This California City Has the Highest Cocaine Consumption Rate in America

Cocaine stands out as one of the most commonly used illicit drugs worldwide, boasting an estimated 18.1 million users in 2019. While its use is widespread globally, certain cities exhibit higher consumption rates than others. This article delves into identifying the Californian and U.S. cities with the most elevated cocaine consumption rates, exploring potential contributing factors.

The City with the Highest Cocaine Consumption Rate in California

Drawing on data from the Substance Abuse and Mental Health Services Administration (SAMHSA), San Francisco emerges as California’s city with the highest cocaine consumption rate. A striking 4.4% of the population aged 12 or older reported past-year cocaine use², surpassing the state average twofold and exceeding rates in any other U.S. city.

San Francisco, renowned for its liberal culture, diverse populace, and vibrant nightlife, may attract individuals inclined to experiment with drugs. The city also boasts a history of drug use and activism, tracing back to the 1960s counterculture movement and the AIDS epidemic in the 1980s and 1990s. Cocaine’s association with social status, wealth, and power may particularly appeal to residents and visitors.

Nonetheless, cocaine use carries severe health and societal consequences, including addiction, overdose, cardiovascular issues, mental disorders, violence, and crime. In 2019, cocaine played a role in 22% of drug-related deaths in San Francisco, as per the San Francisco Department of Public Health. Furthermore, cocaine use contributes to the transmission of infectious diseases like HIV and hepatitis C through the sharing of needles and drug paraphernalia.

The City with the Highest Cocaine Consumption Rate in the United States

While San Francisco claims the highest cocaine consumption rate in California, it is not the sole U.S. city with elevated usage. SAMHSA reported a national average of 1.5% for past-year cocaine use among individuals aged 12 or older in 2019. However, certain cities surpassed this average significantly.

A study by American Addiction Centers analyzed data from 51 metropolitan areas in the United States, identifying Phoenix, Arizona as the city with the highest cocaine consumption rate at 20.6% of the population reporting past-year use. Following closely were Mesa, Arizona, at 19.8%, and Omaha, Nebraska, at 19.5%. Other cities with notable cocaine consumption rates included Tulsa, Oklahoma; Wichita, Kansas; Oklahoma City, Oklahoma; and Fresno, California.

Factors contributing to these high cocaine consumption rates may include proximity to the Mexican border, the primary source of cocaine in the U.S., the drug’s availability and affordability, insufficient prevention and treatment programs, and social and economic conditions prompting individuals to seek relief from stress, boredom, or trauma.


Cocaine, a highly addictive and perilous substance, poses a threat to both individual well-being and community health. While its use is pervasive globally, certain cities exhibit heightened consumption rates. San Francisco leads in California, while Phoenix claims the top spot in the United States. These cities face diverse challenges and risks tied to cocaine use, such as addiction, overdose, disease, violence, and crime. Hence, it is crucial to raise awareness and offer support to those grappling with cocaine use and its repercussions.

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