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The purity of cocaine at the retail level has been increasing in Europe since 2010, and in 2019 it reached its highest level in the last decade, although adulteration continues to take place (see Box Recent trends in cocaine adulteration). Overall, the retail price of the drug remained stable between 2010 and 2020. This appears to confirm the trend, identified in the previous edition of this report, that more cocaine tor market is now available on European retail markets than before (EMCDDA and Europol, 2019). The major population center in the Southern Districtof Illinois is the Metro-East, which is composedof approximately 45 contiguous cities surroundingEast St. Louis. The Metro-East is the secondlargest metropolitan area in Illinois with a populationof 600,000. Louis, Missouri, control drug distribution andsales in the Metro-East area.

These include anxiety, rapid heart rate, violent behavior, a sense of paranoia and high blood pressure. According to the 2020 National Survey on Drug Use and Health, approximately 1.9% or 5.2 million people in the United States over the age of 12 have used cocaine in the past 12 months. In 2019, almost 16,000 people who used cocaine died from an overdose. Ohio has been ranked by the Centers for Disease Control and Prevention (CDC) as one of the leading states in substance abuse and overdose deaths. Medical professionals have administered cocaine in a limited capacity, but recreational use is illegal.