Cocaine is a stimulant drug first synthesized by chemists in the 1800s. Since then, it’s been used as a medical anesthetic and an illicit substance.
Cocaine’s popularity comes and goes, but it never really fades away completely. Understanding what cocaine addiction looks like and how it’s treated could help you protect yourself or someone you love.
What Is Cocaine?
The National Institute on Drug Abuse defines cocaine as a “powerfully addictive” stimulant derived from a South American plant.
Cocaine is sold as a powder that can be snorted (insufflated) through the nose via a straw or rolled-up piece of paper. Some people sprinkle powdered cocaine onto other substances and smoke it. Dealers also make a glass-like form of cocaine (crack) that can be smoked via a pipe. 
Each dose of cocaine causes powerful chemical changes deep within the brain, but the drug wears off quickly. Many people use multiple doses of cocaine in binges that leave their brain cells damaged and their willpower frayed.
Key Facts About Cocaine Addiction
- Less than 2% of the American population 12 and older uses cocaine regularly. 
- Experts say cocaine abuse is one of the hardest drug habits to break since the drug is so addictive and damaging. 
- About 1.4 million Americans have a cocaine use disorder. 
- More than 24,000 people died of cocaine-related overdoses in 2021. 
Cocaine and its various derivatives are used as local anesthetics, especially in operations that involve the ear, nose, and throat.
When cocaine is used as a local anesthetic (for surgery or examination, for instance), this is not abuse, and addiction isn’t a risk. However, if the body absorbs cocaine too quickly, serious side effects may take place.
Because certain individuals react to cocaine differently, it’s important to consult with an experienced medical professional who has some knowledge of your medical history before receiving cocaine as a local anesthetic during a medical procedure of any type.
Cocaine is notorious because individuals can quickly transition from casual use to full-blown addiction. Cocaine can alter the brain the first time it is used.
Cocaine often raises alertness, even for individuals who ingest the drug while engaging in heavy alcohol intake, which makes it popular in the nightclub scene. The fact that it brings out feelings of pleasure and intense euphoria also makes it an attractive social drug.
The drug has an immediate effect, creating a sort of instant high that users often need to maintain throughout the night or even the day when engaged in use.
Methods of using cocaine include the following:
- Snorting: Snorting is the process of inhaling cocaine powder through the nostrils, where it is absorbed into the bloodstream through the nasal tissues. Some people engage in freebasing to make crack cocaine snortable.
- Injecting: Injecting releases the drug directly into the bloodstream and heightens the intensity of its effects.
- Smoking: Smoking involves the inhalation of cocaine vapor or smoke into the lungs, where absorption into the bloodstream is as rapid as it is by injection.
History of Cocaine
Cocaine has been a part of life for centuries. But the ways people use cocaine, and how they justify continued drug use, have changed.
As early as 1905, people began using cocaine, snorting the powdered form of the drug, which became popularized by 1910, so much so that medical professionals started reporting nasal damage among patients who had been using cocaine regularly.
By 1912, cocaine was reported to have caused 5,000 deaths. In 1922, cocaine was officially banned by the U.S. government.
1970s & 1980s
In the 1970s and 1980s, cocaine became part of the club scene. Young professionals began using cocaine, many of them wealthy. Cocaine was even viewed as a somewhat glamorous drug.
Large amounts of cocaine moved into the country from South America. Drug dealers began flying planes into Florida ports, introducing the drug to more and more people.
1990s & Beyond
By the 1990s, other drugs were considered far more mainstream. However, the advent of crack cocaine brought the drug back in a different form, ushering in the crack epidemic of the 1990s.
Today, cocaine is still being used by a variety of people all over the world.
Crack vs. Cocaine: What’s the Difference?
Understanding the difference between crack vs. cocaine is important. Both are dangerous, but one form exposes people to unique hazards.
Both cocaine and crack contain an active stimulant ingredient: cocaine. But crack also contains baking soda, transforming a powder into a glass-like substance that can be smoked.
Crack works faster than cocaine, and it wears off quicker. People who use crack often binge on the drug to keep the high going for long periods.
Side Effects of Cocaine
People who use cocaine can experience several physical and mental side effects caused by drug use. They can be split into short-term and long-term effects.
The short-term effects of cocaine use include the following:
- Intoxication: People may seem energetic, alert, and talkative. Those symptoms appear due to cocaine’s effect on the brain.
- Weight loss: People high on cocaine have a reduced appetite. With repeated use, they often lose weight.
- Cardiac damage: Cocaine can constrict blood vessels and speed up the heart. These two functions put pressure on the heart muscle. Some people die suddenly due to cocaine’s effect on the heart.
People can overdose on cocaine. Taking too much of the drug, even once, can overwhelm the body’s core functions and lead to collapse and death. No medications can reverse a cocaine overdose. Anyone who has taken too much needs medical assistance in a hospital emergency room.
The long-term effects of cocaine use include the following:
- Brain changes: Cocaine-related damage means cells can’t produce dopamine (a chemical signal of happiness). People feel depressed when they’re not using the drug. Some people develop movement disorders or poor cognitive function too.
- Tolerance: People need more cocaine to produce reactions that smaller doses once delivered. Some need to take cocaine to avoid uncomfortable side effects like anxiety or convulsions.
- Poor emotional regulation: Some people develop irritability, restlessness, paranoia, and psychosis.
- Trauma due to drug delivery type: Snorting cocaine can damage the nose and throat. Injecting the drug can damage blood vessels.
- Gastrointestinal problems: Cocaine use can lead to tearing and ulcerations in the gastrointestinal tract.
- Cardiovascular problems: Chest pain, heart palpitations, strokes, and blood vessel ruptures can all be caused by cocaine.
How Addictive Is Cocaine?
Researchers consider cocaine a very addictive drug. 
Cocaine is classified as a stimulant. Part of this stimulation related to cocaine involves dopamine, which is casually referred to as the brain’s feel-good neurotransmitter. Each dose causes a spike of dopamine, which triggers unforgettable euphoria. 
But the good feelings don’t last long. When they wear off, people return to the drug to bring the sensations back. Some people spend the rest of their lives chasing the first high they experienced from cocaine.
Cocaine Addiction Statistics
Statistics on cocaine (particularly in the United States) are astounding. In the 2019 National Survey on Drug Use and Health, 14% of American adults reported trying cocaine. 
The same survey asserts that 1 in every 40 adults in the United States reported using cocaine within the past year. 
Young men ages 18 to 25 exhibited the highest rates of cocaine use, with 8% having used the drug within the past year when surveyed.
Regarding adults 26 or older, 2019 data conveys that 1.7% (3.6 million people) had used cocaine in the past calendar year. Recent data collected shows that cocaine use is around the same frequency as it was in the early 2000s, yet it is higher than the number of people using cocaine from 2010 to 2015.
“There’s a mistaken relaxation of concern around crack. Too many people think there is no longer a crack problem, because the numbers aren’t going up anymore. Well, that’s wrong. Things aren’t terrific. We still have terrible drug problems in virtually every community in this country. In fact, studies just released show that drug use amongst young people in rural environments is higher than it is in urban environments. The truth is that crack cocaine is not over. We still have millions of people who are addicted.”Alan Leshner, Director of the National Institute on Drug Abuse
Causes & Risk Factors of Cocaine Addiction
Many factors can lead to an addiction to cocaine. They can be sheared into several different groups, as follows:
Your genetic makeup doesn’t set your destiny, but some genes can make you more susceptible to cocaine addiction. For example, your genes could limit your ability to produce dopamine. Your first hit of cocaine could be much more powerful and harder to forget as a result.
The place in which you’re born could impact your addiction risk. Growing up with parents who abuse drugs could normalize the behavior. Living in a neighborhood where cocaine is readily available can also make it easier to maintain an addiction.
Peer pressure is real, and it can be a trigger for cocaine addiction. Friends could pressure you to use for the first time. And your friends could hold parties where cocaine is always available.
Experiencing stress, depression, or deep anxiety could all lead to recreational cocaine use. If you self-medicate with cocaine, you could develop an addiction.
Signs & Symptoms of Addiction: What to Look For
Understanding the signs and symptoms of cocaine addiction can help you know what to look for. Problems can be split into three categories:
Cocaine intoxication often results in weight loss. The drug suppresses appetite, and the chaos of addiction makes planning meals and cooking very difficult. Regular users may also complain of chest pain, nosebleeds, or gastrointestinal pains.
Cocaine addiction can manifest itself in ever-alternating states of anxiety and bursts of energy as the individual uses the drug and then crashes after use. Some individuals become highly secretive and paranoid while engaging in cocaine use.
When someone is addicted to cocaine, they often have trouble keeping social obligations. Many individuals who are addicted to cocaine try to keep it secret and will retreat to places like bathrooms during social gatherings to maintain their desired state. Money problems often go hand in hand with cocaine abuse due to the rising price of the drug and the amounts required.
Symptoms of Cocaine Addiction by Type
|Chest pains||Increased energy||Money problems|
|Nosebleeds||Depression||Negative impact on relationships|
|Gastrointestinal pain||Paranoia||Job loss|
Mixing Cocaine With Other Drugs
Cocaine is a very powerful drug, capable of causing intense harm. Mixing it with other substances can increase the risk of physical and mental health problems.
The following combinations are considered unsafe:
- Cocaine and alcohol: Cocaine and alcohol both impact the heart, increasing both heart rate and blood pressure. Heart attack risks rise as a result.
- Cocaine and opioids: Some people mix cocaine and opioids into something called a speedball. This combination can cause breathing problems.
- Cocaine and ecstasy: Both cocaine and ecstasy are stimulants, so combining them can put intense strain on the heart.
- Cocaine and antidepressants: Mixing cocaine with drugs like Zoloft or Prozac can cause a life-threatening complication called serotonin syndrome.
The opioid, fentanyl, deserves special mention. Experts say cocaine sold on the street is often tainted with fentanyl.
People may believe they’ve bought a drug they’re accustomed to, but they’re buying a very strong (and different) drug instead. In one month in Florida, 84 people died with both cocaine and a fentanyl derivative in their bodies.
Cocaine Detox & Withdrawal Symptoms
After years of cocaine abuse, the body doesn’t function normally without it. When people attempt to quit, they develop withdrawal symptoms.
Common cocaine withdrawal symptoms include the following:
- Fatigue and exhaustion
- Overall agitation and anger
- Restless sleep
- Strong cocaine cravings
The cocaine withdrawal timeline can vary, but most people experience symptoms for months.
Cocaine Addiction Treatment
Cocaine is powerful, and it can be very hard to quit without help. A cocaine addiction treatment program can help you to both get and maintain sobriety. Your program might involve the following elements:
Medication-assisted treatment (or MAT) involves the use of prescription drugs to amend chemical changes caused by cocaine. While there’s no specific drug available to ease cocaine-related symptoms, doctors can use prescriptions to address symptoms like anxiety or depression.
Inpatient Drug Rehab
Many people with cocaine addiction are surrounded by dealers, drug-using friends, and plenty of temptation. Inpatient drug rehab involves moving into a facility with staff trained to help people overcome their addictions. You’ll be surrounded by safety and support around the clock.
Counseling can help you understand your relapse triggers. You can also learn how to correct problems in your life that you’ve been trying to solve with drugs. Common forms of therapy used in treatment include dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT).
Support Resources for Cocaine Addiction
- Cocaine Anonymous: Join free meetings with other people in recovery from cocaine addiction, and make friends with people who understand where you’ve been.
- Cocaine Anonymous Online: Join free meetings via your computer or telephone and connect with others in recovery.
- Al-Anon: Family members and friends can learn more about addiction and how to support someone in recovery.
- National Institute on Drug Abuse: Read research reports about how cocaine works and how medical and mental health professionals want to treat it.
- Substance Abuse and Mental Health Services Administration: Find out more about how addiction works, and use a free treatment locator to get help.
Frequently Asked Questions About Cocaine Addiction
We’ve compiled some of the most frequently asked questions about cocaine addiction and recovery.
How long does cocaine stay in your system?
Cocaine can stay in your system for as little as two days, but heavy users may have cocaine in their bodies for weeks.
Is cocaine a stimulant or a depressant?
Cocaine is a stimulant drug, which means that it speeds up brain activity, heart rate, and respiratory rate.
What is the difference between crack and cocaine?
The difference between crack and cocaine involves the method of use. Most cocaine users snort the drug, while most crack users smoke the drug. Additionally, crack is the “freebase” version of cocaine.
What does cocaine smell like?
Cocaine often has a bitter smell, and crack often smells like burnt plastic or rubber.
Can you overdose on cocaine?
What is freebasing?
Freebasing involves adding chemicals to crack cocaine to return it to powder form. It’s incredibly dangerous, as the chemicals used are often flammable.
- Cocaine Drug Facts. (April 2021). National Institute on Drug Abuse.
- What Is the Scope of Cocaine Use in the United States? (May 2016). National Institute on Drug Abuse.
- Cocaine and Crack. (2010). Centre for Addiction and Mental Health.
- What Are the Short-Term Effects of Cocaine Use? (May 2016). National Institute on Drug Abuse.
- What Are the Long-Term Effects of Cocaine Use? (May 2016). National Institute on Drug Abuse.
- Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. (2019). Substance Abuse and Mental Health Services Administration.
- Interview Alan Leshner. Frontline.
- What Happens if You Mix Cocaine with Alcohol and/or Other Drugs? Drug Policy Alliance.
- Deadly Contaminated Cocaine Widespread in Florida. (February 2018). DEA Miami.
- Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study. (February 2021). Frontiers in Pharmacology.
- Comparison of Treatments for Cocaine Use Disorder Among Adults: A Systematic Review and Meta-analysis. (May 2021). JAMA.
- Global Cocaine Intoxication Research Trends During 1975–2015: a bibliometric Analysis of Web of Science Publications. (February 2017). Substance Abuse Treatment, Prevention, and Policy.