How to Recognize Cocaine Addiction

Cocaine, also referred to as “coke” or “blow,” is the third most deadly illicit drug, with fatal overdoses increasing since 2012. According to the National Survey on Drug Use and Health, 5.2 million Americans used cocaine in 2020. Because the drug alters the brain by increasing dopamine levels to a high that many keep chasing, cocaine use can quickly progress into addiction.

Recognizing the signs of cocaine use can help you assist those who are dependent on the drug and give you the context you need to understand their addiction.

Why Do People Use Cocaine?

Cocaine quickly initiates a euphoric feeling, giving users a high that can hit within five minutes and last for up to half an hour. Dopamine levels rise during use because cocaine locks this “feel good” chemical in place. As dopamine builds up, the brain’s synapses fire off pleasure signals. This effect on the brain’s reward system can influence some users to become addicted. The most common way to take cocaine is to snort it so the effects of the drug last longer than smoking or injecting it.

With continued cocaine use, the brain desensitizes itself, and over time, it takes more cocaine to produce enough dopamine for a high. This leads many to increase cocaine consumption to counteract their decreased sensitivity. Even without taking cocaine for a long period, a user can still maintain a high tolerance, and upon relapsing, need large quantities to feel euphoric.

Cocaine use includes reports of crack cocaine, which is a rock that forms out of powdered cocaine. When crack cocaine is developed, the process leads to more products for a cheaper price that offers an intense high within seconds. The potency of crack cocaine leads many to experience a powerful addiction.

Short-Term Side Effects of Cocaine Use

The effects of cocaine start almost immediately after consumption and typically last up to half an hour. Some of the side effects of cocaine use will be immediate, such as:

• A sudden burst of energy
• Hypersensitivity
• Dilated pupils
• Increased body temperature
• Higher heart rate
• Tremors
• Vertigo
• Anxiety or paranoia
• Irritability

Due to the high that cocaine produces lasting a relatively short time, individuals are likely to use several doses to elongate their high. Highs are typically followed by a low, often called a crash or a comedown.

Long-Term Side Effects of Cocaine Use

Long-term cocaine misuse takes a toll on the individual’s physical, mental, and emotional health and can lead to cocaine addiction. Symptoms of prolonged use include:

• Irritability
• Panic attacks
• Angina
• Psychosis
• Tachycardia
• Permanently increased blood pressure
• Blot clots that may lead to heart attack, stroke, or pulmonary embolism
• Cerebral atrophy
• Seizures
• Tremors and difficult mobility

Signs of Cocaine Withdrawal

While withdrawing from cocaine is typically not life-threatening, the withdrawal process can be very painful, taxing, and dangerous. The onset of withdrawal can vary depending on how much and how often the user consumes the drug. For long-term users, cocaine withdrawal often occurs in three stages.

The First 24 Hours

Within 24 hours of using, individuals will experience a crash. Symptoms include:

• Depressed mood
• Irritability
• Anhedonia
• Fatigue
• Confusion
• Anxiety
• Insomnia or hypersomnia
• Suicidal ideation

The First Week

Within a week of the individual’s last use, they will begin experiencing acute withdrawal symptoms. A medical provider may suggest that an individual detoxes under supervision if their symptoms are severe. The symptoms listed below can last anywhere from a few days to several weeks.

• Fatigue
• Anhedonia
• Sleep disturbances
• Increased appetite
• Irritability
• Seizures
• Slow physical movement
• Changing moods
• Cravings
• Paranoia
• Depression and/or suicidal ideation

Months Later

In long-term users, post-acute withdrawal symptoms can be felt several months after their last use. Symptoms include low mood and cocaine cravings.

Identifying Cocaine Paraphernalia

While discovering white powder buildup, syringes, or glass pipes can be an evident indication of cocaine use, other drug paraphernalia can often be made up of everyday items hiding in plain sight. Some of these items include a small mirror (used as a flat surface for snorting cocaine) or Use your best judgment. Rolled-up dollar bills, shortened straws, or paper or metal tubes can be used to snort the powder. Know that if something seems off, it most likely is.

What a Cocaine Overdose Looks Like

Because of cocaine’s short-lived euphoric state, many users begin to use more frequently or take higher doses, placing themselves at risk of overdosing. Others mix cocaine with alcohol or heroin  (called “speedballing”). When a stimulant like cocaine is mixed with a depressant like alcohol, the two substances create a push-and-pull effect on the body. This places extreme strain on major organs and can cause dangerous side effects.

In recent years, fentanyl—a powerful synthetic opioid—has also played a role in the increased number of cocaine overdoses. This is due to users unknowingly taking cocaine laced with fentanyl, which, in even the smallest of quantities, can cause lethal reactions. Recognizing an overdose and getting immediate medical attention can be the difference between life and death.

These are some common cocaine overdose signs to look out for:

• Increased sweating
• Chest pain
• Difficulty breathing
• Blue skin
• Seizures
• Tremors
• Paranoia
• Agitation
• Hallucinations
• Disorientation

If you suspect that your loved one is experiencing a cocaine overdose, call 911 immediately. While waiting for help to arrive, try to keep the individual’s body temperature at a normal level by applying a cold compress. If they are having a seizure, move any objects away from them and place them on their side to keep their airway clear. Do not hold them down. If you know that the individual has also taken opioids, administer Narcan, a medication designed to reverse the effects of an opioid overdose.

How to Help Someone With a Cocaine Addiction

Convincing your loved one to seek treatment can be a challenging endeavor. However, their health and safety is at risk due to cocaine use. If your loved one is resistant to treatment, you can help them discover the full spectrum of care that is available for substance use disorder. By showing your loved one the extent of care that they can receive, not just from others but from yourself, you will make a big difference in their lives.