Cocaine Addiction

Cocaine is an illegal stimulant that produces intense, short-lived euphoria — and potentially life-threatening effects such as heart attack or stroke.  In the United States, cocaine is involved in more emergency room visits than any other illicit drug, according to 2011 data from the Substance Abuse and Mental Health Services Administration.

Derived from the South American coca plant, cocaine is known to be extremely addictive.  The drug is typically snorted through the nose as a fine white powder, or dissolved in water and injected into the veins (which increases the risk of overdose).  Freebase cocaine is known as “crack” — a rock crystal form of the drug that is smoked and crackles when heated.

Addictive and Dangerous

Cocaine stimulates the brain’s reward pathways and floods the body with feel-good dopamine, causing a powerful euphoric rush.  Users may also feel agitated, confident and hyper-energetic.

Tolerance to cocaine develops quickly and requires larger, more frequent doses to sustain the characteristic cocaine high.  This can lead to addiction and devastating health consequences.

Cocaine’s Health Risks

Cocaine impairs judgment and can cause great physical and psychological harm.  Its adverse effects may include:

  • Severe paranoia, anxiety and hallucinations
  • Increased heart rate and blood pressure
  • Seizures, stroke
  • Malnutrition (related to appetite suppression)
  • Sudden cardiac arrest
  • Abdominal pain/intestinal damage and nausea
  • Chest pain, respiratory infections
  • Nosebleeds and nasal damage from snorting cocaine
  • HIV, hepatitis and other blood-borne diseases from injecting cocaine
  • Risk of fatal overdose, especially when cocaine is combined with other drugs


While the abuse of opioid drugs such as heroin and prescription narcotics is on the rise, cocaine use has been declining in recent years.

In 2012, there were an estimated 1.6 million cocaine users in the United States, vs. 2.4 million users in 2007, according to the National Survey on Drug Use and Health.  Cocaine users represent approximately 0.6 percent of the U.S. population; the average age at first use is 20 years old.

Spending by drug users on cocaine has decreased by nearly half, from $55 billion in 2000 to $28 billion in 2010, according to the Office of National Drug Control Policy.  Drug experts attribute the decline to a crackdown on Colombian production and trafficking of cocaine — as well as higher prices per gram, and less cocaine purity in the U.S. market.

The good news is that cocaine addiction rates and overdose deaths are also down, but there is still cause for concern.  Many people remain dependent on cocaine — endangering their physical and mental health, especially when binging on the drug.  They also risk criminal arrest and financial and family hardship.

Do You Have a Cocaine Problem?

Cocaine’s highly addictive properties make it easy to become dependent on the drug.  Even after periods of abstinence, there is a high risk of relapse — as certain cues or memories can trigger powerful cravings for cocaine, according to research from the National Institute on Drug Abuse.

If you have a strong urge to use cocaine, and need increasingly more to get high — or if you continually binge on cocaine despite the consequences, you may be at risk for addiction.

A confidential self-test for cocaine addiction is available online from Cocaine Anonymous, a 12-step fellowship of people in recovery.  Click here to take the test:

Physicians diagnose cocaine dependence by using the gold-standard DSM-5 criteria, developed by the American Psychiatric Association.  A person must meet at least two of 11 criteria within the same 12-month period, such as a strong urge to use cocaine; spending a great deal of time trying to obtain, use or recover from cocaine; building a tolerance for the drug; and having withdrawal symptoms after stopping cocaine use.

Cocaine Addiction in a Loved One

Signs of cocaine use in a loved one may include periods of disappearance and returning in a notably excited, talkative or agitated state.  You may observe that your loved one is not eating much, sleeps very little or all the time (following a drug binge or “crash”), has mood swings or is more prone to aggression and risky sexual behaviors.  Your relative may also lose interest in work and family life, as cocaine use becomes all-consuming.

Physical changes in your loved one may include dilated pupils, a runny nose or nosebleeds (if cocaine is snorted), needle track marks (if cocaine is injected) or blistered, cracked lips and burned fingers (if cocaine is smoked).

Getting Help

You don’t have to fight cocaine addiction alone.  Effective treatment is available, including medically-supervised detoxification programs that can help ease withdrawal symptoms and prevent cocaine relapse.  Like millions of Americans in recovery from addiction, you can experience the rewards of a healthy, drug-free life.

“I’m confident that medications – or perhaps a vaccine – will be the future of cocaine addiction treatment,” says David J. McCann, Associate Director of the Division of Pharmacotherapies and Medical Consequences of Drug Abuse at the National Institute on Drug Abuse.  “However, it is important for patients to know that effective non-drug therapies, such as Cognitive Behavioral Therapy, already exist. There is no reason to delay in seeking treatment.”

Cocaine addiction is typically treated in an inpatient residential facility.  To be most effective, the treatment duration should be at least 90 days, and severe addiction may require longer stays, according to research studies by the National Institute on Drug Abuse.

Your best option for long-term recovery is a program that addresses all aspects of your addiction.  This includes any dependence on other drugs, nutritional depletion caused by cocaine use, and mood disorders or mental health issues that co-occur with the cocaine addiction.

An effective program often includes research-proven psychosocial therapies, such as Cognitive Behavioral Therapy, which helps break patterns of destructive thinking to prevent cocaine relapse.  A strong “after care” program is essential, to build on the gains made in rehab.

On the Horizon: A Cocaine Vaccine, Medications that Ease Cravings

One of the most promising advances in cocaine addiction treatment is a potential vaccine, now in development at Weill Cornell Medical College in New York City.  The vaccine works by creating antibodies that bind to the cocaine, making it too large to reach the brain and have any effect.

Once cocaine is ingested — whether it’s smoked, inhaled, or snorted — it goes to the bloodstream.  The anti-cocaine vaccine binds to the drug molecules, creating a larger molecule that is unable to cross the blood-brain barrier.  And when cocaine fails to reach the brain, the user does not experience a dopamine-induced “high” — which ultimately can break the cycle of addiction.  Even if the cocaine user has a relapse while taking the vaccine, the cocaine will have no effect.

Currently, there are no FDA-approved medications specifically for cocaine addiction, although doctors may prescribe muscle relaxants and anti-depressants to ease cravings and promote well-being. The National Institute on Drug Abuse is conducting trials on several promising medications that could help reduce cocaine dependence.  These established medications are already approved to treat other diseases and include vigabatrin, modafinil, disulfiram, topiramate and tiagabine.

Disulfiram, also known as Antabuse, is a common treatment for alcoholism that has been shown to reduce cocaine use in clinical trials.  Disulfiram discourages cocaine dependence by making the “high” much less pleasant and the user more anxious.  The combination of buprenorphine plus naltrexone is also being studied as a promising pharmacological treatment for cocaine addiction.

Resources for Recovery

Contact Us About ServicesDRUGREHAB.ORG helps people achieve freedom from cocaine by finding the best care for lasting recovery.  We provide FREE referrals to respected rehabilitation centers nationwide – including the latest evidence-based treatment approaches and aftercare programs.  All calls are confidential and help is available 24/7. is an independent service, not funded by or affiliated with any treatment center.  To find help for cocaine dependence, call our experienced counselors today at:

888. 957 .3422


Cocaine Anonymous is a 12-step fellowship of former cocaine-addicted individuals, with online forums and in-person meetings held throughout the United States.  To find the nearest C.A. meeting, go to the website or call 1-800-347-8998.


These websites include online forums, mutual aid organizations and 12-step programs for people with cocaine and other drug addictions:


1-800-NCA-CALL (800-622-2255)  24-hour helpline sponsored by the National Council on Alcoholism and Drug Dependence.>

1-800-662-HELP (4357)  24-hour National Drug and Alcohol Abuse Hotline offering information and referral services to people seeking treatment and other assistance; sponsored by the Center for Substance Abuse Treatment (CSAT)


Reviews questions to ask when searching for a rehabilitation program.  A free publication from the National Institute on Drug Abuse.