Epidemiology of cocaine use and abuse: An evaluation of the National Hospital Discharge Survey (NHDS)

Background: Cocaine use has increased to epidemic proportions. National data show near 70% increases in the number of people receiving treatment for cocaine addiction in recent years. Objective: The objective of this work was to estimate the potential market for a new product to treat cocaine addiction.

Methods: The 2006 National Hospital Discharge Survey (NHDS) was used to estimate the incidence of cocaine use/abuse cases in the U.S. NHDS, a national probability survey provides information on inpatients discharged from non-Federal short-stay hospitals in the U.S. The ICD-9 codes for poisoning by a central nervous system (CNS) stimulant (970) and nondependent abuse of cocaine (305.6) were used to identify patients who use/abuse cocaine. The data was analyzed using SAS 9.2 software.

Results: Approximately 1% (334,368) of discharges were estimated to be users or abusers of cocaine or other CNS stimulants. The demographics of the cocaine users/abusers were consistent with previous literature. Thirty-seven percent of discharges with a diagnosis of ICD-9 code 970 or 305.6 had Medicaid as primary payer and 19% were self-pay. While cocaine users make up a small percentage of total members of any one payer-group, it is worth noting that Medicaid and Medicare are paying for just over one-half of the hospitalizations due cocaine use/abuse.

Conclusions: Estimates from NHDS data indicate a market may exist for a new product to treat cocaine addiction. Based on payer distribution, it will be critical that such a product provide sufficient cost-benefit to assure coverage by government payers.