Attempts have been made to obtain indicators of the abuse of illicit drugs. Many techniques are expensive and/or time-consuming. Others have limitations due to the focus on specific populations. The recent outbreak of fentanyl deaths in Chicago and Detroit related to fentanyl-laced heroin suggest that mortality is a valuable indicator of a drug's presence and prevalence in a community. Drug mortality statistics are accessible from Medical Examiner/Coroner offices. It is possible that including deaths both intentional and non-intentional will give the best overall indication of trends in drug use. By following death rates, it may be possible to provide a “canary in the coal mine” for drugs of abuse. We've studied data from the Florida Department of Law Enforcement for cocaine related deaths. Data from 2005 showed 1,943 deaths compared to 1,034 cocaine related deaths in 2000, a 90% increase. Data from the first 6 months of 2006 reveals a continuing increasing trend with an increase of 10.8% compared to 2005. Supporting data from a survey of students at the University of Florida showed an increase of cocaine use in the previous year from 4.0% in 1991 to 7.1% in 2004. There appears to be a renewed epidemic of cocaine abuse in Florida. Interventions are required to prevent progression of this alarming trend.