Objective:

The purpose of this study was to assess the trends in mortality rate after ischemic stroke and cocaine drug abuse in different demographics in the United States, compared to non-cocaine users.

Background:

Cocaine Abuse has been linked to a higher risk of stroke and mortality in young adults. This has been observed in the US over the last decade and requires further investigation.

Design/Methods:

Death certificates from Centers for Disease Control and Prevention Wide-Ranging On Line Data for Epidemiologic Research database were examined from 1999 to 2020 for multiple causes of death MCD-ICD 10 Codes(F14.0-14.9 and T40.5). Age-adjusted mortality rates (AAMRs) per 1000,000 persons and annual percent change (APC)were calculated and stratified by ten-year age group, sex, race/ethnicity, and urbanization.

Results:

From 1999 to 2020, adults aged 15-55 had 307,615 stroke-related deaths and cocaine-related death were180,155 and combined stroke plus cocaine-related deaths were 6392.. The AAMR inclined from 1.7 in 1999 to 2.6 in2007 (APC: 5.4; 95% CI: 3.6 to 8.2), after which it declined to 1.5 in 2010 (APC: -21.32; 95% CI: -25.8 to 12.6), then steadily increased to 1.6 in 2020 (APC: 2.50, CI: 0.57 to 6.4). Men had consistently higher AAMR than women from 1999 (AAMR men: 1.9 vs women: 1.6) to 2020 (AAMR men: 2.3 vs. women: 0.9). Non-Hispanic (NH) Black or African American adults had the highest overall AAMR (7.8), followed by Hispanic or Latino (2.8), followed by NH White (1.8). AAMR also varied substantially by Urbanization, Large Central Metropolitan areas Highest in 2007 AAMR as 4.5 followed by Large Fringe Metropolitan as 1.6 in 2005 followed by Medium Metropolitan as 2.6 in 2007.

Conclusions:

Deaths from cocaine-related stroke increased from 2007-2010, then declined until 2020. African American adults and overall men in large cities had higher cocaine-related mortality rates. further targeted studies and prevention is required.