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Jessica Pyhtila, PharmD

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This medical web page has been reviewed and validated by a health professional. The information has been screened and edited by health professionals to contain objective information on diagnosis and treatment of diseases. Contains bibliographic reference sources. If you are a healthcare professional and you find any issue, please reach out to [email protected]
Updated on 09/30/21

Cocaine is a highly addictive and commonly abused stimulant drug that can be fatal in some cases. About 2 million Americans used cocaine in 2019.

Unlike some other illicit substances, cocaine is not always considered an illegal drug in the United States. Cocaine has a few medical uses in specific medical situations, primarily in controlling surgery-related nosebleeds. However, cocaine misuse outside of these controlled settings quickly leads to a cocaine addiction for most people.

Article at a Glance:

  • Cocaine is an addictive stimulant drug.
  • Cocaine side effects are lengthy, dangerous, and potentially deadly.
  • Cocaine addiction can be both physical and psychological.
  • Treatment is available for those who struggle with cocaine.

What Is Cocaine?

Cocaine is a stimulant drug derived from coca plant leaves. It enhances the effects of a brain chemical called dopamine, leading to a sense of increased energy and power. The increased impact of dopamine also causes the euphoric and pleasurable sensation of a “high” on cocaine.

People who hear about the effects of cocaine may wonder, “Is cocaine bad for you? If it makes you feel good and have more energy, what’s wrong with that?” These are good questions: the answer is that by overstimulating your body, cocaine puts too much strain on your system. Your body works as at an increased rate, which can cause side effects, including:

  • Alertness
  • Excitation
  • Restlessness
  • Irritability
  • Anxiety
  • Paranoia
  • Irregular heartbeat
  • Heart attack
  • Sudden cardiac arrest
  • Seizures
  • Stroke
  • Death

RELATED: Learn more about commonly abused stimulants.

Common Cocaine Nicknames and Street Names

There are several common nicknames and street names for cocaine. Many of these names are based on the white, flaky appearance of cocaine. These names may include:

  • Bernice
  • Blow
  • Bump
  • Coke
  • Crack
  • Dust
  • Flake
  • Line
  • Nose Candy
  • Rail
  • Rock
  • Schneef
  • Sneeze
  • Sniff
  • Snow
  • Snow White
  • Toot
  • White
  • Yayo

Related Topic: Street Names for Drugs

Cocaine Addiction Potential & Abuse

Cocaine abuse and addiction are similar concepts, but they have some important differences. Cocaine abuse occurs when a person recreationally uses cocaine, often with the intention of getting high. A person who abuses cocaine is not automatically considered addicted to the drug, although they are at risk for addiction.

Statistics show that around 25% of those who start using cocaine recreationally will develop an addiction to cocaine. Addiction occurs when a person continues to use cocaine despite ongoing negative consequences. These consequences can take different forms and may be mental, physical, interpersonal or even legal problems.

Cocaine abuse can develop into addiction with repeated use. Cocaine is a short-acting drug that starts to cause a high within seconds. After the high wears off, a person will often crash and feel sluggish. Frequently, people will have an urge to use more cocaine after this crash is over, leading to a cycle of “binge and crash” that can lead to addiction.

Cocaine addiction includes both physical and psychological components. Recognizing that cocaine addiction is complex and includes a physical and a mental component is key to understanding the addiction process.

Physical Addiction to Cocaine

Physically, cocaine is addicting because of an effect called dependence. As the brain and body become adjusted to the chemical changes that cocaine causes, they start needing cocaine to continue functioning normally. This need can lead to withdrawal symptoms when cocaine use stops. The body needs cocaine to continue normal functioning, so it creates cravings for cocaine that many people find irresistible.

Psychological Addiction to Cocaine

Psychological addiction to cocaine occurs when cocaine fulfills a psychological need. For example, the increased energy and stimulation that cocaine causes may make the person using cocaine feel better about interacting in social situations. The high that cocaine creates may help someone overcome feelings of inadequacy or depression. The person then may have an urge to use cocaine because they link it with feeling better about themselves.

Effects of Cocaine Addiction

Because addiction is defined as continued use of a substance despite negative consequences, addiction always carries a harmful downside.

Cocaine addiction can cause several negative effects that ripple through a person’s life. Some of these effects are physical, including insomnia, feeling shaky, poor memory and even death. Other effects of cocaine addiction are indirect but still harm a person’s quality of life, like a negative impact on your social life, career and loved ones.

Some cocaine addiction effects will become obvious right away, while others may take longer to become noticeable.

Short-Term Effects

Even in the short term, a struggle with cocaine can have obvious negative consequences on your life. These include both the drug’s physical side effects and changes in your behavior.

Some of these short-term side effects are:

  • Loss of interest in things that once gave pleasure
  • Mood changes
  • Hygiene problems
  • Low mood
  • Sleep problems
  • Interpersonal problems
  • Problems with work, school or the law

Long-Term Effects

Over the long term, the effects of a cocaine addiction can become even more pronounced, reflecting the toll that cocaine abuse can take on the body. People who snort cocaine can develop nasal problems like loss of smell and nasal damage, while those who smoke cocaine can develop lung disease. Bleeding in the brain and neuromuscular diseases like Parkinson’s Disease can also occur with long-term cocaine abuse. The brain often becomes desensitized to feel-good stimuli, a change that can lead to a decrease in mood and make it harder to feel happy.

When the body becomes used to the presence of cocaine, a phenomenon called tolerance, higher and more frequent doses may be needed to achieve previous results. Higher doses are more toxic than lower doses, so a person may be more likely to have side effects like seizures after a dose.

Cocaine and Other Drugs

Cocaine is often mixed with other drugs before use. It is sometimes smoked along with marijuana or injected with opioids like heroin, a practice known as “speedballing.”

Mixing cocaine and other substances can be dangerous because your overdose risk increases when you take multiple substances together. Many substances also interact with each other to create additional negative symptoms.

Illicit street drugs often also contain unknown ingredients or are cut with other drugs. People using street drugs can inadvertently take an unintended drug if they are not told what is in their cocaine or they begin mixing substances together.

Cocaine Overdose

Cocaine overdose can occur when you take high doses of cocaine, impacting multiple organs in the body. A cocaine overdose is considered a medical emergency and can be fatal.

Symptoms of a cocaine overdose include:

  • Loss of urine control
  • High body temperature
  • Severe sweating
  • High blood pressure
  • Very fast heart rate or irregular heartbeat
  • Bluish skin
  • Fast breathing
  • Seizures
  • Unconsciousness
  • Death

Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone contact Web Poison Control Services for online assistance.

Factors That Influence Cocaine Addiction Potential

Multiple risk factors determine how likely a person is to become addicted to a drug like cocaine. Although risk factors do not guarantee that a person will become addicted to cocaine, they increase overall risk.

These risk factors include:

  • Environmental risk factors like community crime and unemployment
  • Minority status risk factors like discrimination and generational assimilation
  • Family risk factors like parental cocaine abuse and parental neglect
  • Constitutional risk factors like physical or learning disabilities
  • Behavioral risk factors like low self-esteem and delinquency

Cocaine Addiction Rates and Statistics

Approximately 2% of Americans used cocaine at least once in 2019. This includes the 0.3% of Americans who used crack cocaine that year. Overall, around 1,800 Americans per day tried cocaine for the first time in 2019.

Cocaine use may be more common among youth than previously thought: According to the National Institute on Drug Abuse, as of 2020, more than 4% of 12th graders had tried cocaine at least once, with 1.6% having tried crack cocaine.

How Is Cocaine Abuse Diagnosed?

Cocaine abuse must be diagnosed by a licensed doctor who will consider a variety of individual factors. Ultimately, the doctor will likely use several criteria out of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) to evaluate if you have a cocaine addiction. Typically, diagnosis depends on having at least two of the following criteria:

  • Hazardous cocaine use
  • Social or interpersonal problems related to cocaine use
  • Neglected major responsibilities to use cocaine
  • Experiencing withdrawal symptoms
  • Developing a tolerance
  • Using larger amounts
  • Repeated attempts to quit or control cocaine use
  • Excessive time spent using cocaine
  • Physical or psychological problems related to cocaine use
  • Activities replaced by cocaine use
  • Cravings

Everyone’s addiction is unique, and it ultimately requires individual assessment by a doctor to diagnose someone with cocaine addiction.

Cocaine Addiction Treatment Approaches & Options

It can be easy to feel overwhelmed if you realize that you or a loved one struggles with cocaine. Fortunately, help is here. Cocaine addiction treatment is available and can help you quit cocaine and begin a cocaine-free life. Addiction support begins with cocaine detox and withdrawal management and continues through rehab and aftercare.

Cocaine Detox & Withdrawal Management

Cocaine abuse treatment typically starts with an initial detox. During detox, cocaine is cleared from the body, and a healthcare professional manages the symptoms of withdrawal to keep you as comfortable as possible.

As the drug leaves your system, treatment shifts to developing coping mechanisms that help maintain continuous sobriety. This shift can involve medications and therapies.

Inpatient, Residential and Outpatient Cocaine Rehab

After detox is complete, the hard work of rehab can begin. Rehab focuses on helping you explore why you began to rely on cocaine in the first place and develop coping strategies that can help protect you against further cocaine use.

Rehab can take place in both inpatient and outpatient settings. Sometimes, inpatient rehab is longer-lasting and takes place in a home-like environment, a rehab setting known as residential rehab. In other cases, a person may benefit from outpatient rehab, living at home or at a sober living center and coming to the rehab facility for therapy sessions.

Your addiction counselors can help guide you towards the rehab setting that is most appropriate for your needs.

Cognitive-Behavioral Therapy

During rehab, a commonly used therapy that many find helpful is cognitive-behavioral therapy (CBT). This type of therapy involves learning about the underlying motivations behind our behaviors. By learning how to change our motivations, our behaviors can change. Long-term treatment will involve a follow-up to ensure that sobriety is maintained.

Contingency Management

Contingency management is a motivational treatment strategy used in rehab that has been successful in helping people stay sober from cocaine. For example, one technique involves the use of vouchers for monetary value that you can receive for every cocaine-free urine sample.

Therapeutic Communities

Therapeutic communities are long-term residential treatment facilities used during the rehab process. They support a comprehensive approach to recovery, addressing a person’s mental, physical and health needs as they recover from addiction. While some therapeutic communities support inpatient rehab, others support outpatient rehab or a mixed approach.

Cocaine Anonymous

Cocaine Anonymous is a free support group to help cocaine addicts in recovery. It is run by those with a history of cocaine abuse to support others who wish to become sober. It adopts the 12-step program approach of programs like Alcoholics Anonymous to help those struggling with cocaine quit their drug use for good.

Teletherapy and Online Counseling

Counseling does not need to be face-to-face. Online counseling is available where a therapist guides you through the rehab process via video chat. While this may not work for everyone, teletherapy offers flexible scheduling to give you access to licensed professionals at a time and place convenient for you.

Cocaine Addiction Recovery Rates

Recovery rates from cocaine addiction can vary. In a 2010 study, between 60% to 78% of those who attempted to quit using cocaine on their own experienced at least one relapse back to drug use.

Another study showed that 42% of people who’d undergone addiction treatment used cocaine at least once in the year before their five-year checkup, with 25% reporting weekly cocaine use that year. Those who stayed in long-term residential treatment (90 days or more) had better one-year outcomes than those who did not. Other data also support the idea that a rehab stay of at least 90 days is linked to higher success in staying sober.

Cocaine addiction treatment and therapy can improve the odds of maintaining abstinence by as much as 50%. However, even if you relapse back to cocaine use, relapse does not mean failure: it’s a normal part of the treatment journey towards eventual recovery.

Find the Help You or Your Loved One Needs

It can be overwhelming to realize that you or a loved one has a problem with cocaine abuse or addiction. Fortunately, help is here and sobriety is within reach.

If someone you know lives with a cocaine addiction or is using cocaine recreationally and wants to stop, it’s time to seek professional help. The Recovery Village provides care to those struggling with cocaine. Reach out to one of our knowledgeable representatives today to learn how you can start on your path to recovery.

Common Questions about Cocaine Use

  • How long does cocaine stay in your system?

    Cocaine can stay in your system for several hours after you take it for the last time. Cocaine also has an active metabolite called benzoylecgonine, and that takes longer to be expelled from the body completely. It’s usually between one and two days before the metabolite leaves the system.

    A cocaine screen using urine can show drug use for up to two days. Saliva cocaine testing also may show up as long as two days after use. With hair testing, cocaine may show up in hair samples for at least 90 days after someone has used the last dose.

  • Can a cocaine overdose led to cardiac arrest?

    While cardiac arrest is most often linked to cocaine injections, it can occur with snorted or smoked cocaine as well. Heart problems like a cardiac arrest can occur even if you are not a regular user of cocaine. It is possible to go into cardiac arrest the first time that cocaine is used. Heart problems can occur as soon as a few minutes after cocaine use and as late as a few days after use.

  • Can cocaine use led to psychosis?

    Doctors have known for a long time that cocaine can cause changes in a person’s mental status. One of those changes is psychosis, which involves losing touch with reality. Cocaine psychosis is very common. Doctors have found that up to 86% of people who use cocaine may experience psychotic symptoms at some point. About 96% of people with cocaine psychosis will have hallucinations. Hearing the non-existent is the most common kind of hallucination experienced with cocaine. Additionally, about 90% of people with cocaine psychosis experience symptoms of paranoia.

  • Can cocaine cause schizophrenia?

    No, cocaine does not cause schizophrenia. However, cocaine can mimic some of the symptoms of schizophrenia. Also, people with a co-occurring mental illness like schizophrenia are more likely to have a substance use disorder (SUD).

  • How can I tell if someone is on cocaine?

    People using cocaine will show characteristic signs of use. Cocaine use has symptoms that are physical, mental and emotional. Physical signs and symptoms of cocaine use are:

    • Large dilated pupils
    • Headaches and migraines
    • Hoarseness
    • Impotence
    • Increased body temperature
    • Nausea
    • Rapid heartbeat
    • Bloody nose or running nose
    • Sniffing
    • Stomach pain
    • Twitching or shaking

    Cocaine use also has psychological or behavioral side effects. At first, these side effects may be easier to notice than physical side effects. Psychological side effects include:

    • Anxiety
    • Bursts of elevated mood and euphoria
    • Emotional swings
    • Hallucinations
    • High energy levels
    • Hypersomnia (oversleeping)
    • Insomnia (trouble sleeping)
    • Irritability
    • Lethargy and introversion
    • Loss of appetite
    • Paranoia
    • Short attention span

    The presence of drug paraphernalia is a clear indicator of drug use. Cocaine can be ingested in a few different ways, including snorting through the nostrils, injecting or smoking cocaine. Glass or metal pipes, butane lighters, straws or rolled-up paper tubes, razor blades and needles are examples of objects involved with cocaine use.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

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