Cocaine Addiction: Treatment, Signs, Symptoms, and Risks

Medically Reviewed By

Dr. Po-Chang Hsu

Dr. Po-Chang Hsu

On April 17, 2024

Written By

Amanda Stevens

Amanda Stevens, B.S.

On November 11, 2023

What you will learn

  • Cocaine is derived from coca leaves, which is a plant native to South America. The drug has powerful stimulant effects
  • Other substances, such as laxatives and even fentanyl are often added to cocaine before it is sold and consumed.
  • There are multiple forms of cocaine, however, every form of the drug can lead to addiction and even death.
  • Using cocaine can have serious consequences, some of which may be permanent or even fatal
  • There is help for those seeking to recover from cocaine addiction
Reading Time: 8 minutes

People use cocaine for a variety of reasons. In some cases, it is primarily to achieve the high. In other cases, it is a coping mechanism for dealing with stress and depression or enhancing work performance

Whatever the case, cocaine is a highly addictive substance that is very difficult to quit and can lead to a range of health effects, from mild to severe.

If you or a loved one is showing signs of cocaine abuse, this is everything you need to know from the origins of cocaine, what happens before it gets to the user, side effects, long-term effects, and treatment options.

What is Cocaine, and Where Does it Come From?

Cocaine is a powerful stimulant drug derived from the leaves of the South American coca plant. The drug has been used for centuries by indigenous populations for both medicinal and recreational purposes but can be deadly, addictive, and is illegal in most parts of the world.

A significant proportion of the world’s cocaine is sourced from Colombia, Peru, and Bolivia, where coca plants are cultivated both legally and illegally. Cocaine is often cut with other substances as it moves through the supply chain to the consumer.

Why is Cocaine Cut With Other Substances?

Additives are added to the majority of cocaine before it reaches the user. Cocaine is an illicit substance that is both difficult and dangerous to obtain. Therefore, drug dealers will add substances to the cocaine to increase the supply.

Pure cocaine is a crystalline substance that turns into a white powder when processed. Similar-looking substances are added so that the user will often not know that the cocaine is not pure. Common cocaine additives include substances like baking soda, lactose, talcum powder, and sometimes more harmful adulterants such as boric acid or fentanyl.

Cocaine may also be laced with other illicit substances like fentanyl or amphetamines to enhance the effects. Many cocaine additives can increase the dangers of the drug and lead to fatality.

The Types of Cocaine

Cocaine comes in various forms. Most of the cocaine consumed in the United States comes in powder form, crack cocaine, or freebased, but there are other less common forms and methods of consumption.

Each type and form of cocaine has associated risks, but the intensity and nature of these risks can vary.

Form Description Methods of Use Effects
Powder cocaine The white, crystalline powder Typically snorted but can be further processed and injected or smoked Feelings of euphoria, increased energy, increased heart rate, reduced appetite
Crack cocaine Cocaine that is processed with baking soda or ammonia to create small crystal-like rocks Typically smoked or injected but may be snorted Feelings of euphoria, increased energy, increased heart rate, reduced appetite
The effects of crack cocaine are more intense than those of powder cocaine but shorter-lived and have a higher risk for addiction
Coca paste Sticky, brown substance that is a precursor or powder cocaine Typically smoked Feelings of euphoria, increased energy, increased heart rate and blood pressure
Coca leaves Raw, unprocessed leaves of the coca plant Typically chewed or brewed and consumed as tea Mild stimulation, reduced appetite, increased energy

There is not one form of cocaine that is safer than the others. Each form of cocaine carries a risk for addiction as well as cardiac and respiratory complications.

How Prevalent is Cocaine Use?

Cocaine is one of the most commonly used illicit drugs, with 4.8 million people over the age of 12 years reporting cocaine use in 2022 alone.  Use was highest in the 18-25 age range, with 1.2 million people having used the drug[1].

What are the Side Effects of Cocaine Use?

Cocaine side effects will vary among individuals, depending on factors such as the amount ingested, whether or not any other substances have been ingested simultaneously, weight, age, height, and body composition.

Some side effects of cocaine use include:

  • Dilated Pupils: Pupils become wider as a result of increased norepinephrine. This is one of the first signs of cocaine use and usually happens within half an hour of ingestion.
  • Decreased appetite: Cocaine is known to suppress the appetite. For cocaine users who binge on the drug, it is not uncommon to go days without eating substantial meals.
  • Mood changes: Many individuals who use cocaine report inflated feelings of confidence, as well as irritability and even bouts of aggression, anxiety, and paranoia.
  • Sleep disturbances: Cocaine is a powerful stimulant. Restlessness and insomnia are a common side effect of this drug.

Other more serious side effects include hyperthermia and hallucinations, especially in cases where large amounts of the drug are taken.

Can a Drug Test Detect Cocaine?

Routine drug tests, such as those required for employment, typically test for cocaine. Depending on the type and sensitivity of the drug test, cocaine use can be detected anywhere from a couple of days to 90 days after the last use.

Drug Test Cocaine Detection Time
Blood Up to 4 days
Saliva Up to 2 days
Urine Up to 2 days
Hair Up to 90 days

Cocaine Addiction Risk Factors

Several factors contribute to the likelihood of developing an addiction to cocaine or any other drug. A family history of addiction, a personal history of addiction, underlying mental health conditions, a history of poverty, and the accessibility to the drug all play a role in addiction.

The use of cocaine impacts the brain’s reward system by triggering the release of high levels of dopamine–a chemical that induces feelings of pleasure and reward. This surge in dopamine levels can cause intense sensations of euphoria and a sense of overall well-being, which in turn strengthens the urge to continue using the drug.

Cocaine Addiction: Signs to Look For

If you believe that you or someone you love might be addicted to using cocaine, look for the following hallmark signs:

Increased or Compulsive Use

An individual who is addicted to cocaine may begin to use the drug more frequently. For example, if an individual was only using cocaine socially once per month but then began to use it 2-3 times per week or even more. Or, the individual may begin to use the drug compulsively at times when it may be risky to use the drug, such as at work or before driving a vehicle.

Increased Tolerance

As cocaine is used more and more often, the body becomes accustomed to the drug. This results in the need for higher quantities or more frequent use to achieve the effects the individual initially experienced.

Disregard for Associated Risks

Cocaine use can lead to severe consequences in many aspects of life. From strained interpersonal relationships to financial destitution to physical and emotional destruction. Those addicted to cocaine may use the drug even when these consequences are fully understood.

Cravings and Withdrawal Symptoms

A signature sign of cocaine addiction is the experience of withdrawal symptoms when the use is stopped or the dosage is decreased. Withdrawal symptoms look different for everyone but often include fatigue, anxiety, depression, and agitation. In some cases, someone addicted to cocaine may even experience suicidal thoughts or ideation when not taking the drug.

Not everyone who is addicted to cocaine will exhibit every sign or symptom of abuse. If you believe that you are addicted to cocaine, it is important to seek help from a medical professional for a thorough evaluation.

Cocaine Overdose: What to Look For

Cocaine overdose has increased modestly from 2002 to 2018.[2] Cocaine overdose can be fatal, and the risks increase if the drug is laced with other substances. Some signs of a cocaine overdose include:

  • Heart palpitations or rapid heartbeat
  • Increased blood pressure
  • Chest pain
  • Sweating
  • Breathing difficulties
  • Loss of consciousness

A cocaine overdose can lead to cardiac arrest, respiratory failure, seizures, coma, and death. It is important to seek emergency medical help if you suspect a cocaine overdose.

Long-Term Effects of Cocaine Addiction

Long-term use of cocaine can be extremely damaging and lead to destruction of the organs and system.

Long-term effects of cocaine include:

Nasal Damage

As cocaine is commonly snorted, the nose and nasal passages are at risk for damage. Repeated cocaine use can lead to inflammation, irritation, damage to the delicate nasal tissue, holes in the septum, and nose bleeds.

In some cases, long-term cocaine users may experience loss of smell.

Respiratory Damage

Those who engage in smoking cocaine are at an increased risk of developing pulmonary conditions such as chronic bronchitis, pneumonia, and emphysema.

Cardiac Conditions

Long-term cocaine abuse is extremely damaging to the cardiovascular system. Long-term cocaine use can cause vasoconstriction, the narrowing of blood vessels, which can lead to increased blood pressure and cardiovascular complications. Repeated use can lead to heart failure, arrhythmias, heart attacks, infections, and aortic tears, as well as high blood pressure and an increased risk for stroke.

Complications of the Eyes

Severe eye complications may occur as a result of long-term cocaine use. Those who use cocaine may be at increased risk for ocular conditions like ischemic optic neuropathy, which can lead to vision loss. [3]

Liver Diseases

Using cocaine long-term damages the cells in the liver, resulting in blood clots, fat buildup, liver failure, liver cancer, and hepatitis.

Kidney Damage

Those who use cocaine are at risk for inflammation and scarring of the kidneys, as well as kidney failure.

Changes in Brain Structure and Function

The risks increase for brain damage the longer an individual uses cocaine. Long-term cocaine use can bring about alterations in both the structure and function of the brain, which can result in an escalating challenge for individuals to stop using the drug.

Recovering From a Cocaine Addiction

Before entering recovery, it is important to understand that recovery is a lifelong process. There will not be a time that you can occasionally recreationally use cocaine without the risk of relapsing back into a full-fledged addiction.

But, no matter how long, how often, or how much a person uses cocaine, recovery is possible.

Can You Quit on Your Own?

While it is possible to quit cocaine on one’s own, it is generally not recommended due to the potential for intense withdrawal symptoms and psychological challenges, which can increase the risk of relapse. Professional treatment is often necessary to safely manage withdrawal and reduce the risk of overdose.

It is highly recommended that someone who is addicted to cocaine explores professional treatment options for both the detox process and subsequent relapse prevention.

Detoxing From Cocaine

This stage can be stressful both physically and mentally, and withdrawal can cause uncomfortable side effects. However, detoxing from cocaine is the necessary first step in recovery.

Cocaine withdrawal symptoms can be challenging to manage, and even more so for those who have been using the drug for an extended period or in larger dosages. These symptoms may include intense cravings, mood swings, anxiety, fatigue, restlessness, increased appetite, weight gain, difficulty concentrating, muscle aches, chills, and sweating.

In particularly severe cases, individuals may experience vivid dreams or nightmares, along with depression or suicidal thoughts.

Types of Cocaine Recovery Programs

Inpatient Rehab

Inpatient rehab involves residing at a treatment facility where individuals receive round-the-clock support and supervision to help overcome their cocaine addiction. This type of rehab provides a structured and comprehensive treatment plan, which often includes a combination of therapies, support groups, and medical care.

Partial Hospitalization Programs (PHP)

This step-down level of care offers structured treatment during the day while returning home in the evenings. This program is less intensive than inpatient rehab but more structured than outpatient care.

Intensive Outpatient Programs (IOP)

This level of care offers a more flexible treatment option that allows individuals to receive treatment several times a week while still maintaining their daily routine. IOP usually includes individual and group therapy and may also provide medication-assisted treatment.

Outpatient Programs (OP)

Outpatient programs are a less intensive treatment option that allows individuals to receive care while still maintaining their daily routine. They are best suited for individuals who feel confident in their recovery or have completed a more intensive program.

What to Expect During Cocaine Addiction Treatment

If you are looking into cocaine addiction recovery, there are a few things you can expect during treatment.

Tailored Care Plan

Everyone’s experience with both addiction and recovery is different. When you enter into a recovery program, your treatment plan will be customized to your unique circumstances so that you have the best chance at lifelong recovery. Depending on the severity of your addiction, you will either enter into an inpatient or outpatient program.


A pivotal part of recovery is addressing any underlying issues that may be contributing to your addiction. This may include previously undiagnosed or unmanaged mental health conditions or trauma. Most treatment programs will include individual and group therapy sessions for a more holistic approach to healing. Individual and group therapy will help you work through hang-ups, develop healthy coping skills, and improve interpersonal relationships and communication skills.


Recovery is a lifelong process. To ensure long-term sobriety, your treatment plan must include continued therapy, support groups, or other ways to keep yourself accountable. It will also include a plan for continuing your sobriety journey outside of a recovery setting.

Frequently Asked Questions About Cocaine and Cocaine Addiction

Can You Fully Physically Recover From a Cocaine Addiction?

It is possible for your body to heal from a cocaine addiction. Depending on the length and severity of the addiction, some organ damage may be irreversible, however, this depends on the individual. No matter the extent of the addiction, it is important to seek treatment as soon as possible for the best chance at mitigating any damage.

How Do You Know When You Are Recovered From a Cocaine Addiction?

There is no definitive endpoint to the recovery journey. Long-term healing requires continued recommitment to one’s sobriety. Going through a recovery program does not mean your addiction is “cured.” You will need to continue to take steps to prevent relapse.

Why Do People Cut Cocaine With Fentanyl?

Fentanyl is a powerful opioid that is sometimes added to cocaine to intensify its effects. This combination is extremely dangerous and can result in overdose or death.

How Can You Flush Cocaine Out of Your System?

There are no guaranteed quick methods to rid your body of cocaine completely; the drug’s metabolites naturally clear from the system over time. Cocaine is metabolized in the liver and excreted through the urine, which may take several days. However, staying hydrated and eating nutritious food can help your body stay healthy and facilitate elimination.

Is it Dangerous to Detox From Cocaine on Your Own?

Detoxing from cocaine on your own is not recommended due to potential intense withdrawal symptoms that can be severe and sometimes life-threatening. It is recommended that those who wish to quit using cocaine seek professional medical assistance when detoxing to ensure safety and prevent relapse.

Reclaim Your Life with Treatment for Cocaine Addiction

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[1] Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved April 12, 2023 from

[2] Cano, M. Oh, S. Salas-Wright, C. Vaughn, M. G. (2020, July 15). Cocaine use and overdose mortality in the United States: Evidence from two national data sources. Science Direct Retrieved April 12, 2023, from

[3] Lin, L. Y., Reshef, E. R., Lansberg, M. P., Barshak, M. B., Chwalisz, B. K., Holbrook, E. H., & Wolkow, N. (2022). Posterior Ischemic Optic Neuropathy in the Setting of Cocaine-Induced Orbital and Sinonasal Inflammation. Ophthalmic plastic and reconstructive surgery. Retrieved Apr 12, 2023 from