{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:49:43Z","timestamp":1777884583304,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T00:00:00Z","timestamp":1627603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institutes of Environmental Health Sciences","doi-asserted-by":"crossref","award":["T32 ES007060- 31A1"],"award-info":[{"award-number":["T32 ES007060- 31A1"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000102","name":"health resources and services administration","doi-asserted-by":"publisher","award":["D34HP31025"],"award-info":[{"award-number":["D34HP31025"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Technology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>Background: Cocaine is a stimulant and Schedule II drug used as a local anesthetic and vasoconstrictor. Objective: This descriptive study characterized medical cocaine use in the United States. Methods: Retail drug distribution data from 2002 to 2017 were extracted for each state from the Drug Enforcement Administration, which reports on medical, research, and analytical chemistry use. The percentage of buyers (pharmacies, hospitals, and providers) was obtained. Use per state, corrected for population, was determined. Available cross-sectional data on cocaine use as reported by the Medicare and Medicaid programs for 2013-2017 and electronic medical records were examined. Results: Medical cocaine use decreased by \u221262.5% from 2002 to 2017. Hospitals accounted for 84.9% and practitioners for 9.9% of cocaine distribution in 2017. The number of pharmacies carrying cocaine dropped by \u221269.4%. The percentages of hospitals, practitioners, and pharmacies that carried cocaine in 2017 were 38.4%, 2.3%, and 0.3%, respectively. There was a 7-fold difference in 2002 (South Dakota, 76.1 mg\/100 persons; Delaware, 10.1 mg\/100 persons). Relative to the average state in 2017, those reporting the highest values (Montana, 20.1; North Dakota, 24.1 mg\/100 persons) were significantly elevated. Cocaine use within the Medicare and Medicaid programs was negligible. Cocaine use within the Geisinger system was rare from 2002 to 2007 (&lt;4 orders\/100 000 patients per year) but increased to 48.7 in 2018. Conclusion and Relevance: If these pharmacoepidemiological patterns continue, licit cocaine may soon become a historical relic. The pharmacology and pharmacotherapeutics education of health care providers may need to be adjusted accordingly.<\/jats:p>","DOI":"10.1177\/87551225211035563","type":"journal-article","created":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T07:29:36Z","timestamp":1627630176000},"page":"278-285","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Decline and Pronounced Regional Disparities in Medical Cocaine Usage in the United States"],"prefix":"10.1177","volume":"37","author":[{"given":"Youngeun C.","family":"Armbuster","sequence":"first","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian N.","family":"Banas","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen D.","family":"Feickert","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie E.","family":"England","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik J.","family":"Moyer","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily L.","family":"Christie","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana","family":"Chughtai","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya J.","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf U.","family":"Halden","sequence":"additional","affiliation":[{"name":"Arizona State University, Tempe, AZ, USA"},{"name":"Arizona State University Foundation"},{"name":"AquaVitas, LLC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jove H.","family":"Graham","sequence":"additional","affiliation":[{"name":"Center for Pharmacy Innovation and Outcomes, Danville, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth L.","family":"McCall","sequence":"additional","affiliation":[{"name":"University of New England, Portland, ME, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2295-445X","authenticated-orcid":false,"given":"Brian J.","family":"Piper","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA, USA"},{"name":"Center for Pharmacy Innovation and Outcomes, Danville, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,7,30]]},"reference":[{"key":"bibr1-87551225211035563","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000513"},{"key":"bibr2-87551225211035563","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)28859-5"},{"key":"bibr3-87551225211035563","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.003319"},{"key":"bibr4-87551225211035563","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-5173-3"},{"key":"bibr5-87551225211035563","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215106001459"},{"key":"bibr6-87551225211035563","unstructured":"National Institute on Drug Abuse. 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