Cocaine Addiction

Understanding Cocaine

Cocaine is the only known drug to be both a general aesthetic and a central nervous system stimulant. It is one of the oldest known psychoactive substances and is highly addictive. There are several forms that cocaine can take: a powdered form that can be snorted and ingested or a water-soluble base that can be injected into the veins. When injected into the veins, the user feels a more intense and longer lasting high.

“Crack” is a common term for cocaine, but the term only actually refers to cocaine when it is processed into rock crystal form and smoked in a pipe. Cocaine in the past was used as an anesthetic but all medical applications have become obsolete.

According to SAMHSA’s 2014 National Survey on Drug use and Health, around 1.5 million people or 0.6% of the population, use cocaine. It is easy for users to abuse cocaine leading to addiction and overdoses. In 2013, there were 4,944 deaths in the United States as a result of cocaine abuse.

Cocaine produces a high that makes people feel euphoric and speeds up the whole body. A rush of happiness and excitement occur almost immediately and most often only last 15 to 20 minutes before the high begins to wear off. Some people crash after a high, experiencing feelings of sadness and exhaustion that can last days.

Cocaine Health Effects and Abuse

In 2014, an estimated 913,000 people ages 12 and older had a stimulant use disorder because of cocaine use.
To understand the effect that cocaine and other drugs have on the brain, it is important to understand how the brain works. The midbrain is the part of the brain responsible for releasing reward signals when people have pleasurable experiences. Dopamine (a brain chemical) is released from neurons during these experiences and jumps to receptors attached to other neurons. Once there dopamine releases pleasure signals and is recycled away.

When cocaine enters the brain it blocks the removal of dopamine from the neurons causing a buildup of dopamine. This buildup is responsible for the prolonged and heightened feelings that are associated with a cocaine “high”.

Cocaine can be abused through the nose, veins, and smoked into the lungs. It can also be rubbed into mucous tissue like the gums. Injecting cocaine intravenously and smoking it both deliver the drug directly into to the bloodstream leading to a quicker and longer lasting effects.

Addiction to Cocaine

Cocaine changes brain chemistry resulting in addiction after only a few uses. Cocaine has a high risk of abuse and dependency which is why it is classified so dangerously by the federal government.
There are physical and mental signs of addiction to cocaine. Other than the initial rush and the high that follows, you may be able to identify a user by symptoms that appear as:

  • Dilated pupils
  • Increased body temperature, heart rate and blood pressure
  • Bizarre and erratic behavior
  • Increased Anxiety

Ingesting cocaine can cause negative physical reactions in the body. Some of these include:

  • Sick feelings: Withdrawal can set in if a frequent user of cocaine suddenly stops using. Withdrawal symptoms can include headaches, body shaking, nausea, vomiting, passing out.
  • Loss of appetite: Addicts often do not think about food when they are concentrated on getting high. This can lead to weight loss and malnutrition.
  • Heart attacks and strokes: Cocaine speeds up your body, including your heart and blood pressure. It can lead to fatal heart attacks and strokes.
  • HIV/AIDS and Hepatitis: When cocaine is diluted, it can be injected as a liquid into the veins. People who share needles or use unsanitary needles risk getting blood diseases like HIV/AIDS and Hepatitis.
  • Ulcers and Bowel Problems: Ingesting cocaine through the mouth can lead to ulcers in the stomach lining as well as gangrene in the bowels.
  • Paranoia: People addicted to cocaine tend to suffer from extreme paranoid psychosis. They can also have hallucinations and lose their sense of reality.

As a person abuses more cocaine, their body builds up a tolerance to the drug. As their levels of dopamine increases, their body requires a larger amount of cocaine to achieve the same sensations. This often leads to people using in binge patterns. A binge pattern is taking a drug repeatedly within a short period of time at higher doses each time.

Cocaine becomes more dangerous when mixed with other substances. Combining cocaine with heroin creates a dangerous combination known as speedball and has a high risk of overdose. When cocaine is combined with alcohol, the body creates a drug called cocaethylene. This concoction is very dangerous and often leads to heart failure or heart attacks.

Symptoms of Cocaine Addiction

While in the body, cocaine makes a user feel energetic and mentally alert. Some believe that it helps them with work or other tasks. As the drug begins to wear off, these feelings fade and are replaced with extreme and uncomfortable symptoms. Cocaine affects the brain, the body and a person’s cognitive state.

Physical Effects:

Symptoms of cocaine addiction vary depending on the method of intake and the amount of drug.
Some common physical symptoms apparent in cocaine use (especially snorting through the nose) are:

  • Loss of the sense of smell
  • Nosebleeds
  • Difficulty swallowing
  • Hoarseness
  • A chronically runny nose

Many symptoms, however, are not so apparent and can be life threatening. Cocaine commonly speeds up the heart rate and blood pressure, which can result in cardiovascular disturbances. Heart attacks and arrhythmias are common causes of death in those addicted to cocaine. Because of the strain put on the nervous system, addiction can result in numerous neurological effects including strokes, seizures, headaches, and coma. These often result in death when there is nobody around the addict to prevent asphyxiation or call for medical attention. Although rare, sudden death can occur as soon as the first use of cocaine if the dose is too powerful.

The majority of cocaine-related deaths involve a combination of these complications.

Mental Effects:

Addiction is considered a mental illness. It substitutes a person’s normal needs and activities with the desire to obtain and consume the drug. All thoughts, impulses and consequences are a result of that drug and obtaining it. Constant cravings, dissociation from society and the stress of addiction can create mental instability and erratic behavior.
Some of the mental effects of addiction often appear as:

  • Depression and anxiety
  • Fatigue
  • Difficulty concentrating
  • Inability to feel pleasure
  • Increased craving for cocaine
  • Physical symptoms including aches, pains, tremors, and chills

People are also known to exhibit bizarre, erratic, and violent behavior during a more intense high. Severe paranoia is a common condition suffered by cocaine abusers in which they lose touch with reality and begin to hear sounds that are not real.

Warning Signs

It’s difficult to predict the warning signs of addiction because it can take effect quickly and can happen to anyone. Some people have risk factors that make them more susceptible to addiction should they ever experiment with drugs. The more risk factors that someone has, the greater chance they have at developing an addiction.

Here are some examples of risk factors that could be indicators of addiction:

  • Biology: People are born with certain genes that cause them to be more susceptible to addiction. Some believe that genetic makeup can account for about half of addiction probability. Gender, ethnicity, and other mental disorders are also influences.
  • Environment: A person’s environment has the biggest effect on their chance of addiction. Family and friends, especially, influence a person’s ability to obtain and use drugs. Peer pressure and the lack of authority figures can lead to young people making poor decisions regarding drugs. People with low socioeconomic status and quality of life are more likely to fall into drug addiction. Any one of these examples can begin the occurrence and escalation of drug abuse. Stress or trauma from any source can also be a trigger for drug abuse.
  • Age: Age relates closely to environmental factors in determining addiction probability. The younger a person is, the more likely they are to give in to pressures and abuse drugs. Addiction can occur at any age, but adolescents still have developing brains and are more likely to engage in risky behaviors.

If you feel you are starting to abuse cocaine or have already become addicted, there are many programs and facilities that are dedicated to help you any time, day or night.

We have compiled a list of National Addiction Helplines.
For more guidance, visit Treatment for Cocaine Addiction

View Sources Last Edited: May 10, 2018

Sources and Citations


  1. National Center on Health Statistics, CDC Wonder (Excel Sheet)
  2. SAMHSA: Behavioral Health Trends in the United States: results from the 2014 National Survey on Drug Use and Health.