> Maybe. But if we're comparing like to like cocaine is by far the most dangerous central stimulant in common use.
That's... debatable at best. Contamination with fentanyl notwithstanding, it's relatively rare to have a fatal overdose on cocaine or methamphetamine. However, methamphetamine causes a lot of acute damage which cannot be dismissed.
Neither one is "safe", but methamphetamine causes more acute and long-term harm than cocaine does - in part due to the contexts in which it's used, but in part due to the pharmacokinetics of the drug itself.
I was only talking about lethal overdose, where cocaine has a significantly lower threshold than meth. For acute damage, cocaine also has a lot of that, like the potential for rhabdomyolysis and acute kidney damage.
Usage patterns have an effect for sure, but that was not a part of my analysis. I think if we're including real world patterns, we also have to include adulteration with other drugs, and in that case I think cocaine is the more dangerous. While adulteration with other phenethylamines is a very common thing with amphetamines, especially in Europe, the more dangerous ones like PMMA and 4-FA seem to be fairly rare these days. More common are 2/3-FA and various cathinones.
That's... debatable at best. Contamination with fentanyl notwithstanding, it's relatively rare to have a fatal overdose on cocaine or methamphetamine. However, methamphetamine causes a lot of acute damage which cannot be dismissed.
Neither one is "safe", but methamphetamine causes more acute and long-term harm than cocaine does - in part due to the contexts in which it's used, but in part due to the pharmacokinetics of the drug itself.