• cocaine;
  • substance-related disorders;
  • aged;
  • prevalence;
  • emergency medicine;
  • human


Objectives: To determine the prevalence of cocaine use in a population of elder patients presenting to an inner-city academic emergency department (ED). Methods:This was a prospective, blinded observational study of patients aged 60 years or older who presented to a large urban ED over a six-month period. A urine drug screen was performed on patients who had a sample obtained during treatment for routine analysis. Patients' demographic data were collected and compared. Results: A total of 5,677 visits met the inclusion criteria. Urine samples were obtained in 911 (16%) of these visits with 852 unique individuals. There were 18 cocaine-positive results among the 911 visits, for a rate of 2.0%. The rate of positive subjects was also 2.0% (17/852). The cocaine users were younger (66.4 ± 7.2 vs. 76.0 ± 8.7 years), predominantly male (88.9% vs. 46.6%), and more likely to be diagnosed with drug or alcohol abuse as compared with the cocaine-negative patients. However, there were no significant differences in disposition between the cocaine-positive and cocaine-negative groups. Conclusions: Elder patients may have a higher prevalence of cocaine use than previously estimated by national registries.