Cocaine Addiction

Written by Thomas Christiansen

& Medically Reviewed by Dr. Annie Tye, PhD

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Last Updated - 12/28/2022

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Updated 12/28/2022

Key Takeaways

  • Cocaine is a powerfully addictive drug that causes physiological changes in the brain and the body
  • Common signs of cocaine addiction include dilated pupils, high energy levels, restlessness, irritability, paranoia, frequent sniffling or nosebleeds, anxiety, insomnia and loss of appetite
  • Cocaine use is rising in the United States
  • Treating of cocaine addiction is possible
  • A cocaine overdose is a medical emergency. If an overdose is suspected, call 911 immediately.

Learn about cocaine addiction and how it can develop so quickly. Find out how to identify the signs and symptoms of cocaine abuse.

Cocaine use in the United States has steadily increased since 2013. Deaths from cocaine use increased similarly due in part to the presence of fentanyl and other lethal drugs being cut into cocaine. These studies indicate that a dangerous trend of cocaine abuse has formed. Learning about cocaine addiction and how the drug affects people is key to understanding how addiction can cause someone to mix deadly substances into their cocaine.

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How is Cocaine Abused?

People abuse cocaine to get high. Although cocaine was used in the early 20th century as an anesthetic, it is now largely a street-level drug. The Drug Enforcement Administration classifies cocaine as a Schedule II substance, meaning that it has some medical value but also has a high-risk level for leading to drug abuse. Cocaine is prepared as a fine, white powder. Further processing can produce crack cocaine, which is a light brown crystal. Snorting cocaine, smoking cocaine and injecting cocaine are common routes of use.

Cocaine Addiction Symptoms

Cocaine is a highly addictive drug that causes chemical and structural changes in the brain. Some of those changes require that a person consistently increase the amount of cocaine used to achieve the original high. The continued influx of cocaine can generate telltale signs of cocaine use. Some cocaine addiction symptoms are well-known like dilated pupils and high energy levels. Other cocaine abuse symptoms may include restlessness, anxiety and paranoia. Because of the addictive nature of cocaine, people struggling with cocaine abuse frequently have drug paraphernalia around.

Cocaine Paraphernalia

Paraphernalia associated with powder cocaine includes razor blades (used to chop pressed cocaine into a snortable powder), short straws, hollowed pens or rolled-up dollar bills, “bullets” (small cylindrical devices that deliver precise amounts to the user), and flat, non-porous surfaces (like a mirror) that are scratched or have residue on them. Needles and syringes may indicate intravenous or intramuscular cocaine use.

Crack cocaine must be heated and smoked, so the paraphernalia needed for smoking cocaine is different from what’s needed to snort or inject cocaine. Readily available materials that can be used to smoke crack include light bulbs, aluminum cans, tin foil or spoons. After use, these materials will have burn marks and yellowish residue.

Physical Signs

Physical signs of cocaine abuse include dilated pupils, trembling or twitching, a bloody nose, headaches, stomach aches, rapid pulse or elevated body temperature. Additionally, cocaine is physically addictive, and the physical side effects of addiction can develop over time. There is no safe amount or route of cocaine use. Addictive behaviors may develop after a single use.

Behavioral Signs

Behavioral changes that may indicate cocaine use include high energy levels, short attention span, rapid speech, anxiety, mood swings, insomnia, paranoia, euphoria or elevated self-confidence. People will likely spend more time around others who use or have access to cocaine. They may neglect life responsibilities while pursuing access to cocaine

Side Effects of Cocaine Use

Even moderate cocaine use can cause substantial short- and long-term changes in the brain and body of the user. Learning about the side effects of cocaine addiction can be used to identify and help someone who is using cocaine.

Short-Term Effects

Common, short-term effects of cocaine use include altered mood and exaggerated mood swings, paranoia, weight loss, loss of appetite, trembling, frequent sniffling, nose bleeds, altered sleep patterns, restlessness, agitation and extreme changes in energy levels. Short-term effects of cocaine often last longer than the high cocaine causes. Large amounts of cocaine can lead to erratic or violent behavior, hallucinations, heart attack or seizure.

Long-Term Effects

Among the most significant ways that cocaine exerts its effect is by altering dopamine and glutamate neurotransmitter levels in the brain. These neurotransmitters play vital roles in establishing and maintaining brain structure and function (functional connectivity). Long-term effects of cocaine use are associated with altered neural pathways and structural integrity in the brain, primarily resulting in obsessive drug-seeking behavior, loss of interest/anhedonia, seizures, heart attack, reduced impulse inhibition or attention levels and a reduced ability to perform motor tasks. These long-term effects of cocaine are consequential if a person is in recovery because cocaine use is self-reinforcing, so even a single lapse can reignite the perceived need for cocaine.

Side Effects of Polysubstance Abuse

Cocaine is often abused alongside other substances. Cocaine is often abused with opioidsamphetaminesalcoholXanaxheroin and marijuana. Cocaine users may use other drugs to temper the negative physical and psychological effects of cocaine, or they may seek ways to enhance the high that they get from cocaine.

Side effects of polysubstance abuse vary depending on the combination of drugs, the amounts used and the timing of use (e.g., simultaneous versus concurrent). Common signs of polysubstance abuse are similar to those of cocaine abuse and include a loss of interest in hobbies or social activities, interrupted work schedules, the avoidance of responsibilities, drug-seeking behavior and loss of control of physical and mental capacities.

What Causes Cocaine Addiction?

Causes of cocaine addiction include physical and chemical alterations in the brain. These changes occur rapidly and can have long-lasting consequences. Cocaine use leads to elevated levels of dopamine, a neurotransmitter that is responsible for pleasurable responses to external stimuli (the “reward circuit”) and can cause regional changes in the amount of the neurotransmitter glutamate, which establishes and maintains functional connectivity between different regions of the brain.

Cocaine is a self-reinforcing drug, meaning that its use causes people to want to use more of it. To receive the pleasurable sensation that cocaine delivers, a user must continuously increase the amount of cocaine they use

Cocaine Withdrawal Symptoms

Cocaine withdrawal symptoms are common even after minimal cocaine use. Signs of cocaine withdrawal include exhaustion, irritability/anxiety, depression, increased appetite and cravings for more cocaine. Heavy users may experience withdrawal symptoms for weeks after cessation.

Cocaine Abuse Facts and Statistics

Cocaine facts and statistics in the United States show that cocaine use has grown steadily in the past several years. According to the 2016 National Survey on Drug Use and Health, 1.9% of Americans 11-years old and older used cocaine within the past year. Within this time, death due to cocaine use increased precipitously, likely because of the inclusion of opioids in cocaine.

Interesting facts about cocaine use include gender and age differences that have been noted. This data can be examined to gain an understanding of broader differences in use patterns among Americans, including how many teens use cocaine:

  • Prevalence in Men: 2.5%
  • Prevalence in Women: 1.3%
  • Prevalence in Teens: 0.7%

Signs of cocaine use in men are similar to those exhibited by women using cocaine and include hyperactivity, dilated pupils, elevated heart rate, elevated body temperature, anxiety, restlessness and altered sleep patterns.

Teen cocaine use is often noted by parents who notice sudden behavioral changes (irritability, a sense of withdrawing from the family, restlessness, anxiety/paranoia) within their teenage son or daughter that’s not inline with typical adolescent behavior.

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Cocaine Abuse and Treatment Trends in South Florida

Cocaine abuse in South Florida is increasing compared to the rest of the state and country. Treatment patterns show a similar increase in individuals seeking treatment for cocaine use disorder. The death rate due to a cocaine overdose in Florida ranks in the top 10 states in the country. However, the pattern of cocaine use among teens in South Florida is not significantly different from the rest of the country.

Cocaine Overdose

Deaths due to cocaine overdose increased at a startling rate between 2015 and 2016.

cocaine overdose is deadly. Cocaine overdose symptoms include stroke, seizure or heart attack. The current trend of  “cutting” cocaine with other drugs further increased the potential lethality associated with even a single dose of cocaine. Cocaine overdose is a medical emergency that must be treated immediately. If you observe signs of a cocaine overdose, it is imperative that you call 911.

Cocaine overdose treatment can be started before medical professionals arrive on the scene. Keeping the patient calm will help to stabilize blood pressure and providing ice packs can prevent dangerous overheating. Medical professionals may elect to administer benzodiazepines or sedatives to keep the patient calm.

Cocaine Addiction Treatment

Cocaine addiction treatment methods commonly rely on behavioral modification, for example, cognitive-behavioral therapy. Although there are no FDA-approved pharmacological interventions, research is being carried out to evaluate promising candidate drugs that aim to interrupt the cycle of addiction.


Interventions refer to carefully planned, non-confrontational meetings between an individual struggling with addiction and their family and friends who are concerned about the individual’s drug use. Some interventions are mediated by professional interventionists. Spontaneous or poorly planned interventions can worsen the situation. If someone feels attacked or isolated by their loved ones, they may turn to cocaine or another drug for a sense of comfort and familiarity.

Cocaine Addiction Treatment Options

Common cocaine abuse treatment strategies follow a routine that may include a period of medically assisted detoxification (detox) and residential (inpatient) care, followed by outpatient treatment and aftercare. Most residential rehabilitation facilities can supervise the cocaine detox period. Treatment options typically include:

  • Medically assisted detoxification: Immediately after cocaine cessation, physical withdrawal symptoms can cause significant discomfort. Medical professionals may opt to treat someone undergoing detox with pharmacological agents that can ease the discomfort. How to detox from cocaine varies between individuals and depends on the duration and amounts used.
  • Residential: A key feature of residential cocaine rehab is 24/7 supervision and access to medical professionals and therapists who are trained to provide tools to those in recovery.
  • Outpatient: Outpatient treatment can range from daily treatment to weekly or bi-weekly individual or group therapy sessions. Outpatient is generally more flexible than residential treatment.
  • Teletherapy: Partial Hospitalization (PHP), Intensive Outpatient (IOP) and Outpatient levels of care normally qualify for online substance abuse treatment.
  • Dual Diagnosis: Mental health disorders often co-occur alongside addiction. Addressing both disorders simultaneously is the key to successful treatment.

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