Skip to main content

Cocaine: Patterns of Use, Route of Administration, and Severity of Dependence

  • Michael Gossop (a1), Paul Griffiths (a1), Beverly Powis (a1) and John Strang (a1)

We contacted and interviewed 150 cocaine users in south London community settings. Most were taking cocaine regularly, but not daily, and in substantial doses. Three main routes of administration were used: smoking (40%), intranasal (32%), and injecting (24%). Injectors reported having used cocaine more frequently, in higher doses and for longer periods of time. Despite their frequent and extensive use of cocaine, the overall level of dependence was low for the great majority of the sample. Two-thirds (66%) of the full sample (and two-thirds (65%) of the crack smokers) reported only minor signs of dependence during the year prior to interview. Route of drug administration was related to severity of dependence. Cocaine taken by injection was associated with the highest levels of dependence; intranasal use was associated with the lowest levels, and crack smoking was intermediate between the two. There had been substantial changes in the initial route by which cocaine was used, with a clear trend away from injection on the first occasion of use. Those who first used cocaine before 1986 were more likely to have used the drug either intranasally or by injection. Cocaine users who first tried the drug after 1987 were increasingly likely to take it by smoking crack. Women and black (predominantly Afro-Caribbean) subjects were more evident in this sample of cocaine users than has previously been reported in many UK studies.

Corresponding author
Hide All
Bouknight, L. G. & Bouknight, R. R. (1988) Cocaine - a particularly addictive drug. Postgraduate Medicine, 83, 115131.
Closser, M. (1992) Cocaine epidemiology. In Clinician's Guide to Cocaine Addiction (eds Kosten, T. & Kleber, H.). New York: Guilford Press.
Dackis, C. & Gold, M. (1990) Addictiveness of central stimulants. In Addiction Potential of Abused Drugs and Drug Classes (eds Erickson, C., Javors, M. & Morgan, W.). New York: Haworth Press.
Drugs Intelligence Laboratory (1991) Drug Abuse Trends. Aldermaston: Home Office.
Erickson, P. & Alexander, P. (1989) Cocaine and addictive liability. Social Pharmacology, 3, 249270.
Erickson, P., Javors, M. & Morgan, W. (eds) (1990) Addiction Potential of Abused Drugs and Drug Classes. New York: Haworth Press.
Gawin, F. & Kleber, H. (1986) Abstinence symptomatology and psychiatric diagnosis in cocaine abusers. Archives of General Psychiatry, 43, 107113.
Gold, M. (1987) Crack abuse: its implications and outcomes. Medical Times, 115, 2732.
Goldsmith, M. (1988) Sex tied to drugs = STD spread. Journal of the American Medical Association, 260, 2009.
Gossop, M., Griffiths, P. & Strang, J. (1988) Chasing the dragon: characteristics of heroin chasers. British Journal of Addiction, 83, 11591162.
Gossop, M., Griffiths, P., Powis, B., et al (1992) Severity of dependence and route of administration of heroin, cocaine and amphetamines. British Journal of Addiction, 87, 15271536.
Gossop, M., Griffiths, P. & Strang, J. (1994) Sex differences in patterns of drug taking behaviour: a study at a London community drug team. British Journal of Psychiatry, 164, 101104.
Griffiths, P., Gossop, M. & Strang, J. (1993) Chasing the dragon: the development of heroin smoking in the UK. In The British System: Responding to Drug Misuse (eds Strang, J. & Gossop, M.). London: Oxford University Press.
Griffiths, P., Gossop, M., Powis, B., et al (1993) Reaching hidden populations of drug users by Privileged Access Interviewers: methodological and practical issues. Addiction, 88, 16171626.
Home Office (1992) Statistical Bulletin on the Misuse of Drugs (1991). London: HMSO.
ISDD (1991) Drug Abuse Briefing. London: Institute for the Study of Drug Dependence.
Jeri, F. (1984) Coca-paste smoking in some Latin American countries: a severe and unabated form of addiction. Bulletin on Narcotics, 36, 1531.
Jones, R. (1987) Psychopharmacology of cocaine. In Cocaine: A Clinician's Handbook (eds Washton, A. & Gold, M.). New York: Wiley.
Maden, A., Swinton, M. & Gunn, J. (1992) A survey of pre-arrest drug use in sentenced prisoners. British Journal of Addiction, 87, 2733.
Murphy, S., Reinarman, C. & Waldorf, D. (1989) An 11 year follow-up of a network of cocaine users. British Journal of Addiction, 84, 427436.
Strang, J. & Edwards, G. (1989) Cocaine and crack. British Medical Journal, 299, 337338.
Strang, J., Griffiths, P. & Gossop, M. (1990) Crack and cocaine use in south London drug addicts: 1987-1989. British Journal of Addiction, 85, 193196.
Strang, J., Griffiths, P., Powis, B., et al (1992) First use of heroin: changes in route of administration over time. British Medical Journal, 304, 12221223.
Strang, J., Johns, A. & Caan, W. (1993) Cocaine in the U.K. - 1991. British Journal of Psychiatry, 162, 113.
Sutherland, G., Edwards, G., Taylor, C., et al (1988) The measurement of opiate dependence. British Journal of Addiction, 81, 485494.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 12 *
Loading metrics...

Abstract views

Total abstract views: 80 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 26th May 2018. This data will be updated every 24 hours.

Cocaine: Patterns of Use, Route of Administration, and Severity of Dependence

  • Michael Gossop (a1), Paul Griffiths (a1), Beverly Powis (a1) and John Strang (a1)
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *