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Cocaine Vs. Meth: A Guide To Their Differences And Similarities

Cocaine and methamphetamine, or meth, are both stimulant drugs. As such, both drugs increase alertness, excitability, energy, focus, and concentration. They also speed up heart rate and blood pressure, raise body temperature, and decrease sleep functions and appetite levels. Both of these drugs increase levels of dopamine in the brain.

Despite their similarities, there are also key differences between the two drugs. Cocaine blocks reabsorption of dopamine back into receptors in the brain, and meth actually stimulants the release of more dopamine while blocking its reuptake, the National Institute on Drug Abuse (NIDA) explains. Cocaine also processes out of the body much faster than meth does.

Both cocaine and methamphetamine are classified as Schedule II drugs by the U.S. Drug Enforcement Administration (DEA) because they both are considered to have some medical use in the United States. They are tightly controlled, however, since they both have high rates of abuse, diversion, and a potential for addiction.

Cocaine and meth are highly addictive. They are both dangerous drugs of abuse that come with many adverse effects


Methamphetamine is a synthetic drug, which means it is man-made. Prescription meth is marketed as Desoxyn, but on the street, it is illicitly sold in powder or pill form, or as crystal meth, which looks like small shards of glass. It can be snorted, smoked, swallowed, or injected when taken recreationally.

The National Survey on Drug Use and Health (NSDUH) publishes that 667,000 people in the United States abused meth in the month leading up to the 2016 survey. 

Meth can cause an intense high that can last for many hours. During the high, the user feels alert, active, and awake. When under the influence, it can be difficult to think clearly or make good choices, and behaviors may be erratic or out of character. Aggression, violent behaviors, paranoia, and delusions can be side effects of taking large amounts of meth at once or when meth use is chronic.

Amphetamine drugs are prescribed to treat a lack of focus and attention that is often associated with attention deficit hyperactivity disorder (ADHD). Meth functions in much the same way and can, therefore, keep a person awake, productive, and full of energy for long periods. Meth can overload the system, however, and an overdose can lead to heart attack, stroke, and high body temperatures that can cause kidney damage.

Meth is considered to be extremely addictive with even only a few uses. In 2016, about 684,000 American adults struggled with meth addiction.

Long-term meth use can cause a wide range of physical and emotional problems, including extreme itching and skin diseases, dental decay known as “meth mouth,” unhealthy weight loss, sleep issues, coordination problems, and hallucinations. It can trigger potential lasting brain damage, which can negatively influence learning, memory, and emotional processing functions and even potentially lead to the onset of the movement disorder Parkinson’s disease. Meth withdrawal can be intensely emotional, leading to extreme lows, depression, anxiety, irritability, psychosis, and significant cravings.

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Cocaine comes from the coca plant, and the DEA reports that most of the cocaine that is distributed within the United States comes up from Colombia. Cocaine has some limited medical use as a local anesthetic, but it is most commonly distributed as a recreational drug as a white powder or as small rocks called crack. It can be abused in a variety of ways, including smoking, injecting, or snorting it.

Cocaine can cause a quick burst of euphoria. The cocaine high rapidly takes effect, but it also only lasts a few minutes to an hour.

In addition to the stimulant effects, cocaine intoxication can cause a person to be hypersensitive to touch, light, and sound. Large amounts of cocaine can induce aggression, paranoia, and strange, violent, and unpredictable behaviors. While under its influence, a person may be irritable, excitable, highly active and energetic, and more prone to risk-taking behaviors and unsafe actions.

Cocaine in a bag, pile, and lines

Cocaine use has many possible negative consequences, including the odds for a potentially fatal overdose. A cocaine overdose is indicated by high blood pressure, irregular heart rate, breathing issues, elevated body temperature, tremors, hallucinations, anxiety, seizures, and extreme agitation. Almost 20,000 Americans died from a cocaine overdose in 2017, per NIDA. Cocaine use also increases the potential for having a heart attack, stroke, or damage to the cardiovascular system, the American Heart Association explains.

Cocaine is also addictive. About 867,000 people in the United States battled cocaine addiction in 2016. 

As cocaine wears off, withdrawal can be emotionally intense, causing significant drug cravings, anxiety, insomnia, and depression.


Both cocaine and meth can make it hard for a person to think straight, and this increases the risk of potential hazards related to bad decisions. The risk for contracting a bloodborne or infectious disease is high when injecting either cocaine or meth, a particularly dangerous method of drug abuse that can also cause collapsed veins or infections in the lining of the heart.

Snorting either drug can permanently damage nasal cavities and sinuses, leading to chronic nosebleeds and a runny nose. Smoking cocaine or meth puts a person at risk of developing respiratory infections or diseases and suffering from a perpetual cough.

While taking either of these drugs, individuals are liable to act in erratic ways that can be extreme and hard to predict. Cocaine and meth are often taken in a binge-and-crash pattern, where the drug is taken in back-to-back doses to sustain the high and decrease the comedown; it is sometimes called a “run” when meth is taken in this way.

Again, meth and cocaine work on the brain in similar ways since they both speed up functions of the central nervous system. They do have many differences as well.


  • Cocaine is plant-based, and meth is synthetic and made in a lab.
  • Meth is a prescription drug used to treat ADHD, narcolepsy, and obesity while cocaine is prescribed as a local anesthetic.
  • Cocaine has a short half-life of about an hour while meth’s is much longer at about 12 hours.
  • Meth is considered to be more addictive than cocaine, which is already highly addictive because of the way it interacts with dopamine production and reabsorption.
  • Cocaine can damage the heart with long-term use, leading to cardiovascular disease. Prolonged meth use can have noticeable external physical damage and cause potentially permanent brain damage.
  • Psychotic symptoms are more commonly related to meth dependence than cocaine dependence, per the American Journal on Addictions.
  • Demographics are slightly different for meth and cocaine abuse based on studies published in the Journal of Addictive Disorders. People in addiction treatment programs citing cocaine as their primary drug of abuse were mostly male (70 percent) and black (60 percent). They began using the drug at an average age of 23. Those reporting meth as their primary drug of abuse were only about half male (54.2 percent), mostly white (53 percent), and used meth for the first time at an average age of 19.6 years old.

Both meth and cocaine addiction are managed through specialized programs that involve behavioral therapies, support groups, relapse prevention, and medical care. With comprehensive treatment, complete recovery can be within reach.


(September 2013). How is Methamphetamine Different From Other Stimulants, Such as Cocaine? National Institute on Drug Abuse from

Drug Scheduling. Drug Enforcement Administration from

Methamphetamine. Drug Enforcement Administration from

(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

(June 2018). What is Methamphetamine? National Institute on Drug Abuse from

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

(March-April 2008). Presence and Persistence of Psychotic Symptoms in Cocaine- Versus Methamphetamine- Dependent Participants. The American Journal on Addictions from

(February 2010). Contrasting Trajectories of Heroin, Cocaine, and Methamphetamine Use. Journal of Addictive Disorders from

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