Powder, crack cocaine use varies and overlaps among high school seniors

The use of crack and powder cocaine both varies and overlaps among high school seniors, researchers at New York University and NYU Langone Medical Center have found. Their findings, which appear in the American Journal of Drug and Alcohol Abuse, point to the need to take into account both common and different at-risk factors in developing programming and messaging to stem cocaine use.

"Powder cocaine and crack are commonly collapsed into a single 'cocaine use' category in research, despite different contexts of use, reasons for use and rates of dependence, and adverse outcomes associated with use," explains Danielle Ompad, a faculty member in NYU's Steinhardt School of Culture, Education, and Human Development and one of the study's co-authors.

"While powder and crack cocaine do have many similar determinants, this study helped delineate overlapping, but different risk profiles associated with use," adds Joseph Palamar, an assistant professor at NYU Langone Medical Center, Departments of Population Health and Child and Adolescent Psychiatry.

Rates of powder cocaine and crack use have fluctuated among adolescents in recent decades, yet little attention has been paid to differences between users of powder cocaine and crack—two forms of the substance that are commonly reported together as "cocaine" use, despite having different effects and rates of negative consequences. For example, even in light of recent changes to sentencing guidelines, disparities between crack and powder cocaine remain high—possessing 500 grams of powder cocaine results in a five-year sentence while just 28 grams of crack brings on the same prison term.

In their study, Palamar and Ompad examined 2005-2011 data from the Monitoring the Future (MTF) study, a national survey that questions high-school seniors in 130 public and private high schools on behaviors, attitudes, and values.

Specifically, they examined demographic and economic correlations of cocaine use, then compared and contrasted correlates of powder versus crack cocaine as well as use of both forms while controlling for a range of variables.

Overall, the MTF survey showed that 6.2 percent of high school seniors had used powder cocaine in their lifetime and 2.5 percent had used crack—a result that underscores the researchers' contention that, despite their pharmacological similarity, crack and powder vary in usage.

In many instances, however, likelihood of using either crack or powder cocaine did not vary among high-school seniors. Earning more than $50 a week from a job or from sources other than a job (e.g., an allowance) significantly increased the odds for both cocaine and crack use. In addition, identifying oneself as "religious" and having parents with higher levels of education was associated with lower use of both forms.

But, the researchers found many other differences in usage. For instance, female students were less likely to use powder cocaine while students who identified as "religious" were more likely to report use of crack only.

In addition, users of only powder cocaine--without use of crack--were more likely to reside in a metropolitan area compared to crack users.

"While crack use may be perceived to be more visible in urban areas, possibly due to more problematic use, in reality, powder cocaine appears to be more prevalent in these parts of the country," observes Ompad, a faculty member in NYU Steinhardt's Department of Nutrition, Food Studies, and Public Health.

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