While opioids are the addictive substance that poses perhaps the greatest threat to the country, many other drugs have long been a problem in the United States, and, even in the midst of the opioid crisis, continue to be an issue.

One such drug is cocaine. While cocaine is most frequently associated with the 1970s and 80s, it is still very much in use today, with an estimated 1.5 million users in 2014. Cocaine also does play a role in the opioid epidemic due to how frequently it is used in combination with other drugs, including opioids like heroin. In 2015, cocaine was a contributing factor in about 7,000 overdose deaths.

Unlike heroin or other opioids, cocaine also carries with it an oddly glamorous association due to how often movies and television depict it as the drug of choice for the rich and famous. It has even been frequently referred to as the “caviar of street drugs.”

The effects of cocaine abuse, however, are as far from glamorous as it gets. Long-term cocaine abuse and addiction can cause serious, often permanent damage to the central nervous system, respiratory system, and cardiovascular system, often with fatal results.

It is possible to become addicted to cocaine in just one use and quickly build up a tolerance to its effects, needing to use more and more of it and putting yourself at an increased risk of overdose.

What Is Cocaine?

Cocaine is a central nervous system stimulant made from the coca plant, which is native to South America. While the plant has been used for medicinal purposes for hundreds of years, when synthesized into cocaine it becomes an extremely addictive recreational drug.

Cocaine is typically sold in the form of white powder that is often introduced into the body by rubbing it on your gums, although it can also be snorted and even injected. Cocaine can also be heated up and processed into a smokeable form known as crack.

Cocaine is classified by the Drug Enforcement Administration (DEA) as a Schedule II substance, which means that it has a high potential for abuse and addiction and is recognized as having extremely limited medical usage.

How Does Cocaine Work?

Once cocaine has entered the body, its effects begin to take hold very quickly, causing an intense but brief high. Like most stimulants, cocaine works by altering the user’s dopamine levels. Dopamine is a neurotransmitter that is responsible for regulating emotion, motivation, and reward, among other things, and is in what is referred to as the brain’s pleasure center.

Generally, when the brain produces dopamine as a chemical response, it sits in the synapses until it is no longer needed and is then reabsorbed until its next use.

Cocaine is what is known as a “reuptake inhibitor,” blocking the reabsorption of dopamine, and other brain chemicals tied to balancing mood and emotion like serotonin and norepinephrine so that they build up in the synapses. This buildup is what causes feelings of excitement, alertness, and euphoria.

How Does Cocaine Impact the Brain?

Addiction works by stimulating the reward or pleasure sensors in the brain, thereby creating a psychological and physiological habit that engrains compulsive behaviors in the individual using the substance. The National Institute on Drug Abuse states that cocaine stimulates the release of the neurochemical dopamine in the brain, which facilitates the development of addiction and drives compulsive addictive behaviors.

Dopamine is a chemical that is normally released by cells and then recycled back into the cells, where it is not then acting on the nerve cells in the brain. Cocaine prevents dopamine from being recycled back into the cells, leaving large amounts of the neurochemical to act on the nerve cells and halt normal communication.

When dopamine floods the brain’s circuitry like this, it creates a strong reinforcement for the drug-taking behavior by lighting up the brain’s pleasure sensors. However, the brain becomes acclimated to the excess dopamine in the brain and develops a tolerance to the chemical, becoming less receptive over time to the floods of dopamine.

As this tolerance to the excess dopamine develops in the brain, an individual must take increasing amounts of cocaine to experience the same levels of pleasure from the dopamine release. This results in a compulsion to take more of the drug to produce the same effects and further reinforces the drug-seeking behaviors.

Why Is Cocaine So Addictive?

Research has shown that cocaine addiction is difficult to treat. Cocaine use affects brain tissue and functioning, and the damage that it causes can make addiction treatment more difficult.

Several factors contribute to the relatively high potential for abuse and addiction to cocaine, including:

Fast Absorption and Results

The ingestion methods for cocaine contribute to the addictive nature of the drug.  Snorting, smoking, or injecting the drug creates and quick, euphoric high that almost immediately impacts the brain and triggers the release of dopamine. The quick high associated with cocaine use results in immediate gratification, which reinforces the use of the drug.

A Quick Buildup of Tolerance

Since individuals can quickly build a tolerance to cocaine, high doses often follow the initial onset of use, resulting in addictive patterns that worsen over time with continued use.

Withdrawal Symptoms

Cocaine use can result in withdrawal symptoms that are unpleasant and include cravings for the drug. After tolerance builds up and psychological dependency sets in, withdrawal symptoms are unpleasant enough to cause individuals to seek out more of the drug to prevent withdrawal.

Brain Damage

Cocaine use is associated with a loss of gray matter in the brain and white matter decay. It further changes the dopamine-binding process, resulting in impacts to the brain’s reward system that reinforce drug use.

Easy Access

Cocaine is an easily obtainable drug. It is widely available despite being illegal. In fact, cocaine may be easier to obtain than alcohol for some minors, as the drug’s illicit status means that it is sold solely on the black market, a resource available to people regardless of age. Minors seeking to get high may find cocaine to be a relatively accessible drug of choice, leading them down the path to addiction before they can legally seek out other substances like alcohol.

What Are the Signs of Cocaine Addiction?

The signs of a growing addiction are often hard to spot until it has progressed to the point where someone’s dependency on a substance has become obvious. It can be difficult to notice something if you are not specifically looking for it. That said, the signs of cocaine addiction tend to be more easily distinguished as opposed to those of alcohol abuse, for example.

The abnormal behaviors associated with heavy cocaine use will also typically clash with someone’s normal personality noticeably as they rely more on cocaine abuse to function in their daily lives.

As cocaine becomes the focus of someone’s life and the motivator behind the majority of the decisions they make, many behavioral signs signal not only cocaine addiction but are also consistent with substance use disorders in general.

These behaviors are all signs of cocaine addiction or at least cocaine abuse and dependency that is on its way to becoming a full-blown addiction. If you recognize these signs in someone you care about, or in yourself, then you must seek professional recovery treatment as soon as possible, starting with medical detoxification to clear your system of the substance and stem the physical and mental damage it may have already caused.

Cocaine Abuse Behaviors

  • Experiencing withdrawal symptoms when not using cocaine
  • Attempting to rationalize or justify cocaine use
  • Financial or legal difficulties due to cocaine use
  • Being unable to perform basic daily functions without using cocaine
  • Loss of interest in hobbies and activities
  • A decline in school or work performance
  • Prioritizing cocaine use over responsibilities and relationships
  • Lying or being secretive about using cocaine
  • Wanting to stop using cocaine but being unable to
  • Noticeable lack of hygiene

If you suspect a loved one may be using crack cocaine, common signs of addiction that you can look for include:

  • Rapid weight loss
  • Loss of interest in activities
  • Disappearing for days at a time
  • Loss of financial stability
  • Disheveled appearance
  • Involvement with crime
  • Stealing or pawning objects
  • Frequently asking for money
  • Unexplained loss of money or property
  • Discovery of drugs or drug paraphernalia
  • Changes in mood, behavior, appearance
  • Decreased personal hygiene habits
  • Dental damage

Why Should I Detox From Cocaine?

The process of cocaine withdrawal is not typically a life-threatening one, and so a cocaine detox can usually be done on an outpatient basis, with regular visits to a detox clinic. However, if someone has tried to quit using cocaine multiple times without success, then an inpatient detox may be necessary.

It is important to keep in mind though that just because cocaine has a comparatively less dangerous withdrawal than other substances, that does not mean that someone should attempt to detox on their own without at least some level of medical supervision.

If you have a particularly severe cocaine addiction, then attempting to quit on your own all at once can trigger an intense shock to your body due to the sudden loss of the dopamine supplied by cocaine, which can lead to intense emotional and psychological cocaine withdrawal symptoms.

A man clutching his head with his handsThe symptoms of depression and suicidal thoughts can often feel overwhelming to the point of not only potentially causing a relapse before completing the detox process but also increasing the risk of self-harm or worse.

A professional medical detox team can properly and safely handle these kinds of complications that would be much more dangerous if faced alone.

Another reason medical detox for cocaine is a smart choice is that generally, batches of cocaine that make it to the streets are very rarely pure cocaine. Imported cocaine is often cut with all kinds of different substances to stretch out the batch and make more money for the dealer.

Since there is no way to know just what might be in the cocaine you’ve been abusing, you may have been ingesting other drugs or hazardous substances as well.

A detox center can provide you with an accurate medical assessment that provides insight into drugs you may have inadvertently been taking without even knowing it ensures your health and safety during the detox process

What Are the Cocaine Withdrawal Symptoms?

As a stimulant, cocaine withdrawal symptoms are very different from most other drugs. Cocaine withdrawal, for the most part, lacks the physical withdrawal symptoms associated with substances like opioids or benzodiazepines.

This means that instead of tremors, nausea, vomiting, and other flu-like symptoms, cocaine withdrawal symptoms are mostly mood-based and psychological in nature.

Common Cocaine Withdrawal Symptoms

  • Intense Cravings
  • Exhaustion
  • Depression
  • Increased appetite
  • Anxiety and panic attacks
  • Difficulty concentrating
  • Restlessness
  • Agitation and mood swings
  • Suicidal thoughts
  • Intense nightmares
  • Inability to experience sexual arousal

How Long Does Cocaine Withdrawal Last?

The intensity and length of the symptoms of cocaine withdrawal depend on several different factors, including how long someone has been abusing cocaine, how much of it they were taking, and how they were taking it, to name a few.

The cocaine withdrawal timeline is generally broken into three different phases: crash, craving, and extinction. While the previously mentioned factors will have a significant impact on how an individual experiences cocaine withdrawal, it will typically resemble the following process:

Crash Phase

Cocaine has a very short half-life and peaks very quickly, so someone can begin feeling cocaine withdrawal symptoms as soon as 90 minutes after their last dose. However, it can sometimes take closer to 24 hours for symptoms to manifest.

The early symptoms include anxiety, exhaustion, hunger, and depression, and can last as long as several days. This is also generally when the withdrawal symptoms will be at their most uncomfortable.

Craving Phase

Once the crash stage has run its course, the fatigue, depression, and anxiety will have mostly faded and been replaced with extremely strong cocaine cravings. Symptoms of irritability, restlessness, and difficulty concentrating will be at their peak strength as thoughts of and cravings for cocaine become almost all-consuming.

Unlike the crash phase, the craving phase can last anywhere from one week to more than two months. The longer someone has been abusing large amounts of cocaine, the more likely they are to stay in the craving phase, sometimes for as long as 10 weeks.

Extinction Phase

The final stage of cocaine withdrawal is also the longest, sometimes lasting up to six months. At this point, the majority of the cocaine withdrawal symptoms should have either faded or disappeared entirely, although there are still likely to be random, intermittent cravings for cocaine.

On the bright side, these cravings will at least be much weaker and less frequent than the cravings experienced in the craving phase.

Who Uses Cocaine?

Addiction knows no bounds, so any person can become addicted to cocaine regardless of race, age, sex, or geographic location. However, there are protective and risk factors that can cause certain demographics to be at higher risk for cocaine addiction.

According to the National Institute on Drug Abuse (NIDA), there were more than 1 million current cocaine users in 2014, and rates remained the same for years. According to a 2014 demographics study of powder and crack cocaine use among high-school seniors, some identifying markers were risk factors while others lowered the odds for cocaine use.

Demographics with lower odds included:

  • Identifying as Black
  • Living with one or two parents
  • Making less than $50 per week
  • Identifying as religious
  • Having highly educated parents

Demographics with increased odds included:

However, despite the assumption that cocaine is a drug of high socioeconomic status, according to a NIDA paper published during the crack cocaine epidemic in 1991, income may not play a big role in cocaine use. It writes, “…total income per week showed only a small association with cocaine use.”

Not Just for the White Collar

A six-figure salary may be ideal if you have a cocaine addiction, but your brain’s reward center doesn’t know what’s in your checking account.

If you develop a severe substance use disorder involving cocaine, you may be stuck in an addiction you can’t afford. The financial and chemical demand can lead to risky, desperate behavior. In fact, a 2017 study showed that cocaine-addicted people who are homeless turn to illegal and informal means of funding their drug use.

Can Taking Cocaine Lead To Feelings of Depression?

Although cocaine is in the class of CNS stimulant drugs, frequently using it in large amounts can lead to feelings of depression. There are several different ways a person may experience depression resulting from their use of cocaine.

  • People who regularly use cocaine find they experience feelings of stimulation, euphoria, hyperactivity, and other effects from the stimulant effects of the drug. However, after they discontinue its use, they often find they experience a crash that consists of feelings of apathy, lack of motivation, fatigue, lethargy, increased appetite, and depressive symptoms. This cycle of ups and downs occurs most often in individuals who use large amounts of cocaine or use it regularly.
  • Chronic cocaine use can lead to a person having difficulty experiencing pleasure because of the changes in neuroanatomy resulting from repeated cocaine use.
  • Excessive use of cocaine can result in the development of physical dependence (withdrawal). One of the symptoms of withdrawal from stimulants is an alteration in mood that can include feelings of depression.
  • People who buy cocaine on the street may not be getting pure cocaine. They may be getting cocaine laced with other substances that have the potential to produce feelings of depression.

How Cocaine’s Mechanism of Action Can Lead To Depressive Symptoms

Cocaine affects numerous neurotransmitters, particularly dopamine, norepinephrine, and serotonin. When these neurotransmitters are activated, there is the perception of reinforcement or reward. Depletion of these neurotransmitters is believed to be associated with many effects, particularly depression.

These neurotransmitters are released in massive amounts when people use cocaine, and cocaine blocks their reuptake, leaving them in the space between neurons where they can reattach to the receptor sites. The high from cocaine is extremely short-lived, and abusers of the drug will often go through episodes where they binge on cocaine to maintain the feeling of euphoria.

This activity leads to a cycle of massive neurotransmitter release followed by significant decreases in their availability once a person stops using cocaine.

This cycle accounts for the crash, leads to permanent changes in the neural pathways of the brain, and results in withdrawal symptoms in those who have developed a cocaine dependence. Over time, this can result in permanent changes in the brain that result in difficulty experiencing pleasure from events that would normally produce it. Chronic feelings of apathy or depression are more likely.

What Are the Next Steps of Cocaine Addiction Treatment?

To give yourself the highest chance of recovering from dependence on cocaine, as well as just about any other addictive substance, detoxification is the crucial first step. However, it is only just that, the first of many steps involved in cocaine addiction treatment. If you do not take that next step to ongoing care, then it will be as if you just placed a bandage on the problem instead of truly addressing it. Detox removes the cocaine from your system, but that’s all it does.

To change your addictive behaviors and give yourself the best chance at maintaining sobriety and avoiding an almost certain relapse, then addiction rehabilitation treatment is essential. Depending on the severity of your addiction, this can be done in either an inpatient or outpatient setting. Typically though, most people recovering from cocaine addiction can do so on an outpatient basis.

Whichever type of treatment program you choose, you will have access to different therapies and methodologies meant to help you get to the root of the issues behind your addiction, and learn to understand and better manage addictive behaviors.

Typical Treatment Techniques

  • Addiction Education
  • Individual counseling
  • Group therapy
  • Relapse prevention planning
  • Stress management
  • Dual diagnosis treatment
  • Medication management

No one’s recovery treatment program is going to look the same. Your treatment program will generally be tailored to what will have been determined to be most effective for you personally, often in collaboration between you and your therapist or counselor.

Many treatment centers will also provide post-graduation support services, including alumni programs. These are meant to make it easier for people who have bonded during their shared experience during treatment to keep in touch and act as a network of support for each other.

How Dangerous Is Cocaine?

Cocaine is much more dangerous than many people might think. Since the use of cocaine carries the association of being affiliated with people of high social status, the negative effects of cocaine can often be misconstrued.

But make no mistake, long-term use of cocaine can lead to damaging effects on the body as well as the brain. Cocaine’s effects on blood vessels, heart rate, and blood pressure can lead to serious heart problems and an increased risk of heart attack and stroke.

Other dangers associated with cocaine abuse are based on how someone uses the drug. For example, if you are mainly abusing cocaine by snorting it, you are likely to experience difficulty swallowing, chronic sinus problems and nosebleeds, a loss of sense of smell, and the possibility of perforating your nasal cavity and causing it to collapse.

Effects of Regular Cocaine Use

  • Confusion
  • Extreme paranoia
  • An increased risk of seizures
  • Delusions
  • Unstable moods and aggression
  • Psychosis
  • Permanent damage to the brain
  • Intense “post-high” depression
  • Suicide ideation
  • Constricted blood vessels

If you are primarily injecting cocaine, then you are at extremely high risk of an infection in the lining of your heart valves, as well as contracting hepatitis, HIV, or other diseases borne from sharing needles. There is also a high risk of the injection site becoming infected or getting an abscess.

It is not only possible to overdose on cocaine, but it can also be fatal if it is not treated in time, as cocaine overdoses are commonly followed by a fatal seizure, heart attack, or stroke.

Cocaine abuse and addiction should never be taken lightly. It can permanently damage key pathways in the brain and throw off brain chemistry levels to the point where it can be almost impossible to restore them to normal, pre-addiction functioning.

Signs That Someone Is Overdosing on Cocaine

  • Irregular, erratic heart rate
  • Convulsions
  • Dangerously elevated blood pressure
  • Psychosis
  • Extremely high body temperature
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