Cocaine Use Disorder

Cocaine use disorder is a chronic, relapsing substance-use condition characterized by impaired control over cocaine use, persistent use despite harm, craving, and clinically significant effects on health and social functioning. Its consequences can include cardiovascular and neurological emergencies, mental-health comorbidity, infectious-disease exposure, overdose risk-particularly when substances are adulterated or combined with opioids-and disruption to families, employment, and community safety. Effective responses require coordinated prevention, early identification, evidence-informed treatment, harm reduction, and long-term recovery support. The burden and service environment differ substantially across jurisdictions because of variations in drug supply, stigma, criminal-justice policy, health-system capacity, and access to specialized care.

The landscape is shifting from narrowly punitive responses toward public-health approaches that combine prevention, treatment, harm reduction, and recovery services. Greater attention is being given to stimulant-specific interventions, integrated care for co-occurring mental illness, and treatment pathways that address housing instability, trauma, and social exclusion. Changes in illicit drug supply-including polysubstance exposure and contamination-are increasing the need for rapid toxicology awareness, overdose education, and flexible clinical protocols. Digital screening, telehealth, peer support, and community-based services can extend reach, but implementation must account for privacy, connectivity, workforce capability, and the limits of remote care during acute psychiatric or medical crises.

Artificial intelligence can support cocaine use disorder services by identifying patterns in clinical records, improving screening workflows, assisting risk stratification, and tailoring reminders or recovery support. Natural-language tools may help clinicians summarize histories and detect indicators of relapse, comorbidity, or social risk, while predictive systems can help prioritize outreach when they are appropriately validated. These applications should augment-not replace-clinical judgment and therapeutic relationships. Leaders must address bias, informed consent, data security, explainability, and the risk that automated tools could intensify surveillance or restrict access to care. High-quality local data, prospective evaluation, human oversight, and clear escalation procedures are essential before deploying AI in high-stakes settings.

North America generally has comparatively developed addiction-treatment infrastructure and research capacity, yet access remains uneven and polysubstance exposure, mental-health comorbidity, stigma, and fragmented financing continue to challenge outcomes. Latin America faces varied levels of service availability, workforce capacity, and prevention coverage; community-based care and integration with primary health services are important where specialist resources are limited. Europe benefits from established monitoring and public-health networks, but substantial differences remain among national treatment systems, legal frameworks, and responses to stimulant-related harms. The Middle East requires approaches sensitive to stigma, confidentiality, family involvement, and differences in service availability, with opportunities to strengthen early intervention and integrated mental-health care. Africa has significant unmet need in many settings, making primary-care integration, task-sharing, and low-cost community services particularly relevant. Asia-Pacific spans highly diverse health systems and policy environments; culturally adapted prevention, improved surveillance, and expanded specialist and telehealth capacity can help close access gaps.

Within ASEAN, varied legal systems, cultural contexts, and health-system capacity favor adaptable regional guidance, workforce development, and community-based treatment models. BRICS members encompass large and diverse populations with differing burdens and service infrastructures, highlighting the value of stronger surveillance, affordable care pathways, and research collaboration. The European Union can benefit from coordinated monitoring, cross-border learning, and harmonized quality standards while preserving national flexibility. G7 countries generally possess strong research and clinical capabilities, but must address inequitable access, fragmented services, and emerging polysubstance risks. GCC states may prioritize confidential, culturally responsive services, family-centered engagement, and integration with broader mental-health systems. Across NATO, cooperation on military and veteran health, trauma-informed care, and standardized clinical learning can complement civilian public-health responses.

Australia can build on established harm-reduction and primary-care capabilities while improving access outside major urban centers. Brazil benefits from strengthening community-based and psychosocial care, early intervention, and continuity across regions. Canada faces the need to integrate stimulant-focused services with broader responses to toxic drug exposure, mental illness, and housing insecurity. China requires approaches aligned with its regulatory framework, prevention priorities, and uneven regional access to specialized care. France, Germany, Italy, and Spain can further connect addiction services with primary care, emergency medicine, and mental-health treatment while reducing stigma. India may benefit from expanded specialist capacity, task-sharing, and culturally appropriate community services. Japan and South Korea require confidential, stigma-sensitive pathways and stronger detection of hidden or underdiagnosed need. Mexico can prioritize regional service expansion, workforce development, and continuity between community and specialist care. Russia requires careful attention to accessibility, confidentiality, comorbidity, and evidence-informed treatment engagement. The United Kingdom can continue strengthening integrated treatment, recovery support, and responses to regional inequalities. The United States should improve coordination across healthcare, behavioral health, emergency services, and harm-reduction programs, especially for people exposed to multiple substances.

Industry and health-system leaders should establish measurable pathways from screening to treatment, ensuring that primary care, emergency departments, mental-health services, and specialist addiction programs can exchange information safely and coordinate follow-up. Investment should prioritize stimulant-specific behavioral interventions, contingency-management access where permitted, treatment for co-occurring conditions, peer and family support, and recovery services addressing housing and employment. Organizations should pair overdose and safer-use education with rapid referral mechanisms, strengthen workforce training, and use equity metrics to identify underserved populations. Any AI deployment should begin with a clearly defined clinical need, validated data, transparent governance, bias testing, human review, and outcome monitoring. Partnerships with public agencies, community organizations, people with lived experience, and researchers can improve trust and ensure that services reflect local needs.

This executive summary uses a qualitative synthesis framework for cocaine use disorder, drawing on established public-health, clinical, epidemiological, and policy concepts rather than market estimates or forecasts. The analysis organizes findings across six required regions, six multinational groups, and fifteen countries, considering variation in prevalence measurement, treatment access, drug-supply conditions, comorbidity, policy, stigma, and health-system capacity. Interpretations should be validated against current national surveillance, peer-reviewed clinical evidence, service evaluations, and guidance from relevant public-health authorities. Cross-country comparisons require caution because diagnostic practices, reporting systems, treatment definitions, and data completeness are not uniform. AI-related observations are framed as implementation considerations and should be tested through local validation, prospective evaluation, and ethical oversight.

Cocaine use disorder requires sustained, person-centered action rather than a single intervention or sectoral response. Regional and national differences make adaptable service design essential, while common priorities include earlier identification, integrated treatment, harm reduction, mental-health support, recovery continuity, and reduced stigma. Artificial intelligence may improve reach and coordination when deployed responsibly, but it cannot substitute for trained professionals, trusted relationships, or adequately funded services. Leaders who align clinical practice, public-health surveillance, community expertise, and accountable technology governance will be better positioned to reduce preventable harm and improve long-term recovery outcomes.