As the United States continues to grapple with the national drug crisis, the focus is mainly on opioids, and with good reason. According to the National Institute on Drug Abuse (NIDA), opioids were involved in nearly 70 percent of all drug overdose deaths in 2017.

However, as opioids have dominated the country’s attention, cocaine, as of 2016, has been identified as the primary drug threat in the South Florida metro area.

Throughout Miami-Dade, Broward, and Palm Beach Counties, the rate of cocaine-related overdoses, which had previously been on the decline since 2006 began to quietly, steadily rise in 2013 before hitting a significant spike in 2015 and only soaring upward from there.

The History and Return of Cocaine in South Florida

Unfortunately, South Florida is no stranger to cocaine and the drug trade. The 1970s and 1980s made Miami the epicenter of a war between various Colombian cartels that led to the city being called the “Drug Capital of the World” during this time. At one point, in 1982, more than $100 million worth of cocaine was seized at Miami International Airport.

Eventually, various key cartels were dissolved, and top drug trafficking organizations were taken down by the U.S. Drug Enforcement Administration (DEA). The drug war diminished and, as time went on, the ubiquitous spread of cocaine throughout the lower half of the state was, for the most part, relegated to the 1980s. Cocaine use continued to decline significantly over the ensuing decades, until the past several years.

The reappearance of a drug whose use had previously nearly dropped off the radar in terms of South Florida substance abuse is due, in part, to a major increase in accessibility of the substance. According to the DEA, Colombian cocaine production is at a record high, with traffickers bringing more cocaine into South Florida than even the height of the “cocaine cowboy” days of 1980s Miami.

In 2015, Florida Customs and Border protection confiscated just more than 1,700 pounds of cocaine. These seizures had more than doubled to 4,200 pounds in 2016. However, in just the past year, the Coast Guard in Miami has unloaded more than 36,000 pounds of cocaine coming in at Port Everglades.

The Impact of Cocaine Abuse in South Florida

According to the Florida Medical Examiners Commission, in 2016, cocaine was responsible for more deaths in the state than any other drug, with an 83 percent increase compared to 2015. For the state as a whole, cocaine-related overdose deaths rose by more than 50 percent, from 1,834 to 2,882.

Specific to South Florida, the number of overdoses deaths involving cocaine in major metropolitan areas Miami, Fort Lauderdale, and West Palm Beach all more than doubled. West Palm Beach, in particular, saw a massive increase of more than 130 percent.

When examining a breakdown of the preceding years, the impact of the rising overdose rates, followed by the more recent sudden, lethal surge becomes clear. In 2012, there were less than 200 cocaine-related overdose deaths in Miami, with small increases over the next several years before jumping from 289 in 2015 to 439 just one year later. In 2016, as a whole, Miami-Dade County experienced an average of 36 overdoses involving cocaine each month.

The statistics in Fort Lauderdale are even more surprising, with cocaine-related overdoses actually dropping at first from 129 in 2012 to 102 in 2013 and less than 100 in 2014, only to suddenly increase to 152 in 2015 and even more so to 328 the year after that.

Finally, West Palm Beach, as previously mentioned, has been hit the hardest by the reemergence of cocaine. With just 87 overdoses in 2012, the numbers slowly rose to 173 in 2015 before exploding to 405 in 2016.

Are Opioids Involved in Cocaine Overdose Deaths?

However, even when the subject is stimulants, the shadow cast by opioids is never far behind. One point worth considering is that, as illicit opioids like heroin contribute to the rising overdose death toll, cocaine begins to seem like a safe alternative for those seeking to engage in recreational substance use and abuse without having to worry about the fear of overdosing.

This is, of course, extremely flawed reasoning, both because there is no such thing as “safe” substance abuse, and that another culprit in the major uptick in cocaine-related overdose deaths in not only South Florida but as far north as Massachusetts, is fentanyl.

Fentanyl is an incredibly potent opioid that is at least 50 times stronger than heroin, as well as cheaper and easier to produce. Spikes in heroin-related overdoses have been attributed to the growing trend of cutting heroin with fentanyl to keep costs low and profits high. Because of this, however, people who think they are taking heroin will rapidly overdose, often fatally.

How does this relate to cocaine? While the number of overdose deaths that involved cocaine has skyrocketed, overdose deaths where cocaine was the sole factor have remained relatively low, with 47 in Miami, 53 in Fort Lauderdale, and 48 in West Palm Beach. In fact, of the nearly 3,000 overdose deaths in Florida in 2016, less than 400 were caused only by cocaine.

These statistics have led drug researchers and experts to believe that the increase in overdose deaths involving cocaine is closely linked to polysubstance use, the act of taking multiple drugs at the same time. Opioids like heroin are often taken with cocaine for “speedballing,” which is when users combine the stimulant and depressant so they can get the effects of both substances.

While someone who speedballs are already at extremely high risk of overdosing just by combining these substances, as well as putting significant strain on their heart while also depressing their nervous system, there is also the likelihood that the heroin they are combining with cocaine has been cut with fentanyl. The presence of fentanyl in any substance takes the risk of overdose and essentially turns it into a guarantee.

Another factor to consider is that cocaine is also being cut with fentanyl directly with increasing frequency. Some law enforcement officials believe this is accidental, while others think it may be a purposeful tactic to make cocaine more addictive and cause a casual user to quickly become dependent on the unseen opioid component. Unfortunately, due to the immense strength of fentanyl, it usually just results in an overdose.

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