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Article Summary

A Guide to Cocaine Addiction

While cocaine use and addiction ravaged the United States, and the nation's youth in particular, throughout the 1980s and 90s, cocaine use started to slow in 2002 and dropped dramatically between 2012 and 2016. Today, the use of cocaine remains relatively stable. Cocaine currently accounts for about 10 percent of all drug use in the United States, with about 2 percent of all U.S. adults reporting usage of this drug.

Despite the stabilization in cocaine rates, cocaine remains the third most abused illicit drug in the United States and is an incredibly addictive and dangerous substance. Derived from the leaves of the coca plant and imported primarily from South America, this substance can cost an addict upwards of $50,000 a year and lead to a slew of physical and psychological symptoms, as well as death.

Understanding Cocaine

Cocaine comes from the processing of the coca leaves that are harvested in Bolivia, Peru, and Columbia. Once processed, the cocaine takes the form of a powdery white substance that dealers may cut with other products in order to stretch their supply of cocaine and allow them to sell more. As a result, a bag of cocaine may include everything from caffeine to baking soda, with a purity that varies from almost zero to almost a hundred percent.

Cocaine goes by a number of street names, including "rock," coke," "Coca," "Charlie," "C," "snow," "bump," "flake," "blow,""candy," and "toot." Most often snorted or dissolved in water and injected, a concentrated form of cocaine, called crack cocaine, takes the form of a rock that can be smoked. While cocaine may have some innocuous-sounding names, this powerfully addictive substance can grip an user after just one use.

Cocaine acts primarily as a stimulant, exciting the central nervous system and sending many of the body's natural processes into overdrive. Its addictive properties, however, lie in its ability to hijack the reward center of the brain by releasing a flood of the feel good hormone dopamine.

While dopamine is naturally released by the brain in response to pleasurable activities such as sex, taking a walk in nature, or nursing a child, and while it plays a role in encouraging the repetition of these important activities, cocaine encourages the release of too much dopamine. In addition, this drug blocks the absorption of dopamine by receptors in the brain, leading to a build up of the hormone and the characteristic high.

Eventually, the constant presence of cocaine-induced dopamine encourages the brain to stop producing dopamine on its own. By taking over the brain's reward system in this way, cocaine makes it difficult for an addict to function without the drug, and leads to powerful withdrawal symptoms, such as anxiety and depression, when the user tries to stop.

Despite this activity on the brain, cocaine does have a few legitimate medical uses, with applications in certain medical procedures for its numbing and vessel constricting properties. These medical uses combined with its dangerously addictive powers have caused the U.S. government to classify it as a Schedule II drug.

Cocaine Uses

Cocaine use, as is crack and meth use, is characterized by a "binge" pattern. This means that the user will take another dose as soon as the first dose has worn off, in a pattern of rush and crash, euphoria and comedown, that can last for days. During these binges, the user may not eat or sleep, remaining focused only on chasing the short-lived high that the drug delivers.

Recent Cocaine Use Statistics

  • In 2020, 5.2 million people (1.9 of people over the age of 12) reported using cocaine in the past year).
  • 1.3 million people over the age of 12 reported having an addiction to cocaine (cocaine use disorder) within the past year.
  • In 2020, 19,447 people died from an overdose of cocaine.

Reasons for Use

Many reasons drive someone's decision to use cocaine. Because cocaine delivers a rapid, euphoric high (called a "rush), followed by a loss of inhibitions and a sense of excitement, sociability, and confidence, many people take this drug in order to gain confidence in social situations or in other situations where they need a boost of talkativeness and self-esteem.

Cocaine is sometimes taken with alcohol or combined with heroin ("speedball") to enhance these effects. However, once the cocaine high wears off, the resulting comedown is often its own motivation for the user to try another dose.

Factors Contributing to Cocaine Addiction

Cocaine use can happen across demographic and age ranges. However, certain life circumstances can leave someone more prone to use cocaine. In particular, individuals who experience high levels of stress may be more sensitive to lower doses of cocaine due the higher levels of corticosterone, a stress hormone in their bodies. This hormone may interact with cocaine in such a way as to facilitate addiction. As a result, stressed individuals may become addicted more quickly than those who are not.

Intense stressors linked to greater drug use in general include the following:

  • Mental illness such as depression, anxiety, or bipolar disorder
  • Poverty
  • Childhood trauma
  • Homelessness

Cocaine Effects

Cocaine has a huge impact on the body, affecting the body, the mind, and the user's behavior both during and after the high. The speed with which these effects take hold, their intensity, and the specific ones the user will experience depend upon a number of factors, including the following:

  • Purity of the cocaine
  • Dose of the cocaine
  • Length of use
  • Method of ingestion

These effects begin within seconds when cocaine is injected, and within minutes when it is snorted. The typical high can last up to 2 hours, but generally peaks around 20 minutes, meaning the user will begin looking for their next dose very quickly.

In part because of how much cocaine users tend to ingest over a short period of time, this drug tends to take hold very rapidly. The primary effects of cocaine are the tolerance, dependence, and addiction that quickly form as the user chases their high over and over again.


Tolerance refers to the user's need for more and more of a drug as time goes by. Typically the result of the brain producing fewer of its own hormones in response to the steady stream of hormones being supplied by the drug, tolerance drives the addict to take more or purer doses of the drug to achieve the same high.


Tolerance quickly turns to dependence - The point at which the addict feels as if they cannot even function normally without the drug in their system. Dependence signals a restructuring of the brain and introduces withdrawal symptoms when the addict tries to stop taking the drug.


The full-blown disease of addiction occurs when the addict can no longer regulate their intake of the drug, despite experiencing negative consequences (e.g. health, relationship, or job problems). At this point, professional support is required to help the addict break free of addiction and begin to heal.

Cocaine Side Effects

Short-Term Effects

During the high, and shortly thereafter, the user may experience a number of effects in addition to the sensations that accompany the high.

  • Restlessness
  • Irritability
  • Anxiety
  • Paranoia
  • Exhaustion (From binging)
  • Elevated blood pressure and heart rate
  • Dilated pupils
  • Insomnia
  • Loss of appetite
  • Sweating
  • Muscle weakness
  • Nausea
  • Feeling very hot or cold
  • Abdominal pain
  • Risk-taking behavior (e.g. Sexual promiscuity)

As tolerance to cocaine develops, addicts often become accustomed to these temporary effects of the drug, and may even consider them a positive part of their experience because they accompany the pleasurable sensations of the high. However, these effects tend to fade after the high wears off.

Long-Term Side Effects

If an user consumes cocaine regularly, they will experience a range of very serious long-term consequences that impact both their minds and their bodies.

  • Sensitization (Less cocaine is needed to generate dangerous side effects such as seizures)
  • Convulsions
  • Heart attack
  • Stroke
  • Psychosis
  • Loss of smell
  • Nosebleeds
  • Swallowing problems
  • Nasal irritation
  • Chronically runny nose
  • Track marks
  • Infectious diseases such as hepatitis C and HIV
  • Allergic reactions (To the cocaine or substances mixed with the cocaine)
  • Heart inflammation
  • Aortic ruptures
  • Brain bleeds
  • Parkinson's disease
  • Cognitive impairment
  • Impulsivity
  • Hallucinations
  • Motor function deterioration
  • Ulcers
  • Skin infections
  • Bowel gangrene (Tissue death)
  • Kidney damage
  • Suppressed immune system
  • Death

The side effects a person experiences may be impacted by how they ingest the cocaine. For example, infectious diseases often occur as a result of using dirty needles, while nasal irritation and loss of smell occur when an user snorts cocaine over a long period of time. While the specific side effects an user may experience vary, one thing is certain: Prolonged use of cocaine will lead to serious short and long-term consequences for the addict.

Cocaine Overdose

Cocaine Overdose Defined

One of the most serious side effects of cocaine use is overdose. Overdose occurs when the addict consumes too much cocaine at one time. This could be because the product they purchased was much more pure than they expected, from mixing multiple drugs, or from other accidental means. For example, mixing heroin with cocaine increases the addict's chances of experiencing an overdose and death. Overdose often causes death by causing a seizure or heart attack, and can occur very quickly.

Signs of Cocaine Overdose

A cocaine overdose may initially mimic the signs of a cocaine high. However, the signs of an overdose quickly exceed what is expected from a high. They can include any of the following:

  • Extreme agitation
  • Hallucinations
  • Fever and sweating
  • Elevated heart rate
  • Chest pain
  • Delirium
  • Panic
  • Seizures
  • Breathing difficulties
  • Tremors
  • Nausea and vomiting
  • Stroke
  • Heart arrhythmias
  • Signs of an overdose mean that the individual requires immediate medical assistance.
  • Cocaine Withdrawal
  • Withdrawal refers to the set of symptoms a drug user experiences when the drug is leaving their body. Typically intense and potentially dangerous, withdrawal from cocaine is typically also short - About 7-10 days. Symptoms of withdrawal can include any of the following:
  • Depression
  • Difficulty concentrating
  • Slowed thinking
  • Exhaustion
  • Tremors
  • Nerve pain
  • Anxiety
  • Restlessness
  • Muscle aches
  • Intense drug cravings
  • Inability to experience sexual arousal
  • Nightmares
  • Chills
  • Anhedonia, or the inability to feel pleasure
  • Suicidal thoughts or actions

Signs and Symptoms of Cocaine Abuse

Because of the illicit nature of cocaine use, most individuals who abuse this drug will try to hide it from their loved ones. However, there are telltale signs of abuse, and over time, these signs may become more and more evident as the loved one spirals into full-blown addiction.

  • Physical Signs:
  • Burned fingers or lips from smoking
  • Dilated pupils
  • Runny nose or nosebleeds
  • Track marks
  • Sudden weight loss
  • Poor personal hygiene
  • Muscle twitches
  • Exhaustion
  • Alertness
  • Excess energy
  • Rapid heart rate
  • Behavioral Signs:
  • Change in sleeping habits
  • Change in eating habits
  • Agitation
  • Apathy
  • Argumentativeness
  • Major changes in self-confidence
  • Lack of concentration
  • Mood changes
  • Excitability
  • Social isolation
  • Talkativeness
  • Poor judgment
  • Fast speech
  • Increase in desire for privacy
  • Restlessness
  • Hyperactivity
  • Risk taking
  • Skipping school or work
  • Financial problems
  • Psychological:
  • Delusions
  • Euphoria
  • Hallucinations
  • Paranoia
  • Depression
  • Mood changes
  • Irritability
  • Loss of interest in activities once enjoyed
  • Paraphernalia:
  • Glass, plastic, or metal straws
  • Mirrors
  • Powdery residue
  • Razor blades
  • Small spoons
  • Tightly rolled up money bills

Treatment For Cocaine Addiction

Individuals who are addicted to cocaine are suffering from a disease that requires professional treatment to manage. With the structure of the brain fundamentally altered, the only way forward requires support and treatment.

Professional treatment for heroin addiction usually involves the following three steps: Detox, treatment, and aftercare.


Detox is the process of supervising the addict's withdrawal. Provided in a facility with medical professionals and a therapist, detox provides support to alleviate the symptoms of withdrawal, keep the addict safe, and ensure that they avoid relapse.


After detox, the patient enters comprehensive treatment. For many cocaine addicts, inpatient treatment is most effective because it provides residential care and structured support. The type of treatment the patient receives depends upon the treatment facility and the patient's needs, but can include any of the following:

  • Cognitive behavioral therapy
  • Group therapy
  • Individual therapy
  • Family therapy
  • Medication
  • Holistic treatment (e.g. Yoga or massage)
  • Exercise and nutrition
  • Aftercare

After treatment, the patient and team will set up a plan for ensuring that the addict can successfully continue their recovery. This treatment can include any of the following:

  • A stay at a sober living facility
  • Outpatient rehab programs
  • Ongoing counseling
  • Ongoing medication
  • 12-step programs

If you suspect that a loved one, or if you yourself, are suffering from cocaine addiction, rsearch your options for qualified rehab in your area. The right treatment can put recovery and a fulfilling life within reach.


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