Why Cocaine Is Making a Comeback and Why Supply Crackdowns Aren’t Enough

January 13th, 2026

A Shift We’re Seeing More Often 

Over the past few years, therapists, addiction counselors, treatment centers, and public health agencies have noticed something concerning: cocaine use is rising again in the United States. After years in which opioids, especially fentanyl, dominated headlines, stimulant use is quietly re-emerging, often alongside alcohol and other substances. This rise in cocaine popularity is not random or harmless. 

This shift is happening at the same time as more aggressive efforts to restrict fentanyl supply, including border enforcement, precursor chemical controls, and international pressure on trafficking routes. Despite aggressive military and political interventions, demand for escape hasn’t gone down as a result. While these measures are important for public safety, history and current data tell us something crucial: when people are addicted, changing the drug supply doesn’t change the underlying need to escape emotional pain. 

Cocaine Isn’t “Back” by Accident 

Recent surveillance data show increases in cocaine-related emergency visits and overdose deaths, particularly when cocaine is used with alcohol or opioids [1]. While fentanyl remains the leading cause of overdose deaths, cocaine-related harms have climbed steadily since 2020. In fact, data from the Center for Disease Control [CDC] shows that cocaine-related deaths rose from 4,681 in 2011 to 29,449 in 2023. These numbers make the real dangers of cocaine very clear, especially when it is mixed with other substances. 

One reason is substitution. When one drug becomes harder to obtain, more expensive, or more dangerous, people often shift to another substance that promises relief, energy, confidence, or emotional escape. This pattern has been observed repeatedly across decades of drug policy and is well documented in addiction research [2]. 

Why Reducing Supply Doesn’t Reduce Addiction 

Addiction is not driven by access alone. It is driven by unresolved emotional distress, trauma, and nervous system dysregulation. 

Recent research emphasizes that substance use disorders are best understood as maladaptive coping responses to stress, trauma, and emotional pain, not simply as habits maintained by availability [3]. 

When fentanyl becomes harder to access, the emotional drivers don’t disappear. People still want relief from: 

• Anxiety and overwhelm 

• Depression and numbness 

• Shame and self-criticism 

• Unprocessed trauma 

• Relationship pain or loneliness 

Cocaine, with its short-term effects of confidence, energy, and emotional distance, can feel like a solution until it creates its own destructive cycle. 

This is why supply-side crackdowns alone cannot solve cocaine addiction or other substance use disorders. If someone is using drugs to cope with grief, trauma, or chronic stress, they will often find another substance, another dealer, or another risky behavior. Real change comes from healing the reasons they reach for cocaine in the first place. 

Trauma, Stimulants, and the Nervous System 

Research continues to show strong links between childhood trauma, chronic stress, and stimulant use. 

A 2023 study in The American Journal of Drug and Alcohol Abuse found that individuals with higher Adverse Childhood Experience (ACE) scores were significantly more likely to use cocaine, especially in response to emotional/physical abuse and neglect [4]. 

From a neurobiological perspective, cocaine temporarily boosts dopamine and suppresses emotional pain, but repeated use worsens stress sensitivity and emotional crashes, increasing cravings and relapse risk [5]. 

This is why people often describe cocaine as helpful at first and then unmanageable later. 

Signs Cocaine Use Is Becoming a Problem 

Because cocaine use often starts in social settings, it can be hard to tell when casual use has turned into addiction. Some warning signs include: 

• Using cocaine more often than planned, or needing more to feel the same effect 

• Mixing cocaine with alcohol, opioids, or pills  

• Feeling strong cravings or thinking about cocaine much of the day 

• Changes in sleep, appetite, or mood, especially irritability and anxiety 

• Money problems, secrecy, or lying about how much is being used 

• Trying to cut back and finding it hard to do so on your own 

If these patterns sound familiar in you or a loved one, it may be time to seek help. 

The Demand Side of the Equation 

Public policy often focuses on stopping drugs from entering the country. But addiction treatment focuses on something else entirely: why people want to escape in the first place. 

When trauma is addressed through therapy, nervous system regulation, and meaningful connection, the demand for substances decreases naturally. Studies show that trauma-informed treatment reduces substance use frequency, relapse risk, and co-occurring mental health symptoms [6] [7]. 

At Windmill, we see this every day. When clients learn to tolerate emotions they once had to escape, the chances of success go up significantly. 

How Windmill Approaches Cocaine and Polysubstance Use 

Cocaine use rarely exists in isolation. It often overlaps with alcohol, cannabis, prescription medications, or opioids. That’s why Windmill Wellness Ranch takes a whole-person, trauma-informed approach, including: 

• Comprehensive assessment of trauma and related patterns 

• Evidence-based therapies like EMDR, IFS, and CBT 

• Support for co-occurring anxiety, depression, bipolar, and other challenges 

• Relapse prevention that addresses emotional triggers, not just behaviors 

• Multiple sessions each week with master-level therapists and individualized recovery coaching 

Recovery is not only about avoiding drugs forever. It is about reducing the underlying need for them. 

The Bigger Picture 

Cocaine’s resurgence is not a failure of enforcement. It is a reminder of something deeper. As long as emotional pain remains untreated, substances will continue to fill the gap 

Real change happens when we treat addiction not as a supply problem, but as a human suffering problem. 

If someone in your family is struggling with substance use or mental health challenges, you don’t have to face it alone. There is help available, and healing is possible. 

At Windmill Wellness Ranch, we specialize in compassionate, evidence-based treatment for both addiction and trauma, helping individuals and families rebuild stability and hope. If you or someone you love needs support during this holiday season, we are here. Call 830-223-2055 or contact us online to take the first step toward healing. 

References  

1. Tanz, L. J. (2025). Drug Overdose Deaths Involving Stimulants―United States, January 2018–June 2024. MMWR. Morbidity and Mortality Weekly Report, 74. 
2. Mars, S., Ondocsin, J., Holm, N., & Ciccarone, D. (2024). The influence of transformations in supply on methamphetamine initiation among people injecting opioids in the United States. Harm Reduction Journal, 21(1), 57. 
3. Moustafa, A. A., Parkes, D., Fitzgerald, L., Underhill, D., Garami, J., Levy-Gigi, E., ... & Misiak, B. (2021). The relationship between childhood trauma, early-life stress, and alcohol and drug use, abuse, and addiction: An integrative review. Current Psychology, 40(2), 579-584. 
4. Martin, E. L., Neelon, B., Brady, K. T., Guille, C., Baker, N. L., Ramakrishnan, V., ... & McRae-Clark, A. L. (2023). Differential prevalence of Adverse Childhood Experiences (ACEs) by gender and substance used in individuals with cannabis, cocaine, opioid, and tobacco use disorders. The American Journal of Drug and Alcohol Abuse, 49(2), 190-198. 
5. Miteva, R., Abrashev, H., & Nikolova, G. Illicit Substances on Dopamine Receptors and Brain. 
6. Dobischok, S., Archambault, L., & Goyer, M. È. (2024). Trauma Informed Care (TIC) Interventions for Populations Experiencing Addiction and/or Homelessness: A Scoping Review of Outcomes. Journal of Drug Issues. https://doi.org/10.1177/0022042624126326
7. Bales, A. M. (2023). Trauma-Informed Treatment for Alcohol Use Disorder: Improving Long-Term Recovery.