Cocaine Addiction: Signs, Symptoms, and Treatment

Cocaine is a highly addictive drug but treatment is available to help you stop using. This article will help you understand the health risks and effects of using cocaine and how to spot the signs and symptoms of cocaine addiction. 

Cocaine treatment often involves various forms of therapy, detox, and withdrawal treatment as well as ongoing relapse prevention plans.

Cocaine Addiction: Key Facts

• Cocaine is a highly addictive drug sold as a white powder and sometimes mixed with other substances.
• Occasional cocaine use can turn into an addiction where you crave your next hit and experience withdrawal symptoms without it.
• Regular cocaine use can lead to heart problems, depression and anxiety, impaired brain function, and sometimes psychosis.
• Specialized treatment is available through therapy and medication.

Understanding Cocaine Addiction

Cocaine is an addictive stimulant that gives users energy, confidence, and a sense of euphoria. It’s the most commonly used Schedule II drug and is often taken in social settings. It has many street names including Blow, Coke, Flake, Snow, and Basa. 

In a relaxed party setting where people openly use cocaine it’s easy to forget that it’s dangerous, addictive and illegal. People who are using cocaine for the first time or infrequently underestimate the risks.

What Is Cocaine?

Cocaine is a white powder that is often snorted or, in some cases, dissolved and injected. It comes from the leaves of the coca plant grown in South America and 90% of the cocaine entering the U.S. is produced in Colombia.

Cocaine is made by processing the coca leaves into cocaine paste. This paste is processed further to produce hydrochloride crystal which is the element responsible for the cocaine high.

The white powder sold as cocaine is rarely pure cocaine hydrochloride crystal as it is often mixed with other substances. This practice increases the amount of the substance and enables dealers to make more money from it. It also makes cocaine far more dangerous because users do not know what they are consuming.

Dealers add cheaper stimulants in white powder form that mimic the effect of cocaine. These can include caffeine, amphetamines and crystal meth. These concoctions are not only more dangerous but also more addictive.

The addition of fentanyl is particularly concerning. One study found that it accounted for most of the increase in cocaine-related deaths from 2015 to 2016.

Types of Cocaine

There are different types of cocaine other than the standard white powder form. Two common street drugs include crack and pink cocaine.

Crack, also known as crack cocaine or “rock,” is a stimulant drug that’s been processed into a rock crystal and is usually smoked.

Pink cocaine is not actually cocaine. It is a powdered mixture of different substances such as ketamine, MDMA, cocaine or fentanyl.

Cocaine Use Disorder vs. Occasional Use

Cocaine use disorder (CUD) is a mental health condition described in the Diagnostic Statistical Manual (DSM 5). 

Casual use of cocaine means you may occasionally use the drug but you do not experience the signs and symptoms of CUD. A comprehensive list of the specific signs and symptoms will be outlined later in this article.

The main difference between occasional use and CUD is the inability to stop using the drug even when the negative impacts of its use are evident.

How Addictive Is Cocaine?

Cocaine is highly addictive as it affects the neurotransmitters in the brain, specifically dopamine, norepinephrine, and serotonin. These monoamine hormones are linked to a person’s mental health and mood. 

Increasing the level of these hormones enhances an individual’s mood, leading to a sense of euphoria and the desire to take more of the drug.

As a result, the user will associate cocaine use with something good for them and thus seek it out more and more. As drug use becomes more frequent, the user requires more of the substance to achieve the same effect, and addiction can result. Recovery from cocaine addiction is possible but challenging.

Recent studies have shown that cocaine use can cause structural changes in the brain. These changes persist even after prolonged abstinence and occur in regions of the brain associated with response inhibition and addiction. Relapse is an ongoing risk due to these changes and a person’s reduced ability to resist taking drugs.

Current U.S. Prevalence and Demographics

The National Institute on Drug Abuse (NIDA) found that in 2020, 1.9 % of the US population aged over 12 (around 5.2 million people) used cocaine in the past 12 months. 

Of these, approximately 1.3 million people had an addiction known as cocaine use disorder, a form of substance use disorder (SUD). A SUD is diagnosed when someone cannot stop using a drug despite it harming their life.

The Monitoring the Future study found that cocaine use among students has decreased significantly since the mid 1990s. While this is encouraging, a similar decrease is sadly not yet reflected in the overdose death rates which still demonstrate the prevalence and dangers of cocaine.

In all, 19,447 people died from an overdose involving cocaine in 2020. The vast majority of these deaths (around 15,000) also involved an opioid other than methadone (primarily fentanyl).

Stages of Cocaine Addiction

To develop a drug addiction, an individual goes through a process of use, increased use, and then dependency. Three distinct stages often lead to addiction to cocaine.

Experimentation

Drug use often begins with experimentation. People can find themselves in situations where taking drugs seems normal and acceptable. They are curious to discover what it is like and experience what other people are experiencing. 

At this stage, someone may see cocaine as a positive experience. Taken only in social settings, they may find that they enjoy the newfound confidence and energy that cocaine gives them. However, this is how addiction can start with someone wanting to achieve this feeling more regularly.

Habitual Use

By the second stage, the person uses cocaine regularly and is dependent on it. Obtaining the same effect from the substance can become harder with increased use. Using more cocaine to achieve the same sense of euphoria is necessary. 

The person seeks out situations and people with whom they can use cocaine. They are suffering from withdrawal symptoms and resort to taking more cocaine to alleviate these. The person’s life is starting to suffer.

Full Addiction

Cocaine is now in control of the person’s life. They spend much of their time thinking about it and seeking it out. At this stage, an addicted person can resort to criminal or dangerous behavior. 

To have the money to fund their drug use, they may turn to theft, prostitution, selling cocaine themselves, and other crimes.

The person may suffer from health problems and risk serious complications such as stroke and death from overdose. They often cannot work or function normally and may have become estranged from friends and family.

Signs, Symptoms, and Side Effects

There are several signs, symptoms, and side effects to be aware of in cocaine addiction. Understanding the effects of the drug on your physical and mental health is an important part of the recovery process.

Physical Health Risks and Side Effects

There are quite a few short term and long term effects that cocaine use has on your health. The short term effects can occur with just one occasion of using the drug.

Short Term Effects of Cocaine Use

The high that cocaine generates is very short lived. Users temporarily feel more energetic, alert, and confident due to the rush of hormones in the brain.

This instant and favorable reward can leave the user craving more cocaine soon afterward. To replicate the high they experienced, the user can resort to taking a larger quantity than they first intended.

The withdrawal symptoms of cocaine can start as early as the first use. As the use of the substance intensifies in frequency and amount, so do the withdrawal symptoms. Examples of these include:

Long Term Effects of Cocaine Use

When someone suffers from cocaine withdrawal symptoms, they often have a strong urge to use more cocaine to alleviate these symptoms. This cycle of more frequent use and larger doses increases the risk of adverse psychological or physiological effects.

Examples of some of the health risks associated with long term use of cocaine include:

Behavioral Changes

Cocaine, like all drugs of abuse, has side effects, withdrawal symptoms, and things to look out for if you are worried that you may be addicted. The warning signs can be physical or behavioral. Some are short lived whereas others develop as the addiction develops.

Below are some of the questions to ask yourself about your relationship with cocaine.

Self Assessment

According to the DSM, if you have two or more of the following signs then you meet the criteria for a diagnosis of CUD:

• Using more of a substance than intended or using it for longer than you’re meant to
• Trying to cut down or stop using the substance but being unable to
• Experiencing intense cravings or urges to use the substance
• Needing more of the substance to get the desired effect, also called tolerance
• Developing withdrawal symptoms when not using the substance
• Spending more time getting and using drugs and recovering from substance use
• Neglecting responsibilities at home, work, or school because of substance use
• Continuing to use even when it causes relationship problems
• Giving up important or desirable social and recreational activities due to substance use
• Using substances in risky settings that put you in danger
• Continuing to use despite the substance causing problems to your physical and mental health

Why Professional Treatment Matters

Cocaine addiction is treatable, and there are various professional treatment options available. Trying to quit on your own can be very difficult, especially when you consider the relapse rates for substance use disorder.

Evidence Based Outcomes and Relapse Statistics

While treatment can help you overcome cocaine addiction, it’s important to note that relapse is a normal part of the recovery process.

Relapse when dealing with a chronic health or mental health issue is not a sign of failure; it is just part of the treatment process and should be considered when making long term treatment plans.

It is possible to quit cocaine on your own; however, structured programs like cognitive behavioral therapy (CBT) and contingency management (CM) are more effective. 

A meta-analysis of studies shows that patients receiving these evidence based treatments had roughly a three times higher continuous abstinence rate than those who tried to quit on their own.

When to Seek Immediate Help (Overdose, Psychosis)

Using cocaine does pose a risk of overdose or serious side effects.

You should seek immediate medical attention if you experience any of the following:

• Chest pain
• Seizures
• Extreme agitation or paranoia
• Hallucinations
• Suicidal ideation
• Slowed breathing
• Tremors
• Heart attack
• Cardiac arrest

When you obtain cocaine, you may not be aware that it might be mixed with other dangerous drugs. In one study, a total of 15% of powdered cocaine samples that were tested showed that fentanyl was also present.

Cocaine mixed with opioids, or “speedball,” as it’s sometimes called, may be done on purpose or without the user’s knowledge but it can have serious side effects including death.

Many communities and healthcare facilities offer quick and easy access to a life saving drug called naloxone, also known by the brand name Narcan. This drug can be used to reverse the effects of an opioid overdose.

If you are experiencing signs of an overdose or you see someone who is then please take action immediately. Here are the steps to take:

Treatment Pathways for Cocaine Addiction

There are several different pathways for the treatment of cocaine addiction. Treatment typically involves a period of detox followed by various therapies and then some form of aftercare.

Medical Detox and Withdrawal Timeline

The first step of treatment often includes a period called “detox.”

This is the process where your body rids itself of cocaine, and it often comes with unpleasant withdrawal symptoms. This will look different from person to person but you can generally expect this to happen in three phases.

The “crash” phase happens within the first few hours or days of detox.

This is essentially when you notice that your high from the cocaine has worn off and may cause you to experience:

• Extreme fatigue
• Inability to fall asleep
• Increased blood pressure
• Increased heart rate
• Runny nose
• Aches and pains
• Increased appetite
• Agitation
• Anxiety
• Depression
• Mood swings

The second phase is acute withdrawal which may last 1 to 2 weeks.

Some of the symptoms during this phase are similar to the crash and may include:

• Anxiety
• Irritability
• Depression
• Poor concentration
• Slowed thoughts and movements
• Fatigue
• Changes in sleep patterns (e.g., hypersomnia or increased sleeping)
• Increased appetite
• Cocaine cravings
• Paranoia

Lastly, you may experience protracted dysphoria in the weeks or months after detoxing cocaine from your system. This means that you may experience a persistent negative mood or some of the symptoms listed earlier that linger for months after the drug has left your body.

Detoxing is most safely done in a medical environment where you can be properly monitored. 

Monitoring protocols include:

• Ensuring vital signs are good.
• Checking for suicidal thoughts or ideation.
• Providing medicine such as propranolol or trazodone to relieve some withdrawal symptoms.

Most withdrawal symptoms you experience while detoxing from cocaine are non life threatening but they can trigger severe depression.

When you experience severe depression, your physical health can be in danger due to thoughts of self harm and suicide, so medical supervision needs to be part of the detox process.

Levels of Care (Inpatient, Residential, PHP, IOP, Outpatient, Telehealth)

When you enter a rehab program, you will find your provider may recommend different levels of care depending on where you are in your recovery journey and your specific needs.

The American Society for Addiction Medicine (ASAM) uses a system with the following criteria to determine the level of care for each patient:

Many recovery centers will follow something called a step down model where you transition from one level of care to another as your recovery progresses. Progress can happen through lessening of cravings, no longer having co morbidities, or changes in your support system.

Several rehabs offer telehealth services to those living in rural areas and with less severe conditions. Research suggests that telehealth treatment can be just as effective as in person treatment for some patients.

Core Behavioral Therapies (CBT, Contingency Management, MI, Matrix Model)

Four core behavioral therapies are used to treat cocaine addiction including cognitive behavioral therapy (CBT), contingency management (CM), motivational interviewing (MI), and the Matrix Model.

Cognitive Behavioral Therapy (CBT)

CBT is one of the most used therapies to treat cocaine addiction. This approach seeks to help you better understand triggers that cause cravings to use. The way CBT works is to identify unhealthy thinking patterns and learn coping skills to change thinking and behaviors.

Some of the common exercises utilized in this approach include:

• Relaxation techniques
• Grounding exercises
• Affirmations
• Thought stopping
• Cognitive restructuring

Contingency Management (CM)

CM is another popular technique for cocaine addiction. This approach utilizes a voucher or prize system to incentivize positive behaviors over negative ones. For example, a patient may be rewarded for a goal period of abstinence with cash prizes or gift cards.

Motivational Interviewing (MI)

MI is an approach that uses powerful questioning to help an ambivalent or hesitant patient fully engage in the recovery process. It’s an important part of the beginning stages in certain programs like the Matrix Model’s 16 week treatment curriculum because it helps increase the individual’s motivation towards change.

The Matrix Model involves group therapy, family education, individual counseling, urine testing, and other techniques to help each patient on their recovery journey.

Medication and Emerging Pharmacotherapy (Disulfiram, Modafinil, Cariprazine Trials)

There are currently no medications that are FDA approved for cocaine addiction. However, there are some off label options and promising pipeline agents to know about.

Disulfiram is a dopamine hydroxylase inhibitor. This medication is approved to be used in treating alcohol addiction. It works in the body to interfere with metabolizing alcohol. Some studies are looking into how it may be effective for cocaine as well.

Modafinil is another drug that has sometimes been used to promote wakefulness, and off-label uses for it include helping with fatigue and depression.

Two types of medications that are currently in Phase II and Phase III trials include cariprazine and GLP 1 receptor agonists. Cariprazine has been used to treat some mental health disorders and is being looked at as a helpful medication during detox from cocaine.

GLP 1 receptor agonists are thought to dampen compulsive pleasure seeking behavior and cravings for addictive substances, although studies are still being conducted.

Holistic and Complementary Supports (Mindfulness, Exercise, Nutrition, Art/Music)

Holistic approaches can also be a beneficial addition to addiction recovery. Activities like mindfulness, exercise, art, and music have been shown to help in the recovery process.

Studies show that physical exercise may improve negative emotions, cognitive behaviors, and drug cravings for those in rehab centers. Adding nutrition counseling or art and music therapy into your treatment plan can improve your level of engagement in rehab and treat anhedonia—the inability to feel pleasure from rewarding activities.

A specific technique called mindfulness based relapse prevention (MBRP) is very useful in helping patients increase their stress tolerance and cope with urges to use. It focuses on becoming aware of triggers and staying present and mindful through distressing emotions. 

This approach teaches helpful mindfulness exercises such as urge surfing and progressive relaxation.

Integrated and Specialized Care

Everyone’s treatment journey does not look the same which is why specialized care exists for different population groups.

Dual Diagnosis Mental Health Treatment

Most rehab centers will have specific treatment plans for those with a dual diagnosis. This means you have another mental health condition in tandem with your CUD.

It is important for medical professionals to work together when treating a patient with a dual diagnosis to ensure that there are no conflicting treatments. Typically, psychiatry and addiction center teams will share electronic health records and conduct joint case conferences to discuss a patient’s progress and goals.

Therapeutic approaches should also consider dual diagnoses when applying approaches like CBT and trauma focused therapy. A trained therapist will utilize multiple techniques to treat these conditions simultaneously to avoid “ping pong” care where the client bounces back and forth between issues without real progress.

Gender Specific, LGBTQ+, and Culturally Sensitive Programs

You may have preferences or specific needs in your treatment plan because of your gender, culture, or sexual orientation.

There are several options you can consider including:

• Women’s programs that can address pregnancy, childcare, and trauma histories.
• LGBTQ+ tracks that provide minority stress coping skills and affirming peer groups.
• Culturally adapted contingency management groups with culturally relevant reinforcers and bilingual clinicians.

Family Involvement and Systems Therapy

Research shows that long term abstinence is improved when partners or family members attend weekly sessions with the patient. An approach that seeks to include the family in therapy is called the Community Reinforcement and Family Training, or CRAFT. 

In comparison, only 37% of those with substance use disorders whose loved ones underwent confrontational interventions sought help.

When you include multi family groups in the recovery process, you can expect:

• Communication education
• Tips on setting boundaries
• Warning signs for relapse and how to help
• Conflict resolution

Aftercare and Long Term Recovery

Recovery does not end when you leave a rehab center. Aftercare and long term treatment are important parts of your recovery.

Relapse Prevention Planning and Triggers

Relapse prevention is an important part of the recovery process. Your treatment team may recommend some ongoing tools to help you prevent relapse.

HALT is a helpful acronym that allows you to go through a series of self check-ins to assess your risk level of using again.

The way it works is this:

• Pause and take a breath
• Ask yourself if you are feeling Hungry, Angry, Lonely, or Tired
• If you are feeling those things then identify why
• Address the feeling by doing something to help
• Repeat these HALT self checks regularly

Many treatment teams will work with you to create written relapse prevention plans before you leave the facility. These plans will include coping strategies that work for you, accountability contracts, and contingency contracts.

Attending ongoing CBT or CM sessions at certain milestones in your recovery can also be helpful. Consider setting these up for your 30 , 60 , and 90 day milestones to maintain sobriety.

Peer Support Options (Cocaine Anonymous, SMART Recovery)

Another helpful part of most recovery programs is attending peer support groups. Evidence shows that those who regularly attend peer support groups double their one year abstinence odds.

Some peer support options include a spiritual framework to the program. These 12 step programs include Alcoholics Anonymous and Narcotics Anonymous. The central belief in 12 step programs is that your recovery relies on trusting in a higher power outside of yourself.

In comparison, another peer support option is SMART recovery groups. SMART stands for Self Management and Recovery Training, and it focuses on self empowerment and utilizing CBT tools and techniques.

You can search online for peer support meetings near you including remote attendance options.

Sober Living, Alumni, and Digital Recovery Apps

Sober living homes can be peer run or supervised by paid staff.

It is a shared home where you can find support and accountability while you continue your recovery process outside of a facility.

Some of the rules you can expect in a sober living home include:

• Attending 12 step programs
• Being accountable
• Creating a sober fellowship
• Creating positive friendships that help to reinforce abstinence
• Finding a recovery mentor
• Being involved in mutual aid support
• Fostering communal learning
• Undergoing drug screenings

Many recovery programs also offer alumni programs for those who are no longer attending active treatment but still want to keep in touch. These programs often include follow up group meetings, mentorship opportunities, and social events.

There are also digital recovery apps that provide cravings check ins and tele coaching to help aid in your ongoing recovery. Some of the top rated apps include WEconnect, Sober Grid, and Sober Sidekick.

Cost, Insurance, and Payment Options

The range of costs for rehab can vary greatly depending on the level of care, geographic location, and number of amenities provided at the facility.

Here are some of the U.S. averages on different programs:

When gathering prices to make your decision on where to go for treatment, request all inclusive quotes to avoid any surprise ancillary fees.

Verifying Insurance and Financing Alternatives

Many treatment programs accept insurance. First, the facility will collect your insurance policy information.

Next, they will call your insurer and confirm your ASAM level authorization and ask about CM coverage. Once you understand what your insurance covers, you can better understand how much treatment will cost you out of pocket.

Many insurance programs offer in network and out of network coverage. This means some healthcare providers and programs will be covered by your insurance policy while others will not.

If a treatment program is not covered by your insurance then you do have other options including:

• Applying for a loan from a medical loan company
• Setting up a Health Savings Account
• Asking treatment centers about sliding scale scholarships

Low Cost and State Funded Programs

The Substance Abuse and Mental Health Services Administration (SAMHSA) has block grant funded community clinics all over the country.

These are facilities funded by the government through grants to help individuals with mental health services. You can visit FindTreatment.gov to search for centers near you and learn more about how to qualify for free care.

Medicaid is another option for low cost programs. Some things to consider when checking on your eligibility for Medicaid include:

Help for Loved Ones

Signs That Someone You Know May Be Addicted to Cocaine

Often, those around the person with the addiction notice the telltale signs and initiate the process of getting help.

The addicted person may be in denial about their addiction, or it may have developed to the point that they cannot see a way out. When addicted to drugs, they can become so engrossed in the situation and an environment that normalizes drug use that they do not have clarity of thought to see what is happening.

Some of the signs that you can look out for in others include:

• More energy: The person may be more energetic than usual. They may appear hyperactive and unable to retain focus on anything for more than a few minutes. They may have fewer inhibitions, be more talkative and social, and generally have more confidence than usual. They may also suddenly appear to have new friends and a new social life.
• Agitation and paranoia: The high of cocaine is short lived, so the addicted person can appear agitated and on edge in between taking the drug. They may also appear distrustful of others and display signs of paranoia.
• Lying and secretiveness: To fulfill their cravings, the addicted person may be more secretive than usual. They may lie about their whereabouts and sneak off or disappear for periods of time.
• Physical signs: The side effects of cocaine include cold-like symptoms including a runny nose. The person’s pupils may dilate, and they may develop tics or twitches, especially around the mouth. They may also start breathing more heavily, excessively sweating, and experiencing nosebleeds.

Planning an Intervention

• Compare the Johnson Model (confrontational) and CRAFT approach (invitation & positive reinforcement), outlining pros/cons and success stats (~70 % entry to treatment for CRAFT).
• Provide a step by step preparation list: assemble team, rehearse statements, arrange treatment options, plan logistics for transport immediately after the meeting.
• Include a “when to involve professionals” call out (licensed interventionists, counselors) for high risk situations such as violence or severe mental health comorbidity.

Setting Healthy Boundaries

• Explain the concept of enabling vs. supporting; give concrete examples of boundaries (no cash loans, no drugs in the home, mandatory curfew).
• Offer scripts for “I statements” to communicate limits without shaming: “I feel worried when … so I will …”.
• Encourage self care: recommend Al Anon–style detachment practices, therapy, and stress management techniques to prevent caregiver burnout.

Support Groups for Families & Partners

• List main options with a one line description: Nar Anon (12 step), Al Anon (alcohol & polysubstance), GRASP (overdose loss), and SMART Family & Friends (CBT based).
• Provide links to meeting locators and virtual sessions, noting rising attendance for online formats since 2020.
• Highlight evidence that regular group participation improves family cohesion and treatment retention for the loved one.

Frequently Asked Questions

Find Cocaine Addiction Treatment Centers Near You

You can use the online directory at Rehab.com to find treatment centers near you. You can filter your search by location, level of care, insurance providers, and special programs. We also offer a 24 hour helpline where you can call today to talk to someone about your treatment options and see if your insurance will cover rehab.

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