In the United States and in Canada use of cocaine declined among young people until 2024, but not among the general population. Men continue to account for higher levels of use and harms than women, with cocaine-related overdose deaths rising much more sharply for men over the past decade – widening the difference between genders.

• In the United States, after a drop in use during the COVID-19 pandemic, cocaine use among the adult population returned to high pre-pandemic levels. Recent data point to a possible decrease in cocaine use, between 2023 and 2024, among the general population of the United States. Among adolescents, the decline which started during the COVID-19 pandemic persisted until recently, with signs of a rebound emerging between 2024 and 2025.
• Over the past decade, overdose deaths involving opioids alongside cocaine have driven a strong increase in the overall number of overdose deaths involving cocaine, and have come to account for the majority of such deaths. However, during 2020-2023 overdose deaths involving cocaine without any opioid have increased by around one half – approximately the same rate as those involving both substances at the same time.
• In Canada, the use of cocaine among the younger population also dropped, while use increased among other age groups. Overall cocaine consumption appeared stable between 2022 and 2023 based on wastewater analysis in major cities.