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How Addictive Is Cocaine? How to Tell Someone Has a Problem

Cocaine may not be as addictive as some sources claim, but it is still a drug with significant abuse and addiction potential. Repeated cocaine use has real potential to damage a person’s physical and mental health. Its use should be avoided outside some highly specific medical contexts, where a doctor might administer it.

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How Addictive Is Cocaine?

Cocaine is an addictive drug, but its addictiveness is often overblown. You are unlikely to become addicted to cocaine with sporadic use, although that drug use is still going to affect your body and could potentially result in serious health issues, especially for those at risk for heart problems. 

With that said, cocaine does still have significant abuse and addiction potential. A small percentage of people who have tried cocaine continue to use it regularly, and about 0.3 percent of Americans over the age of 12 met the criteria for a cocaine use disorder in 2016 (although this number may be on the rise). 

The more often one uses cocaine and the more you use in one session, the more likely you are to develop issues with drug dependence and drug addiction. 

Keys Facts About Cocaine Addiction

Some key facts about cocaine use and addiction include the following:

Key Facts

  • Almost 2 percent of Americans over age 12 reported using cocaine in the past month, according to one 2020 survey.
  • That same survey showed 0.5 percent of people ages 12 or older had a cocaine use disorder (often just called an addiction) in the past 12 months, which is 0.2 percent higher than the earlier noted 2016 rate of cocaine use disorders.
  • A 2021 survey showed an estimated 0.2 percent of 8th graders, 0.6 percent of 10th graders, and 1.2 percent of 12th graders reported using cocaine in the past 12 months.
  • In 2020, approximately 19,447 people died from an overdose involving cocaine.

Why Is Cocaine Addictive?

Even if the degree to which it is addictive is sometimes overstated, cocaine still has real psychoactive and addictive effects on the brain that can cause a person to seriously struggle with its use. These are some of the primary reasons it can be addictive:

It Hijacks the Brain’s Reward Systems

Regardless of how it’s used, cocaine causes a buildup of the neurochemical dopamine. While this chemical has a number of important purposes in the body, one of especially important note is how it helps to generate the feeling of reward. 

When the brain is unaffected by drugs, dopamine reinforces behaviors that are generally important for human survival, such as having sex or eating food. However, cocaine use can cause an intense feeling of reward detached from any behavior beyond using cocaine, which has the potential to cause problems with addiction and drug abuse.

Repeated Drug Use Causes the Brain to Adapt

It’s possible to engage in drug abuse without being addicted. Generally, a person who becomes addicted to cocaine will have started out repeatedly using it while still feeling in control of their drug use. Unfortunately, this kind of repeated use can cause the brain to adapt, starting to treat the brain in its “high” state as normal, and thus developing a dependence on a drug (in this case, cocaine). 

Explained more later, dependence doesn’t necessarily mean a person is addicted to a drug, but it can be a major factor that leads to addiction. Many people who have an addiction are also physically dependent on the drug. 

Drug Cravings Can Be Triggered Even After Long Abstinence 

After a person has repeatedly engaged in cocaine use, even after periods of long abstinence from cocaine, it’s been shown that the memory of the euphoria associated with cocaine use or exposure to cues associated with drug use can trigger powerful cravings for cocaine. While not wholly unique to cocaine, this can still make quitting cocaine difficult for people who have struggled with cocaine use in the past. 

Difference Between Addiction & Dependence

Addiction and dependence are terms that are often used interchangeably, but they’re actually different (although related) concepts. In fact, at least one paper has identified this problem is even present in some commonly used medical literature. 

Very broadly, dependence can refer to either physical or psychological dependence. Physical dependence is when the brain and body adapt to a drug’s use. They then exhibit withdrawal symptoms when the person is abstinent from a drug for a long enough period of time. While temporary, withdrawal can cause enough discomfort that it can make it hard to quit a drug, even if one isn’t truly addicted to it. 

Psychological dependence, which is even more closely associated with addiction than physical dependence, is the emotional or mental component of a substance use disorder. It is essentially when a person feels compelled to use a drug on a psychological level, even when logically its use may be doing them harm. 

When the term dependence is used in a medical context, it generally refers specifically to physical dependence, not psychological dependence, despite psychological dependence being a more core component of addiction. 

As described in the paper linked to earlier, “physical dependence is an ordinary biological consequence of taking certain medications for weeks or years” and isn’t the same as addiction. In fact, addiction sometimes occurs without any level of physical dependence. Addiction is a loss of control over strong impulses to take a drug, even once a person understands the consequences of misusing that drug. 

Signs of Cocaine Abuse

Some common signs of cocaine abuse, and drug abuse in general, include the following:

  • Greater levels of risk-taking behavior, such as driving under the influence of drugs or having unprotected sex
  • Neglecting responsibilities, such as going to work or school, especially to engage in drug use or acquire drugs
  • Legal issues, including those not directly related to drug charges, such as disorderly conduct
  • Sudden changes in habits, including changing the people one associates with, where they hand out, or the hobbies one engages in
  • Unexplained changes in mood or personality
  • Higher levels of anxiety, fear, or paranoia with no obvious cause

Problems Associated With Cocaine Addiction & Dependence

Cocaine use is associated with a variety of symptoms, including these:

  • Constricted blood vessels
  • Decreased appetite
  • Dilated pupils
  • Increased energy
  • Increased heart rate and blood pressure
  • Increased body temperature
  • Mental alertness

No level of cocaine use, except in very specific medical circumstances when administered by a medical professional, is considered safe. Long-term use can cause the following problems:

  • Addiction
  • Auditory hallucinations
  • Irritability
  • Mood swings
  • Restlessness
  • Paranoia

Cocaine Addiction Is Treatable

Repeated cocaine use has the potential to seriously damage a person’s physical and mental health. Addiction can destroy a person’s social relationships, cause financial hardship, lead to legal trouble, and more. Cocaine specifically can wear on the heart, potentially causing serious complications, especially for those who already have heart problems.

For those seeking help, the good news is that cocaine addiction is treatable. While no medication exists to help directly with cocaine addiction, research in that area is ongoing. 

Cognitive behavioral therapy (CBT) is a go-to treatment for addiction that can help. This type of therapy focuses on identifying what draws you to use drugs and shapes how you think about drugs. You learn to channel negative thoughts in healthier ways and fundamentally change how you think to avoid thinking about drug use as often. In essence, CBT allows you to work with a mental health professional to better understand your mind and reconstruct it to better resist using drugs.

Can You Prevent Cocaine Addiction?

The only way to definitively avoid a cocaine addiction is not to use cocaine. Continually using any addictive substances raises the risk of addiction. While some people are more vulnerable to addiction than others, there isn’t a good way to guarantee you won’t become addicted if you engage in regular cocaine use.

The best path is to avoid substance use altogether, but particularly if you have certain risk factors for addiction, such as a family history of addiction, co-occurring mental health issues, or a history of trauma or abuse.

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Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated May 1, 2023
  1. Can You Become Addicted to Cocaine After Using It Once? Drug Policy Alliance.
  2. Cocaine Abuse & Addiction. NYC Health.
  3. Drug Dependence Is Not Addiction—and It Matters. (2021). Annals of Medicine.
  4. The Neurobiology of Cocaine Addiction. (December 2005). Addiction Science & Clinical Practice.
  5. Warning Signs of Drug Abuse. TN Department of Mental Health & Substance Abuse Services.
  6. What Is the Scope of Cocaine Use in the United States? (May 2016). National Institute on Drug Abuse.
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