Cocaine is a powerful and highly addictive, illegal stimulant drug that, with repeated use, has the potential to cause changes in the brain that may affect functioning.⁹

If a person uses enough cocaine to cause harmful health effects or combines cocaine with other substances like alcohol or opioids, it’s possible for a cocaine overdose to occur.¹¹ From 1999 to 2019, there has been a steady increase in overdose deaths involving cocaine use. In 1999, there were 3,822 overdose deaths involving cocaine; in 2019, there were 15,883 overdose deaths involving cocaine.²

An overdose can be treatable and survivable, but it is often a sign that a person is misusing cocaine and needs addiction treatment.

If you or a loved one are struggling with a cocaine addiction, continue reading to learn about the signs of a cocaine overdose and treatment for cocaine addiction. If you are having a medical emergency related to substance use, call 911 for immediate assistance.

Signs and Symptoms of Cocaine Overdose

Overdose severity depends on the purity and potency of the drug, how much a person takes/uses, and whether it is smoked, inhaled, injected, or taken orally.

Cocaine overdose may include symptoms such as:^{3, 4, 10}

Dangerously high body temperature.
Increased sweating.
Increased heart rate and blood pressure.
Chest pains.
Tremors.
Hyperactivity and irritability.
Confusion.
Nausea and vomiting.
Seizures.
Stroke.
Acute mental health changes include depression, paranoia, and other psychotic features.

How to Help a Person Experiencing a Cocaine Overdose

If you or a loved one are experiencing signs of a cocaine overdose, call 911 right away.

As you await emergency services, the following tips may be helpful in keeping a person safe until medical help arrives:^{5, 6}

Reassure the person you are there to help.
Loosen tight clothing.
When possible, monitor pulse and breathing rates, and check blood pressure.
If there are no signs of breathing or a pulse is absent, begin CPR immediately after calling 911.
If the person is having seizures, clear away any objects that may cause injury, turn the person on his/her side to ease breathing, and continue reassuring him or her in a calm voice. Do not offer food or water or try to hold the person in one place.

Risk Factors for Overdose

Using cocaine with heroin.¹⁰
Combining cocaine with synthetic opioids like fentanyl.²
Mixing alcohol and cocaine, which can produce a toxic substance called cocaethylene.³
Inability to control the dose and purity of the drug.
Tolerance, which requires the user to take larger amounts of the drug to achieve the same effect.⁷

Emergency Care for Cocaine Overdose

A cocaine overdose needs to be treated by trained medical personnel. Initial treatment for an overdose may include:^{3, 4}

Tests: Along with the information provided, tests will be done to check for levels of cocaine and its metabolite chemicals, and for any other drugs present in the system. Urine and blood analyses also test for kidney and liver function, cardiac enzymes, blood acidity levels, and complete blood count.
Medication: Cocaine overdose treatment involves the use of drugs for different possible complications. A benzodiazepine (sedative) such as lorazepam may be administered intravenously (IV) if needed to manage the hyperexcitable state associated with cocaine overdose.
Harm prevention: In rare cases, to prevent further physiological damage, drug-induced paralysis and mechanical ventilation can help prevent severely agitated people from further harm. If elevated blood pressure does not respond to benzodiazepines, physicians may employ an IV nitrate like nitroprusside.
Cooling: Ice packs, IV saline, and sedation are used to control dangerously high body temperatures.
Heart evaluation: Chest pain is often associated with cocaine abuse and, if present, will necessitate a full cardiac evaluation. Chest X-rays, cardiac enzymes, electrocardiogram, echocardiography, and other diagnostics can help rule out any damage to the heart.
Psychiatric evaluation: Prior to leaving the emergency room, the physician may order a psychiatric evaluation for further diagnosis and treatment. A social worker may explore post-discharge treatment options.

Effects of Cocaine Addiction

Even when an overdose is not fatal, the effects of cocaine addiction can be devastating. The following are a few other potentially dangerous health effects from repeated cocaine use:^{7, 11}

Chronic nasal inflammation, nosebleeds, and damage to one’s sense of smell due to snorting cocaine.
Damaged lungs and worsened asthma can be caused by smoking crack.
Increased risk of getting HIV and hepatitis C from injection.
Allergic reactions to the drug itself or mixed impurities can be life-threatening.
Increased risk of stroke
Inflamed heart
Weight loss from damage to the gastrointestinal system
Damage to the brain, which may lead to memory loss, poor judgment, attention span deficit, and movement disorders such as Parkinson’s disease.

Treatment and Recovery After a Cocaine Overdose

With prompt medical attention, cocaine overdose is survivable. But overdosing on cocaine is a strong indicator that a person may have a substance use disorder. To prevent another overdose and avoid the consequences of long-term drug dependence, you or a loved one may consider seeking treatment at an addiction treatment facility.

In some instances, people are using multiple drugs in addition to cocaine or have co-occurring mental or physical health conditions, which may require additional support. Finding a cocaine rehab facility that focuses on individualized treatment will help to address your various needs so that you can build a solid foundation for recovery.

Depending on the person’s treatment needs, addiction treatment can be sought through either inpatient or outpatient settings.

Inpatient or residential programs are those in which a person lives at the facility while receiving care. Treatment length varies depending on the severity of a person’s addiction, co-occurring conditions, substance, and level of care assessed and can range from a few weeks to months. Many facilities incorporate services such as 12-step facilitation, detox, behavioral therapy, and aftercare planning.⁸
Outpatient treatment programs can be a form of continuing care after inpatient treatment or be a person’s primary mode of treatment, depending on their level of care. Outpatient facilities offer a range of services including drug education and counseling, behavioral therapy, detox, medication, 12-step facilitation, legal aid, and more. Some will require regular monitoring to assess for recovery setbacks and to help with accountability.⁸

American Addiction Centers maintains a strong partnership with a large group of insurance companies at our addiction treatment facilities. Start the journey to recovery and find out instantly if your insurance provider may be able to cover all or part of the cost of rehab and associated therapies.

Behavioral Therapies for Cocaine Addiction

Currently, there are no approved medications to treat cocaine addiction. However, behavioral treatments may be useful in helping a person change their patterns of substance use.

Contingency management uses rewards and incentives to reinforce positive changes and behaviors related to recovery, such as remaining sober.¹²

Cognitive behavioral therapy helps people learn to avoid situations that trigger cocaine use and how to cope with problems that may contribute to drug use. With this knowledge and support, people may be more likely to prevent a relapse.¹³

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