Drug-producing countries, such as the Andean countries of South America where cocaine is manufactured, are confronted by special difficulties associated with the widespread availability of drugs. Information about patterns of cocaine use and severity of dependence was collected from a sample of 68 drug users who were receiving treatment for cocaine problems at treatment centers in Bolivia and Peru. Levels of cocaine consumption were extremely high. The mean daily dose was 16.4 grams. The majority of the users (87 percent) smoked cocaine in the form of pasta, pitillo, or basuco. More than half of the sample reported using cocaine at least 20 times a day. Severity-of-dependence scale scores were high, and these were consistent with the frequent and compulsive pattern of use reported within the sample. The more severe cocaine problems reported in South American compared to some western countries may be due to the substantial differences in the amounts of cocaine typically ingested. 2 figures and 19 references