The National Institute on Drug Abuse now considers cocaine the "drug of greatest national public health concern." Lower prices and a new administration route, cocaine smoking, have increased the potential for addiction. An estimated 2 million individuals in the United States may be addicted to cocaine, or four times the number addicted to heroin. Contrary to population representations of the intractable power of cocaine addiction, cocaine dependence is a treatable disorder. The primary care physician must become familiar with signs of dependence and with therapeutic approaches to cocaine abuse, with particular attention to emerging advances in both psychotherapy and pharmacotherapy.