that year, not total users. The broader population of people who used cocaine at least once in the prior 12 months is considerably larger, consistently estimated in the low millions.
Young adults between 18 and 25 account for a disproportionate share of that use. About 68 percent of all new cocaine users in 2015 fell into that age range, even though 18- to 25-year-olds make up only 13 percent of the U.S. population aged 12 and older. Adults 26 and older accounted for 20 percent of new users, while adolescents aged 12 to 17 made up roughly 12 percent.
That concentration among young adults is consistent across years of data and mirrors patterns seen with other recreational drugs. The gap between young adult use and use among older age groups is especially stark with cocaine, partly because stimulant use tends to decline as people age and partly because access and social environments shift after the mid-twenties.
Cocaine Use in Europe
Cocaine is the most commonly used illegal stimulant in Europe as well. According to the European Union Drugs Agency’s 2025 report, approximately 2.7 million Europeans aged 15 to 34 used cocaine in the past year, representing about 2.7 percent of that age group. Prevalence varies significantly across countries. Belgium, Spain, and the Netherlands consistently report the highest volumes of cocaine seizures, which serves as a rough proxy for how much cocaine is circulating in those markets.
European use has been climbing. The 2025 report notes that both the supply and demand sides of the cocaine market are expanding, with record quantities seized at European ports in recent years. The drug is no longer concentrated in a handful of Western European countries the way it was two decades ago.
Cocaine in Workplace Drug Tests
One indirect measure of how common cocaine use is comes from workplace drug screening. Quest Diagnostics, which processes millions of employment-related drug tests each year, publishes an annual index tracking positivity rates by substance. In 2024, the cocaine positivity rate in the general U.S. workforce was 0.24 percent, unchanged from the prior year. For federally mandated safety-sensitive workers (truck drivers, pilots, rail operators), the rate was slightly lower at 0.20 percent.
These numbers are low compared to other substances. Amphetamine positivity, for example, hit 1.7 percent in the general workforce in 2024. But workplace testing has well-known blind spots: cocaine clears the body faster than many other drugs, people who know they’ll be tested may abstain, and the workforce population skews toward employed adults rather than the younger demographics where cocaine use peaks. Still, the stability of cocaine’s positivity rate over recent years suggests usage in the working population hasn’t shifted dramatically in either direction.
Overdose Deaths Involving Cocaine
The most alarming trend in cocaine statistics isn’t how many people use it. It’s how many people are dying from it. In 2023, cocaine was involved in 29,449 overdose deaths in the United States. That number has climbed steeply from about 12,122 in 2015, nearly tripling in under a decade.
The driving force behind that increase isn’t cocaine itself becoming more dangerous in isolation. Nearly 70 percent of stimulant-involved overdose deaths in 2023 also involved illicitly manufactured fentanyl. Fentanyl has infiltrated the cocaine supply, sometimes mixed in deliberately by dealers and sometimes through cross-contamination during packaging. A person who has used cocaine many times without incident can face a fatal overdose if a batch contains even a small amount of fentanyl. This contamination risk has fundamentally changed the danger profile of cocaine use, even for people who consider themselves experienced or occasional users.
Purity and Supply Trends
The cocaine reaching U.S. consumers is potent. The Drug Enforcement Administration’s 2024 National Drug Threat Assessment reported that average cocaine purity in the United States sits at about 84 percent. That’s a historically high figure and reflects a well-supplied market. When purity is high, it generally means supply is outpacing enforcement, keeping prices stable or low and reducing the need for dealers to dilute their product.
Most cocaine consumed in North America and Europe still originates from coca crops grown in Colombia, Peru, and Bolivia. Mexican cartels have attempted to cultivate coca domestically, but so far only on a small scale and with significantly lower purity. The supply chain remains robust, which is one reason cocaine availability and use have held steady or grown in most Western markets rather than declining.
Putting the Numbers in Context
Cocaine is far less common than alcohol, tobacco, or cannabis. Depending on the survey year, roughly 2 percent of U.S. adults report past-year cocaine use, compared to over 20 percent for cannabis and well above 50 percent for alcohol. But “less common” doesn’t mean rare. Millions of people in North America and Europe use cocaine in any given year, and the drug’s footprint in emergency rooms and morgues has grown considerably since fentanyl entered the picture.
The profile of a typical cocaine user has also broadened over time. While young adults remain the peak demographic, cocaine use spans income levels, professions, and geographic regions. It is not confined to any single social group, and its presence in both rural and urban drug markets makes it a persistent feature of the broader substance use landscape.