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Identifying A Cocaine Overdose

Cocaine once dominated drug culture during the later years of the 20th century. American life was speeding up, aided by emerging digital technologies and trends toward big city lifestyle. Clubs, back rooms, and behind closed doors in office buildings, lines of the white powdered coca plant derivative was fueling clandestine industries and contributing to the countries ever growing addiction problem. 

The powerful stimulant proved to be a helpful tool in increasing energy, alertness, and giving users a feeling of power. However, it came at a high cost. Cocaine is highly addictive and can lead to a life-threatening overdose.

Cocaine is sometimes called the rich man’s drug, because of its high price and its prevalence in high-powered business circles in the 1970s, ʼ80s, and ʼ90s. Cocaine’s price is also a significant threat to people who become addicted to it. It can cause financial ruin quickly, but the addiction persists, leading to increased criminal activity and unsafe routes to continue drug use. In some cases, cocaine addiction can cost hundreds of dollars every day.


However, cocaine’s physical effects are what makes it truly dangerous. It’s a powerful stimulant that affects dopamine and other chemicals in the brain that affect reward and motivation, which makes it highly addictive. Cocaine, like other illicit drugs, is unpredictable in its purity. Pure cocaine is rare in any setting after it is initially synthesized. Dealers at all levels of the black market cocaine trade add adulterants to increase their profits, which means street-level cocaine is often much weaker than the original product. This makes it challenging to determine an appropriate dose with any given hit, which increases your risk of overdose.

A cocaine overdose can be even more dangerous after a long period of use and when mixed with other drugs. For this reason, it’s been involved with a variety of celebrity deaths involved in the party lifestyle. It’s often mixed with alcoholopioids, and other depressants, contributing to the deaths of personalities like comedians Chris Farley and John Belushi, and singer Whitney Houston.

If you or your friends have used cocaine and you are worried about addiction or overdose, there are several signs that can point to a potential cocaine overdose. Though there is no antidote to cocaine overdose on the level of Narcan, the drug that can reverse an opioid overdose, quick medical attention can save a person’s life.


Cocaine is a stimulant, which means it causes you to feel energized and excite your body’s central nervous system. Cocaine works in the chemical messaging pathways in the nervous system, specifically by affecting presynaptic dopamine neurons. That means it works on the nerve cells that release dopamine, serotonin, and norepinephrine. These feel-good chemicals play several roles in the body, but they are major influencers when it comes to reward and motivation.

Cocaine interrupts a process called reuptake, which is when the presynaptic neuron absorbs and recycles excess chemicals. Nerve cells will release dopamine and other chemicals into your nervous system to bind and activate dopamine receptors. Cocaine then blocks the reuptake process, leaving more dopamine in your system to activate more receptors. This significantly increases the stimulating effects of your naturally occurring brain chemicals.

A line of cocaine

The result is an energized feeling, euphoria, a feeling of power, increased heart rate, anxiety, and paranoia. Dopamine is tied to reward, which is controlled in the part of the brain that is vulnerable to addiction. Repeated use of cocaine can cause chemical dependence, but it can also lead to an addiction that is hard to overcome without help.


Though heroin overdose death rates have recently skyrocketed in the addiction epidemic, cocaine overdose continues to be a problem. According to the National Institute on Drug Abuse (NIDA), cocaine overdose rates also have risen in the past few years. In 2016, overdose deaths exceeded 10,000, and 2017 estimates put the number as high as 14,556. Many of these cases also involve drug cocktails that include cocaine and other drugs.

As a stimulant, too much cocaine can increase your nervous system activity to dangerous levels. With regular use, cocaine can cause an elevated heart rate, high blood pressure, increased body temperature, and cognitive issues. During an overdose, these symptoms are felt in extremes. Extremely high blood pressure and heart rate can lead to medical complications like a heart attack or a stroke. An overexcited nervous system can cause a seizure, panic, or psychosis.


Cocaine may not just be a powerful drug that can potentially lead to an overdose. It has a significant threat of cardiotoxicity. When it comes to a psychoactive substance, toxicity refers to the drug’s ability to damage your body. Research has shown that repeated cocaine use can damage your heart. A review in the American Journal of Cardiovascular Drugs states, “…decades of research have established that cocaine can cause irreversible structural damage to the heart, greatly accelerate cardiovascular disease, and initiate sudden cardiac death.”


Cocaine also becomes significantly more dangerous when it’s mixed with alcohol. It’s generally more dangerous to mix stimulants and depressants, but cocaine and alcohol react to each other in a unique way. When both substances reach the liver, they react with enzymes that produce a chemical byproduct called cocaethylene, which is more dangerous than cocaine on its own. Many sudden deaths involving cocaine may be due to the presence of this metabolite since cocaine is a party drug that is used in the presence of alcohol.

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A cocaine overdose can come on suddenly, but it can also follow various signs and symptoms. Knowing these signs and symptoms can potentially save someone’s life if you encounter cocaine overdose in yourself or someone else. Symptoms can come in the form of physical side effects or behavioral signs, including:

  • Extreme confusion
  • Unaware of surrounding
  • Difficulting breathing
  • Sweating
  • Extremely high heart rate
  • Palpitations
  • Irregular heart rhythm
  • Fever
  • Vomiting
  • Seizures
  • Extremely high blood pressure

Many of these symptoms can happen during cocaine intoxication when a person is not going through an overdose. However, during an overdose, symptoms will be much more severe than normal, leading to a medical emergency.


Since a cocaine overdose is life-threatening, the first thing you should do is call 911  if you believe someone may be in danger. While there is no antidote for a cocaine overdose, medical professionals can manage a person’s symptoms, and the person’s risk of death significantly diminishes. While you wait for paramedics, the person should sit down and avoid standing or moving around. In the event of a seizure, falls and convulsions can cause injuries if there are dangerous objects in the immediate area. If the person has a fever, apply a cold compress to cool them down like you would if they had the flu.


Cocaine addiction increases your likelihood of experiencing dangerous consequences like financial ruin and serious health risks. If you or a loved one is struggling with a substance use disorder involving cocaine, there is help available that can help lead you to freedom from active addiction.


Hearn, W. L., Rose, S., Wagner, J., Ciarleglio, A., & Mash, D. C. (2002, November 07). Cocaethylene is more potent than cocaine in mediating lethality. from

MedicineNet. (2016, May 5). Definition of Reuptake. from

National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. from

Phillips, K., Luk, A., Soor, G. S., Abraham, J. R., Leong, S., & Butany, J. (2009). Cocaine cardiotoxicity: A review of the pathophysiology, pathology, and treatment options. from

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