How to Spot the Signs

Cocaine addiction can be difficult to treat, and the majority of those seeking treatment for cocaine addiction are polydrug users (use more than one drug recreationally).  By recognizing the signs of addiction, those who are addicted can identify the problem, seek professional treatment, and experience recovery.

Cocaine, also known as coke, is a powerful stimulant derived from the coca plant. It is a highly addictive drug. It is abused by several methods, including snorting it through the nose, smoking it, and injecting it intravenously. 

When snorted, smoked, or injected, cocaine induces intense feelings of euphoria. Tolerance to the drug develops and more and more cocaine is needed to achieve the desired effect.

As an individual develops tolerance to cocaine, they also become physically dependent on it. If the drug is discontinued, withdrawal symptoms, with physical effects, can occur. A strong craving for cocaine is the most prominent effect of withdrawal, but other symptoms usually occur as well.

Cocaine withdrawal symptoms include:

• Depression and apathy
• Anxiety
• Trouble concentrating
• Feeling overwhelmingly physically and mentally exhausted
• Restlessness or agitation
• Physical discomfort, including aches, pain, or feeling hot or cold
• Appetite changes
• Vivid dreams

Cocaine addiction can develop quickly, often within a month. When a person is addicted to cocaine, they may begin to use it with methods that produce a more intense effect—such as smoking or injecting the drug instead of snorting it. Sometimes an intense effect is achieved by using more powerful forms of the drug, such as crack, or using other drugs in addition to cocaine.

Signs and Symptoms

The euphoric effects of cocaine use are accompanied by physical effects, including a rapid heart rate, sweating, and pupil dilation (widening of the pupils). Cocaine can also cause other adverse effects, such as anxiety, crawling sensations on the skin, hallucinations, and paranoia. Some of these feelings can persist, or might even increase, during the comedown (“crash”) as the euphoria is wearing off.

The signs of cocaine addiction extend beyond the physical symptoms and also involve emotional and behavioral changes.

Signs of cocaine addiction can include:

• Teeth grinding
• Dry mouth
• Dilated pupils
• Persistent runny nose or nosebleeds (without a reason like allergies or a sinus infection)
• Hyperactivity, excessive or unusually rapid speech
• Overconfidence
• Reckless behavior
• Mood or behavioral changes
• The presence of visible white powder or burn marks on the mouth, nose, or hands
• Appetite changes and weight loss
• New, erratic, or unusual sleeping patterns
• Avoiding others, being secretive, or hiding drug use
• Decreased interest in and participation in activities that had been previously enjoyable – such as socializing, work, or leisure activities
• Unexplained spending or financial problems
• Neglecting personal appearance or hygiene

Having drug paraphernalia, or other items for using cocaine in your home or apartment can be a sign of addiction too.

Complications

There are a number of complications of cocaine addiction, and they can differ depending on your method of using the drug.

You may develop thinning or deterioration of the septum nasi (the septal cartilage in your nose) if you snort the drug. Injecting the drug can increase your risk of a serious skin infection, such as a bacterial staphylococcus infection. Cellulitis (a severe type of skin infection) and necrotizing fasciitis (destruction of the infected tissue), and a systemic infection can develop as well. Sharing needles can increase the risk of HIV and hepatitis B. Cocaine use can also contribute to kidney injury.

The main complication of cocaine addiction is overdose, which results in cocaine toxicity. While cocaine can adversely affect every organ in the body, its most dangerous and life-threatening effects are on the
cardiovascular system.

Tachycardia (rapid heart rate), arrhythmia (irregular heart rate or rhythm), and malignant hypertension (severely high blood pressure) can lead to a heart attack, stroke, or death. Acute kidney failure (rather than slowly deteriorating kidney function) is a life-threatening emergency that’s also common with cocaine overdose.

Causes

Some people are more vulnerable to cocaine addiction than others. There is no way to predict who will develop cocaine addiction. With that said, studies have suggested that some groups are at the highest risk. These include people who also abuse alcohol and cannabis, as well as individuals who have depression.

Cocaine addiction is one of the different stimulant use disorders. Stimulant use disorders are a subcategory of substance use disorder.

For a person to be diagnosed with stimulant use disorder, they must be more than just a user. For this diagnosis, a person must meet at least two of 11 criteria outlined in the DSM-5 within the previous 12 months.

The DSM-5 criteria for substance abuse disorder include the following:

1. Using more of the substance or taking it for a longer duration than prescribed or intended
2. Being unable to reduce or stop taking the substance, despite wanting or trying to
3. Devoting excessive time, money, or resources to obtaining, using, or recovering from use
4. Craving the substance
5. Neglecting or having difficulty carrying out responsibilities at work, school, or home because of the substance use
6. Persisting in using the substance despite its effect on relationships
7. Missing out on activities (social, recreational, school, work) because of the substance use
8. Using the substance in a dangerous or harmful way
9. Using the substance despite adverse emotional or physical effects  
10. Developing a tolerance to the substance
11. Experiencing withdrawal symptoms when the substance is reduced or stopped

Detox and Treatment

Coming off cocaine is a process that may take several weeks. Some people who are trying to stop using cocaine may experience better outcomes from inpatient rehabilitation, especially because cocaine cravings can be intense during withdrawal, and relapse is common.

If you seek an inpatient program, you would be in a supervised setting where you are not able to obtain or use the drug. When you stop taking cocaine, you can experience severe withdrawal symptoms that need to be managed.

For example, you may need medication for the treatment of abrupt or severe changes in your blood pressure. You might need counseling, supervision, and medication if you develop depression and suicidal ideation.

Behavioral treatment includes psychotherapy and other psychosocial interventions. These approaches help to maintain abstinence from cocaine after detox.  And you might need to continue your behavioral treatment for months or even years after you stop using cocaine. The goal of behavioral therapy is to avoid relapse or abusing or becoming addicted to another drug in the future and learning how to live a healthy and sober life. 

If you are having suicidal thoughts, call a suicide hotline.

If you or a loved one are in immediate danger, call the emergency services.