Cocaine use is becoming a much more routine consideration for emergency doctors. Young men appearing with chest pain, or even a true heart attack, brought on by using the drug is an issue that is only going to get more prominent.
In the past few years, we have been seeing patients aged in their 20s and 30s who are seemingly fit, with no family history of heart problems and no other indications that they should be at risk, presenting with these problems.
People are reluctant to tell us that cocaine has played a part in their problem, which can hinder our search for the right treatment.
Many users will think that they are healthy, so taking cocaine will not affect them. That is a mistake.
Cocaine use is a big problem for us, so much so that now, when we see a young person with heart problems, asking them if cocaine was involved has become a routine part of our questioning. Less than five years ago, this was not the case. Violence brought about by cocaine creates a double-whammy for emergency department workers.
This is not just a Saturday night problem. It occurs throughout the week. And it is getting more serious. Addressing this concern is essential and timely. The Health Department needs to get to grips with it, and given the group affected is typically resistant to education about health risks, the justice system may need to adopt a "zero tolerance" approach to cocaine.
The writer is the president of the College of Emergency Medicine