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Signs of Cocaine Use & Abuse

Signs of cocaine use and abuse include euphoria, irritability, anxiety, excitability, paranoia, and shakiness.

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Cocaine is a stimulant drug sold as a sniffable powder, smokable glass, or injectable solution. Users never forget their first dose of the drug. They feel happy, confident, and energetic. But the sensation wears off quickly, and its loss leaves people searching for more cocaine.  

While prescription painkillers dominate news stories about overdoses, don’t be fooled into thinking cocaine is safe. People can and do die due to cocaine abuse. And researchers say the number of people dying from cocaine is rising every year. 

Cocaine & Your Body: What You Should Know

Brain cells release the chemical dopamine when you encounter something rewarding and fulfilling. Cocaine hijacks this natural system and floods your brain with dopamine. 

Use cocaine often, and brain cells recalibrate. You must take bigger cocaine doses, often very close together, to come close to the sensations delivered by your first dose. In time, you’ll need cocaine just to feel normal. 

Cocaine alters other parts of your body too. Some dangers pass quickly, but others stay with you for weeks, months, or years.

Short-Term Risks

Cocaine users often binge on the drug. They take doses repeatedly, and each hit is bigger than the last. During a binge, people feel:

  • Irritable
  • Panicked
  • Paranoid 
  • Psychotic 
  • Restless

You could hurt yourself or someone else during an episode like this. You could also get arrested due to erratic or dangerous behavior. 

The way you use cocaine could also harm your body.

  • Snorting: Cocaine can cause nosebleeds, trouble swallowing, and a loss of a sense of smell.
  • Smoking: Crack cocaine can cause lung damage, coughing, and asthma. 
  • Shooting: Needle use raises your risk of HIV and hepatitis.

Long-Term Risks

Cocaine is a blood-vessel constrictor. Use it regularly, and your vital organs will be deprived of oxygen and nutrients. You could experience the following:

  • Heart attacks 
  • Stomach ulcers 
  • Strokes 
  • Weight loss 

Cells inside your brain can also die due to a lack of oxygen and nutrients. You could struggle to remember critical information, and some people with a long-term habit develop impulse control and inhibition issues. If the part of your brain controlling motor function is damaged, you could develop shaking in your hands and feet. 

Addiction is a risk with long-term use. If you use crack cocaine, for example, you could become addicted to the drug in just two or three weeks of regular use. 

Signs of Cocaine Use

Cocaine use rates vary. Some people get high just a few times per year, while others use the drug 20 times or more each year. 

Physical Signs

Cocaine use is easiest to spot when the person is high. Look for these signs:

  • Chattering conversation
  • Euphoria 
  • Excitability
  • Nervousness
  • Restlessness
  • Shaking 

As the drug wears off, look for depression, sadness, and anxiety. The person might leave your company for a minute and return high again. You might notice wide swings in mood and energy levels.

People who use cocaine need paraphernalia like needles, lighters, and straws. If you spot these tools, a cocaine habit may be present. 

Psychological Signs

Some people who abuse cocaine know they shouldn’t, and they can seem repentant and guilty the day after a binge. They might say they’ll never use again, and they might promise to stay sober. 

A cocaine comedown can also lead to depression, and some people may cry or shut themselves away until they feel better. 

Signs of Cocaine Addiction

About 1.3 million people have a cocaine use disorder. Someone like this has lost control over when, how much, and how they use cocaine. 

Physical Signs

A long-standing habit takes its toll on the person’s body. You might notice the following:

  • Complaints of chest pain 
  • Coughing
  • Recurrent infections
  • Scratching at skin 
  • Sniffling 

You might also notice dramatic changes in personality and demeanor as the person cycles through episodes of bingeing and sobriety.

Psychological Signs

Common addiction signs include the following issues:

  • Financial concerns: Cocaine is expensive, and people with a habit need a lot of drugs. Theft, sales of valuable possessions, or falling behind on bills could all be signs of addiction. 
  • New friends: The person might associate with others who use cocaine rather than sober friends and family members. They may be secretive about these new friends.
  • Poor performance: The person might start performing poorly at work or school. They might stop attending work or school altogether.
  • Distance: In time, the person will have no time for anything that does not involve cocaine. They may increasingly isolate themselves from family members and friends.

3 Reasons Cocaine Is So Dangerous

You’re tempted to use cocaine for the very first time. What should stop you? And why should you step in to help someone with a problem? Here are three good reasons. 

1. Mixing Cocaine Can Be Unpredictable

People often use cocaine in party situations, and they blend the drug with other substances. Cocaine is known to react with these substances:

  • Alcohol: Both substances can impact the cardiovascular system. Mixing them can lead to a heart attack. 
  • Opioids: One is a stimulant, and the other is a depressant. Mixing them leads to confusing signals in your body. You could develop breathing difficulties and heart problems. 
  • MDMA: Both are stimulant drugs, and taking them together puts immense strain on your heart. 
  • Antidepressants: Both work on brain cells. A combination of these substances can lead to seizures. 

2. Cocaine Is Rarely Pure

You can’t get cocaine from a pharmacy, doctor, or friend. Dealers make and sell drugs, and they rarely produce a product that contains 100% cocaine.

Most doses are mixed with other substances, including amphetamines and opioids. Your next dose could be stronger than you expected, and it could easily lead to problems.

3. Cocaine Overdose Is Possible

Cocaine was responsible for one in five overdose deaths in 2019. Taking too much is very easy, especially if you’re in the middle of a binge episode. Being aware of cocaine overdose symptoms could potentially save a life. 

What to Do Next

If you suspect that someone you love has a cocaine abuse problem, it’s time to speak up. People with an addiction may struggle to quit without help. 

But in a treatment program, they can get the medication management and counseling they need to kick the habit for good. The conversation you have now could save your friend’s life.

A treatment center can help you learn how to start this conversation. Don’t be afraid to reach out for help today.

Profile image for Dr. Alison Tarlow
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 June 9, 2023
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  3. What Are the Long-Term Effects of Cocaine Use? (May 2016). National Institute on Drug Abuse.
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  5. Facts You Should Know About Crack. Illinois Department of Human Services.
  6. How Many People Use Cocaine? Drug Policy Alliance.
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  8. What Happens if You Mix Cocaine with Alcohol and/or Other Drugs? Drug Policy Alliance.
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  10. Other Drugs. (November 2021). Centers for Disease Control and Prevention.
  11. Global Cocaine Intoxication Research Trends During 1975–2015: A Bibliometric Analysis of Web of Science Publications. (February 2017). Substance Abuse Treatment, Prevention, and Policy.
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