Cocaine psychosis is one of the dangerous side effects of using the drug. Cocaine is a commonly used drug that produces feelings of euphoria, increased energy and a false sense of well-being.

Using drugs like cocaine changes how the brain communicates with the rest of the body.  Psychosis can develop from long-term cocaine use, psychosis is a symptom of several mental health conditions and can produce hallucinations and delusions.

woman with hands on head
Cocaine affects people in a variety of ways. While some people may find that using cocaine allows them to feel happier and sociable, other people feel the effects of paranoia or symptoms similar to schizophrenia.

After using cocaine, people may experience a “crash” after the high diminishes. The effects of a cocaine high may last for up to an hour. As the cocaine high wears off, dopamine levels typically go back down and lead to a deficiency in the neurotransmitter, which can cause conditions like depression and anxiety. When someone uses cocaine for an extended period, a condition referred to as cocaine-induced psychosis can occur.

Cocaine-induced psychosis lasts anywhere from a few hours to as long as days or weeks. More than half of the people who have used cocaine reported that they experienced cocaine psychosis symptoms after using cocaine. The more someone uses cocaine, the more severe the symptoms of cocaine psychosis can become over time. Researchers suggest that cocaine-induced psychosis is a result of a deficiency of dopamine.

The symptoms of cocaine-induced paranoia can resemble the symptoms of a mental health disorder like bipolar disorder and schizophrenia. Some common symptoms of cocaine-induced psychosis include:

  • Paranoia
  • Anxiety
  • Delusions
  • Violence
  • Anger
  • Hallucinations
  • Delirium
  • Suicidal or homicidal thoughts
  • Disorganized thoughts
Cocaine Paranoia is a primary symptom of cocaine-induced psychosis. According to a study by Satel S, Southwick SM and Gawin FH., over half of the people who have used cocaine reported that experienced paranoia following use. Before the onset of cocaine paranoia, people may develop suspiciousness, which is a precursor of paranoia. Cocaine paranoia can cause someone to act aggressively or violent toward other people.
When someone uses a large amount of cocaine over an extended period they may experience hallucinations. Hallucinations may cause someone to be paranoid and delusional and could prevent them from managing real dangers. Hallucinations may cause someone to ignore environmental signs like traffic lights because they are instead focusing on something that isn’t real.
Another primary symptom of cocaine psychosis is cocaine delusions. Someone may experience different types of delusions including:

  • Identity delusions – Someone experiencing an identity delusion may not know who they are or think that they are someone they’re not.
  • Possession delusions – A possession delusion may involve someone thinking they own things they do not, like houses and cars.
  • Grandiose delusions – Someone who has grandiose delusions can have over-inflated self-esteem, power, knowledge or identity.
  • Imposter delusions – Imposter delusions are when someone is suspicious of the true identity of family members, friends or other people.
Because cocaine affects dopamine, there are several risk factors for someone developing cocaine-induced psychosis. Researchers found that studying these factors could provide answers for why psychotic symptoms emerge following substance use. The risk factors of cocaine psychosis may include:

  • The individual’s age
  • Duration of use
  • Gender
  • How the drug is taken
  • Dosage
  • Genetic factors
  • Body mass index
The first step for treating cocaine-induced psychosis is detox in a hospital or a rehab facility that offers medical detox. It’s important the patient stops their cocaine use so that the psychosis can be treated as well. Once detoxification is complete, the patient can either inpatient or outpatient treatment depending on the severity of their addiction. In both programs, the patient will likely engage in therapy and could be prescribed medication for their psychosis.

The type of therapy that the patient receives is determined by the patient’s:

  • Mental health disorder
  • Overall health
  • Recovery goals
  • Potential threats to sobriety

In addition to treating the patient’s cocaine addiction, treatment providers can address their psychosis as well. Clinicians may feel that the patient needs to take medication to help manage their psychosis symptoms. Some of the medications prescribed for psychosis treatment include:

Treatment providers may not consider using some anti-anxiety medications like benzodiazepines because of the high risk of addiction.

If you believe you or a loved one has a cocaine use disorder, take The Recovery Village Assessment to take the first step.

Some relevant facts to remember about Cocaine-induced psychosis includes:

  • Cocaine-induced psychosis is a temporary onset of psychosis due to cocaine use
  • Cocaine-induced psychosis can last for a few hours and the severity can depend on the person and the extent of use
  • Heavy cocaine use can lead to long-lasting symptoms like paranoia, that persists for months.
  • One of the most severe risks of cocaine-induced psychosis is harming oneself or the people around you
  • It’s important to treat cocaine use and psychosis at the same time to avoid setbacks

If you or someone you know struggles with cocaine use and psychosis, help is available. At The Recovery Village, a team of professionals can design an individualized treatment program to suit your specific conditions. Call and speak with a representative to learn more about which program could work for you.

Alexander Morton W., Pharm.D. “Cocaine and Psychiatric Symptoms”., August 1999. November 30th, 2018.

Roncero, Carlos.,Ros-Cucurull Elena.,Daigre Constanza.,Casas Miguel. “Prevalence and Risk Fcators of Psychotic Symptoms in Cocaine-Dependent Patients”., 2012. November 30th, 2018.

Satel SL1, Southwick SM, Gawin FH. “ Clinical Features of Cocaine-Induced Paranoia”., April 1991. November 30th, 2018.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.

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