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One of the most notorious recreational drugs in the world is cocaine, a powerful stimulant that is most commonly injected, smoked, or snorted. Cocaine is the second most popular illegal substance worldwide, with at least 35 million Americans over the age of 12 having admitted to using the drug.
While cocaine abuse is a difficult addiction to break, there is hope.

Signs of Cocaine Abuse

Cocaine is a stimulant, meaning that most people on the drug will be overly excited and confident.

Some signs of cocaine addiction include:

  • Track marks from shooting up (or other signs from snorting or smoking)
  • Drug paraphernalia (hypodermic needles, baggies with residue, etc.)
  • Unexpected episodes of excitement and confidence
  • Paranoid episodes
  • Financial problems because of increased drug use
  • Abnormal sleep patterns

To get treatment for cocaine abuse, it’s important to work with a reputable rehabilitation center that understands this drug and its impact.
Despite the well-known dangers that cocaine use presents, it remains the second most commonly abused drug in the world, behind only marijuana. Cocaine overdose deaths remain a significant factor in the ongoing drug overdose epidemic in the United States.

Effects of Cocaine Addiction

The primary effect of cocaine’s ability to act as a reuptake-inhibitor of dopamine causes the brain’s reward circuit to be flooded with the neurotransmitter. This, in turn, leads to an intense euphoria felt by the user and many of cocaine’s addictive properties.

Some common effects of cocaine addiction and abuse include:


  • Chronic cocaine use causes sensitization, which is when increasingly smaller amounts of the drug produce negative side effects, such as convulsions, anxiety, and others.
  • Cocaine, like the majority of other stimulants, has several effects on mental function. Cocaine causes the user to have an intense level of concentration and hyper-focus far above the normal baseline. This can cause the user to become fixated on a specific goal, idea, or action.
  • Cocaine has negative effects on several major organs. Cocaine has been demonstrated to be toxic to the heart and cardiovascular system, including causing inflammation of the heart.
  • Users who smoke crack (crack cocaine) run the risk of developing acute pulmonary syndrome, commonly nicknamed “crack lung.” This painful condition causes inflammation of the lungs and severe discomfort in chronic users.
  • Cocaine’s ability to act as a reuptake-inhibitor of the neurotransmitter norepinephrine also produces several effects on the user. Cocaine causes the user to experience increased blood pressure and breathing during the duration of its action.
  • Users who inject cocaine greatly increase the chances of developing life-threatening infections, including contraction of HIV and hepatitis-C.

Powder Cocaine

Powder cocaine is the most commonly used form of cocaine in the world. It is composed of cocaine hydrochloride, along with invariably some form of cutting agent. Cocaine hydrochloride is water-soluble, which accounts for powder cocaine’s popularity. Powder cocaine’s water-soluble nature is what allows powder cocaine to be snorted, mixed in water and injected, or rubbed on the gums for oral absorption. Cocaine hydrochloride, however, cannot be smoked.

Crack Cocaine

Crack cocaine is the common name for the form of cocaine that can be smoked. Cocaine hydrochloride decomposes at the high temperatures necessary to smoke it, and therefore cannot be smoked. Reacting cocaine hydrochloride with basic substances such as baking soda allows the hydrochloric acid to escape, ultimately yielding crack cocaine. The resulting crack cocaine rocks vaporize much more readily than powder cocaine, allowing them to be smoked without decomposing the cocaine alkaloid.

Cocaine Overdose

Cocaine overdose and poisoning is a very real phenomenon that oftentimes results in death. While opioid and heroin overdoses continue to dominate national headlines, cocaine overdose deaths have increased every year since 2010.

Preliminary data from 2017 states that over 14,500 people in the United States lost their lives to a cocaine overdose. Cocaine overdoses can be broken down into three phases. Without medical intervention prior to the third and final phase of a cocaine overdose, the overdose will result in death.

Phase 1

Unlike heroin and many other drugs, the first phase of a cocaine overdose is almost indistinguishable to the user. The side effects of the first phase of a cocaine overdose are essentially the normal effects the user gets from cocaine use. Thus, the majority of users will not realize they have overdosed during the initial phase of a cocaine overdose.

Phase 2

The second phase of cocaine overdose is much more unpleasant for the user. At this point, they will realize something is terribly wrong. The central nervous system of the user will essentially go into overdrive, leading to severe heart palpitations, headaches, nausea, and vomiting. Seizures are also common during this phase of a cocaine overdose. Finally, breathing will become more difficult for the user.

Phase 3

The third and final phase of cocaine overdose results in death. The overstimulation of the central nervous system during the second phase eventually leads to the system shutting down in the final phase. Once the central nervous system shuts down, the circulatory and respiratory systems cease to function.

Cocaine Tolerance and Addiction

Cocaine abuse leads to tolerance to the effects in which it produces on the user. 

Tolerance refers to the phenomenon where increasing amounts of the drug need to be used in order to achieve the same effect as previously experienced.

Cocaine dependence results from a wide range of complex adaptive changes that occur in the brain to counter chronic drug use.

Cocaine addiction is the result of both structural and biochemical changes to the brain that occurs through repeated abuse of the drug. Cocaine addiction is largely caused by the overexpression of the protein delta-FosB in response to repeated use. Delta-FosB has been implicated in practically every form of behavioral and drug-induced addictions, including cocaine.

Cocaine has been shown repeatedly to cause a strong physiological addiction in chronic users. The intense desire and craving to use cocaine often result in drug-seeking behavior that continues despite growing consequences. In lab animals, for example, cocaine has been shown to be preferred over food, water, and sex. When provided with unlimited access to the drugs, the majority of animals will use it until they either overdose or die of starvation. In a similar manner, chronic users of cocaine will often use it until they are in financial ruin or their physical health deteriorates.

Cocaine Withdrawl Syndrome

Chronic cocaine abuse and subsequent dependence result in a defined cocaine withdrawal syndrome when users cease using. This withdrawal syndrome results from the adaptive changes the body has made to chronic cocaine use that make cocaine physically and physiologically addictive.

Cocaine withdrawal syndrome can be broken down into two distinct phases, followed by a post-acute withdrawal syndrome that will be covered in the next section.

Phase 1

The first phase of cocaine withdrawal syndrome is commonly referred to as the “crash” phase. This name derives from the crash the user experiences in the absence of both physical and mental surge of energy cocaine delivers that they had been accustomed to. This phase typically results in a reversal of many of the common effects of cocaine use. Exhaustion and a strong desire to sleep long hours often occur during this phase. A surge in appetite compared to during a cocaine binge also is commonly experienced. The lack of euphoria the user had grown accustomed to will be typically replaced by irritability, feelings of depression, and general restlessness. Unlike most other drug withdrawals, the first phase of cocaine use is often associated with an absence of drug cravings. This phase starts a few hours after the last use and continues for a few days.

Phase 2

The second phase of cocaine withdrawal syndrome begins a few days after the last use and lasts up to a few weeks. This phase is defined by the return of strong cravings and obsessions to use cocaine. Therefore, the risk of relapse is highest during this phase of withdrawal. The intense focus and increased working memory associated with cocaine use typically give way to an inability to concentrate and trouble with memory. A general feeling of lethargy and depression is often accompanied by this phase of withdrawal. General sleep disturbances are also common during this phase. Finally, anxiety and mood swings are typically encountered during this phase of withdrawal.

Cocaine and Post-Acute Withdrawl Syndrome (PAWS)

Once the initial cocaine withdrawal syndrome has passed, a subsequent syndrome with a defined set of symptoms tends to follow, known as post-acute withdrawal syndrome (PAWS).

While these symptoms typically are not as severe as the initial withdrawal period, the long duration in which they are experienced makes them a very difficult challenge to overcome in obtaining long-term sobriety. Cocaine post-acute withdrawal syndrome typically begins after the first few weeks and can last several months. Post-acute withdrawal syndrome from cocaine occurs due to the adaptive changes to the central nervous system that occurs in response to chronic cocaine abuse. These changes, unfortunately, require extended periods of abstinence time to fully heal.

A common example of this phenomenon is the difficulty many people in early sobriety experience for feeling or sensing happiness during activities the brain normally would reward for, such as a nice meal. This is the result of overstimulation of the brain’s reward system by chronic drug use. Common symptoms of post-acute withdrawal syndrome include the return of some of the original withdrawal symptoms, such as sleep disturbances and depression.

Cravings and obsessions to use cocaine are also very common during this period, particularly in response to stimuli that may remind the user of past drug use. One study found that impulse control in recovering cocaine addicts took longer than a month to show any sort of improvement.

Addiction Treatment 

At True, we offer unique treatment options for cocaine abuse in Newport Beach, CA, including an intensive outpatient treatment program (IOP) that takes an individualized, holistic approach to cocaine addiction counseling and recovery.

We accept the majority of private insurance plans, and we can verify your coverage in as soon as an hour.

There are many treatment centers throughout Orange County that offer cocaine addiction treatment, but there are very few that are as extensive and unique as True. To us, you’re not just a number.

You are an individual who deserves a personalized treatment plan focused on your goals. Through our multiple therapy programs, we help you refocus your energy on your passions, hobbies, and goals to grow beyond substance use. Our small caseloads allow us to focus on you and only you while addressing your unique needs.

If you or someone you know has a cocaine addiction, don’t let it become more of a problem than it already is. Fill out our contact form or call today and speak with an admissions counselor right away.