By In Addiction Recovery, Addiction Withdrawal, Street Drug Encyclopedia, Tools for Recovery
Posted December 3, 2018

While news coverage focuses on the U.S. heroin epidemic, cocaine use and cocaine overdose deaths are also on the rise.

In this guide, you’ll learn everything you need to know about this dangerous stimulant, including signs of cocaine addiction, withdrawal symptoms, treatment options, and advice for friends and family impacted by cocaine addiction.

What Is Cocaine?

Cocaine, commonly referred to as “coke,” is a highly addictive stimulant. Cocaine comes from the leaves of coca plants, which are native to South America.

More than 100 years ago, cocaine hydrochloride, the purified chemical, was isolated from coca plants. This purified cocaine was an ingredient in many medical treatments in the 1900’s, and it was an ingredient (in small amounts) in the early version of Coca-Cola. It was also used as an anesthetic to numb pain.

However, research soon revealed that cocaine is a highly addictive substance that—if taken repeatedly—can change the structure and function of the brain.

Two chemical forms of cocaine are abused. The first is hydrochloride salt that appears as a fine white powder and is referred to as coke, blow, snow, or powder. Dealers sometimes dilute this drug with substances like baking soda or flour to maximize their profits.

It’s also increasingly common for cocaine to be laced with fentanyl, an opioid that is up to 50 times more powerful than heroin. When people buy fentanyl-laced cocaine, often without their knowledge, the results can be fatal.

The other form is the cocaine base (or freebase) that has undergone a process involving heating to remove the hydrochloride and make a smokable substance known as crack.

What Is Cocaine Addiction?

The most basic cocaine addiction definition is “a psychological desire to use cocaine regularly.” Repeated cocaine use changes brain systems associated with decision-making, pleasure, and memory, impairing the addict’s ability to resist drug cravings.

After just a few uses, physical tolerance to cocaine can increase. This results in users needing more and more of the drug to achieve the same euphoric effect, eventually leading to physical dependency.

Cocaine has a short half-life, so effects can be felt in as little as a few minutes. Depending on how the cocaine is ingested and how quickly it’s absorbed in the bloodstream, these effects may last only 5-30 minutes. Increased use can decrease the period of stimulation.

Because the drug leaves the body so quickly, people often binge cocaine, taking several doses back to back. This causes tolerance and dependence to form more rapidly.

Cocaine Addiction Facts

  • According to the 2015 National Survey on Drug Use and Health (NSDUH), 1.9 million people aged 12 or older were active cocaine users.
  • Per the National Institute on Drug Abuse (NIDA), overdose deaths involving cocaine have increased from 4,000 in 2010 to 7,000 in 2015, the second highest rate since 2006.
  • From 2010 to 2015, overdose deaths involving both cocaine and opioids have more than doubled, from 2,000 to more than 4,000.
  • Behind heroin, cocaine is the second-leading cause of overdose deaths in the United States. In 2014, 5,856 deaths were attributed to cocaine overdose.
  • Provisional counts of overdose deaths from 2016-2017 list 6,896 cocaine overdose deaths for the twelve months ending in January 2016. Another 10,619 deaths are listed for the twelve months ending in January 2017.
  • While opioids are the most common contributor to overdose deaths among white Americans, cocaine is the most common contributor to overdose deaths among black Americans.
  • In England and Wales, cocaine deaths have reached an all-time high, quadrupling since 2011. These countries report 875,000 users of cocaine.

Signs of Cocaine Addiction/Abuse

In general, addiction is characterized by cravings, the inability to abstain from a substance, impaired control over behavior, and diminished recognition of problems with one’s behavior and relationships. An addict will continue using a substance even after experiencing legal, financial, health, or personal issues, including deteriorating relationships with family and friends.

Specifically, short-term effects of cocaine use include:

  • Energy, alertness, excitability
  • Dilated pupils
  • Intense happiness
  • Extreme sensitivity to touch, sound, and sight
  • Anger/irritability
  • Paranoia
  • Decreased appetite

Long-term effects may include:

  • Headaches
  • Convulsions and seizures
  • Mood problems
  • Heart disease, heart attack, and stroke
  • High blood pressure
  • Lung damage
  • Runny nose and nosebleeds
  • Trouble swallowing
  • Bowel decay (if cocaine is swallowed)
  • Hepatitis or HIV (if cocaine is injected)
  • Nasal or venal Tissue damage

If you’re worried that a loved one may be abusing cocaine, other signs to watch for are:

  • Weight loss
  • Mood swings
  • Social isolation
  • Risky behaviors
  • Boost in confidence and talkativeness
  • Changes in sleeping and eating patterns
  • Powdery white residue around nose and/or mouth
  • Burn marks on lips and hands
  • Poor hygiene
  • Increase in financial difficulties
  • Increased need for privacy
  • Loss of interest in previously enjoyed activities, friendships, etc.
  • Drug paraphernalia in person’s room or in their clothing (e.g. razor blades, spoons, plastic baggies)

Cocaine withdrawal and detox.

Cocaine Addiction Withdrawal/Detox

When an individual becomes physically dependent on a substance, such as cocaine, stopping or rapidly decreasing use causes unpleasant physical and emotional symptoms.

Because of cocaine’s short half-life, symptoms of withdrawal can begin as soon as 90 minutes after last dose. Symptoms generally last for 7-10 days, but this timeline depends on factors such as:

  • Length of use
  • Drug purity
  • Environment
  • Size of dose
  • Other mental health problems

Physically, cocaine withdrawal isn’t as intense as withdrawing from other drugs. It carries mostly psychological symptoms, including:

  • Fatigue or exhaustion
  • Difficulty concentrating
  • Increased appetite and cravings
  • Inability to feel pleasure or experience sexual arousal
  • Depression or anxiety
  • Suicidal thoughts
  • Vivid nightmares
  • Slowed activity and slower thinking
  • Restlessness

Some physical symptoms like muscle aches, chills, tremors, and nerve pain may also occur.

Although it’s possible to detox from cocaine at home, the supervision and safety of medical detox is often a better alternative. For individuals who have released during previous withdrawal attempts, medical detox is recommended.

Severe mood swings, depression, and anxiety are perhaps the most difficult part of cocaine withdrawal. When the euphoria produced by cocaine is gone, many people experience suicidal thoughts, and some act on these ideas. Individuals with a history of depression or suicidal thoughts should also detox under the supervision of medical professionals.

Cocaine Addiction Help

Of course, detoxing from cocaine is only the first step in the process. Once your system is free of cocaine, you can explore long-term treatment options.

This may include counseling/therapy to address underlying issues or mental health disorders, 12-step meetings such as Narcotics Anonymous(NA) or Cocaine Anonymous, and inpatient or outpatient cocaine addiction treatment.

Cocaine Addiction Treatment

Treatment for cocaine addiction can come in the form of outpatient or inpatient treatment. Outpatient treatment is generally recommended only for individuals who have been addicted to cocaine for just a short amount of time or who have abused the drug in small amounts.

Outpatient treatment allows patients to visit a treatment center a few times a week for a set number of hours for therapy sessions, meetings, workshops, etc. The increased flexibility is convenient, but it’s also limited in its effectiveness. A tight support network is essential under these circumstances.

Inpatient treatment centers are residential facilities where the individual lives, sleeps, eats, and participates in activities for a minimum of 30 days. Inpatient treatment is often more effective because it provides a safe, structured, and drug-free environment.

Inpatient treatment generally combines individual counseling and group therapy to give residents the tools they’ll need to remain sober after treatment. Residents are given the opportunity to address underlying issues that are related to drug use, determine their individual triggers, and develop a plan for avoiding or responding to these triggers.

At inpatient treatment, individuals can focus exclusively on the recovery process without the stress and distractions of day-to-day life.

Life After Treatment

Before leaving treatment, you’ll develop an aftercare plan designed to help you maintain your sobriety in the real world.

Generally, an aftercare plan includes recommendations for living a healthy lifestyle, avoiding or managing triggers, developing a positive support system, and pursuing positive activities. It may also involve attending support group meetings, staying in touch with a sponsor, building positive friendships and finding positive hobbies, and working on your career, education, or housing.

Sticking to your aftercare plan can help you avoid relapse, but it’s important to note that addiction is a chronic disease and relapse is sometimes part of the process. If this does occur, try not to be too hard on yourself, as this is counterproductive. Instead, turn to your support system, increase your meeting attendance, and reevaluate your current plan. What thoughts, behaviors, or events contributed to your relapse? How can you avoid this in the future? Learn from the lapse and keep going.

Helping family and friends with cocaine addiction.

Advice for Family and Friends

  • Remember that cocaine addiction is a disease rather than a choice. Research its mental and physical effects, treatment options, and so on so that you can better understand and support your loved one.
  • Be patient and supportive of your loved one, but don’t enable him or her. Don’t provide financial support or make excuses to cover for their drug abuse. It can be difficult, but make it clear that while you support the individual, you do notsupport the individual’s drug use.
  • When you have conversations about drug use, try to do so when your loved one is sober. Don’t attack or blame. Instead, frame the conversation as a discussion about how your loved one’s drug abuse is impacting you and others.
  • If your loved one seeks treatment, offer ongoing encouragement and support throughout the recovery process. Try to spend time together doing positive activities.
  • Don’t forget to take care of yourself first. Seek help and advice from a professional if needed.


Cocaine addiction wreaks havoc with an individual’s health, finances, personal relationships, and career. Sometimes, abusing cocaine has fatal consequences.

However, recovery is possible. Inpatient or outpatient rehab, support groups, and counseling are often an effective treatment combination.

Recovery is an ongoing and challenging process, but it can be done with persistence and support. If you or a loved one is suffering from cocaine addiction, the best time to seek help is now.

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