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Is Someone You Know Using Cocaine? A Guide To Recognizing The Signs

In 2016, there were nearly 2 million people in the U.S. who were current users of cocaine, per the National Survey on Drug Use and Health (NSDUH). Cocaine is a potent and quick-acting drug that is typically distributed illicitly, either in white powder form or in a solid rock form called crack. Cocaine is smoked, rubbed on the gums, or snorted when abused.
The U.S. Drug Enforcement Administration (DEA) classifies cocaine as a Schedule II controlled substance, as it does have some rare medical use as a local anesthetic; however, most of the cocaine in the U.S. is used recreationally as a street drug.

Cocaine is a dangerous drug with many associated risks. The National Institute on Drug Abuse (NIDA) reports that in 2017, close to 20,000 Americans died from an overdose involving cocaine; this was more than triple the cocaine overdose fatality rate in 2010.
Since it is an illegal and unregulated drug, cocaine can be cut with many potentially toxic substances that can raise the risks for complications. Abuse of cocaine can easily become life-threatening as it’s such a potent and extremely addictive narcotic.
If you think someone you care about may be abusing cocaine, help them. Once you can identify cocaine use, you can help the person get into a specialized addiction treatment program and potentially save their life.


As a stimulant drug, cocaine speeds up heart rate, blood pressure, and respiration, and it raises body temperature. Concentration improves, energy levels rise, and sleepiness fades. Cocaine takes effect almost immediately after it enters the bloodstream, and it causes an intense euphoric rush or high that also wears off rather quickly.
Cocaine works by causing levels of dopamine to flood the brain. Dopamine is a neurotransmitter that the brain uses to send signals of pleasure and to regulate moods and emotions. When its levels go up, so do feelings of happiness. 

In the same vein, when levels of dopamine drop, a crash can ensue. Depression, anxiety, low energy, fatigue, and overall malaise are common. This push and pull on the brain’s dopamine levels is part of what makes cocaine highly addictive.

Individuals build up cocaine tolerance rapidly and with relatively few uses, and increased tolerance increases the risk of drug dependence. The symptoms that accompany withdrawal are emotionally intense and include significant cravings that encourage repeated cocaine use. This can cause cocaine to be used in a binge pattern in back-to-back doses. Heavy and regular cocaine use can cause paranoia.

Addiction is a serious side effect of regular cocaine use. There are additional long-term side effects associated with how the drug is used, such as damaged sinus and nasal cavities from snorting the drug, which can result in chronic runny nose, nosebleeds, and a loss of one’s sense of smell. Smoking cocaine can cause respiratory problems, an increased risk of lung infections, and certain diseases. Injecting the drug raises the odds for contracting an infectious disease, such as HIV/AIDS or hepatitis C. Skin infections and collapsed veins are also hazards of injecting cocaine.
Cocaine can wreak havoc on the cardiovascular system. The American Heart Association warns that cocaine use can lead to an increased risk of stroke and heart attack as well as other issues with heart health.


Cocaine can drastically affect moods and energy levels. When someone is under the influence of cocaine, they are likely to be restless, excited, and overly alert. Other noticeable effects of cocaine use include dilated pupils, insomnia, suppressed appetite, muscle tremors or twitches, irritability, and potential violence and aggressive behaviors.

Cocaine use can cause a person to act in unpredictable ways. They may be more social than usual. They may be unable to make rational decisions and can, therefore, take bigger risks and do things that are out of character.
Use of the drug affects appetite and sleep functions, and changes in a person’s sleeping and eating habits can be signs of drug abuse. Weight loss can be an indicator of cocaine use. Significant mood swings are some of the most recognizable signs of cocaine use. Since the drug starts working quickly and also burns off quickly, this up-and-down cycle can be intense and rapid.

NIDA explains that, depending on how cocaine is used and in what amount, the drug typically starts working within a few minutes, and the high can last from a few minutes to an hour.

Other indicators of cocaine abuse can be outward signs, such as the presence of white powder on a person’s face, clothing, or hard surfaces. Drug paraphernalia, including rubber tubing, shoelaces, syringes, burned spoons, crack pipes, empty ballpoint pens, straws, and rolled-up dollar bills or pieces of paper, can all be used to snort, smoke, or inject cocaine.

Addiction can cause a person to struggle with controlling use and the amount used each time. This can mean that a person will spend much of their time figuring out how to get the drug, using it, and then trying to recover from the cocaine crash. Finances can take a hit, as money is shelled out for more cocaine. Job performance can decline, and work attendance may be spotty.
Health issues can crop up. Someone battling cocaine addiction may experience a complete personality shift and become secretive and socially isolated. Peer groups often change, and the person is likely to neglect regular obligations in all aspects of life. Relationships may become strained, and the person’s actions may become erratic and unpredictable.
Paying attention to changes in the following can all help to identify cocaine abuse and addiction:

  • Regular habits
  • Friend circles
  • Health issues
  • Sleep patterns
  • Appetite fluctuations
  • Mood swings
  • Behaviors

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f cocaine use is suspected, the next step is to find a way to talk to your loved one about it. The use of an intervention can guide this conversation. An intervention is a planned and structured meeting that is hosted by loved ones and family members of a person who is struggling with problematic drug use. The goal of an intervention is to help a person to recognize that professional treatment is needed and to get them to agree to enter into a specialized program as soon as possible.

Woman grabbing her head in pain because of her cocaine abuse

A professional interventionist can help families and loved ones to build a team of people who care about the individual and want to support their recovery. The National Council on Drug on Alcoholism and Drug Dependence (NCADD) publishes that when loved ones use a trained professional, an intervention is nearly always successful in getting a person the necessary help. An interventionist will often meet with the intervention team a few times before the formal intervention, helping families and loved ones to come up with a concrete plan and carry it out.

If your loved one has a history of violence or self-harming behaviors, or has a co-occurring mental illness, or struggles with abuse of multiple substances, an interventionist is often the key to a safe intervention. There also are many models of intervention that can be used to guide a person into a treatment program. A trained professional can work with families and loved ones to decide on the best course of action and then implement it.
An intervention comes from a place of love and needs to stay on task and focused. Generally, members of the intervention team will cite specific examples of how the drug abuse has affected them directly to help the person recognize that their drug use is hurting those around them. An intervention can be a great tool for helping individuals realize that cocaine use is problematic, and it is time for a positive change.


Addiction can be treated in a variety of settings with many different methods. Per NIDA, there currently are no approved medications for managing cocaine addiction, but there are several that can be beneficial in managing withdrawal symptoms and drug cravings during detox.
Detox is often a component of addiction treatment, as a medical detox program can provide the optimal location to allow the drug to process out of the body while attending to all emotional and medical needs.

Generally, cocaine addiction is treated through behavioral therapies.

The use of cognitive behavioral therapy (CBT) and contingency management (CM) is common. CBT strives to uncover root causes of negative behaviors, including drug use and then teaches healthy coping mechanism and life skills to make positive changes. CM is a therapeutic technique that rewards clean drug tests with prizes or events to promote continued abstinence.

Cocaine addiction treatment likely will include these components:

  • Medical detox
  • Individual, family, and group therapy sessions
  • Relapse prevention training
  • Educational workshops
  • Support group meetings
  • Aftercare support

Being part of a supportive community can help to sustain recovery. Groups like Cocaine Anonymous (CA) offer local meetings and opportunities for individuals to connect. These support groups allow participants to be part of an encouraging and sober fellowship of peers.
There are many sources of support available for those who struggle with cocaine abuse and addiction. Ultimately, the issue can be managed best through a comprehensive and specialized program that can improve overall wellness.


(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration from

Drugs of Abuse A DEA Resource Guide 2017 Edition. Drug Enforcement Administration from

(August 2018). Overdose Death Rates. National Institute on Drug Abuse from

(July 2018). What Is Cocaine? National Institute on Drug Abuse from

(July 2015). Intervention- Tips and Guidelines. National Council on Alcoholism and Drug Dependence from

(May 2016). How is Cocaine Addiction Treated? National Institute on Drug Abuse from

(2015). Cocaine Anonymous World Services. Cocaine Anonymous from

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