Cocaine is an illegal stimulant drug that can be highly addictive. People who have taken cocaine often suffer intense side effects, both short- and long-term.

According to the Substance Abuse and Mental Health Services Administration’s 2017 National Survey on Drug Use and Health, about 2.2 million people, or 0.8% of the population age 12 and older, had used cocaine in the past month. That number included 473,000 people who used crack in the past month.1

Studies have estimated the dose at which cocaine becomes toxic and could lead to an overdose or death (96mg/kg). But the exact dose for each person will vary based on their tolerance to the drug, the drug’s purity, the person’s age, and their health. An overdose can be fatal and requires immediate medical attention.

The National Institute on Drug Abuse reports that deaths from cocaine overdose increased from 6,784 in 2015 to 10,375 in 2016. The estimated number of deaths for 2017 is 14,556. From 2010 to 2017, there was a 3.5-fold increase in the total number of deaths.2

Increasingly, cocaine overdose deaths have involved fentanyl, a powerful opioid. In 2016, 37% of cocaine-related overdose deaths in New York City involved fentanyl. That same year, Connecticut recorded 143 overdose fatalities with fentanyl and cocaine.3

Effects of Cocaine

If a person has recently taken cocaine, they may exhibit behaviors and symptoms such as:4

  • Euphoria.
  • Surge of energy.
  • Increased alertness.
  • Rambling speech or rapid talking.
  • Sensitivity to sight, sound, and touch.
  • Pupil dilation.
  • Raised heart rate, body temperature, or blood pressure.
  • Aggression and violent behavior.
  • Irritability.
  • Anxiety.
  • Panic.
  • Paranoia.

Long-term effects of cocaine abuse include:5,6

  • Weight loss.
  • High blood pressure.
  • Irregular heartbeat.
  • Heart disease.
  • Insomnia.
  • Depression.
  • Paranoia.
  • Sexual dysfunction.
  • Damage to the nasal cavity and sinuses (if snorted).
  • Damage to the lungs (if smoked).
  • Increased risk of stroke.
  • Impairments in memory, attention, and impulse control.

 
Regular cocaine users take the drug in binges. They will use the drug repeatedly and in higher and higher doses. This practice can lead to overdose or serious psychological or physical side effects.6

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What Is an Overdose?

Man tapering off drugsA cocaine overdose occurs when a person takes a large amount of cocaine or a concentrated dose, uses during hot weather (which can lead to more harmful effects because of dehydration), or uses cocaine with other drugs.7

Symptoms of a cocaine overdose include:5

  • Extreme anxiety or panic.
  • Agitation.
  • Paranoia.
  • Hallucinations.
  • Tremors.
  • Chest pain.
  • Seizures.
  • Fast or irregular heartbeat.
  • Difficulty breathing.
  • Kidney failure.
  • Stroke.

 
When a person ingests too much cocaine, seizures or convulsions may begin within 2-3 minutes, and the person can die within half an hour.8

If you or someone you know has these symptoms after using cocaine, call emergency services immediately.

How Much Cocaine Causes an Overdose?

The exact amount that someone will overdose on is hard to predict. Chronic users build a tolerance to the drug,6 so they may be fine with a dose that would be too much for a novice user.

Studies have found that the LD50 for cocaine in mice is 96mg/kg. This means that the dose at which about half of the research animals the dose is tested on die is 96 milligrams per kilogram of weight of the person who takes cocaine.9

Other studies have shown that cocaine has a lethal dose that is 15 times its effective dose, which means that it does not take much more than the regular dose to cause toxicity.10

In 74% of cocaine-related fatalities, another drug is usually co-ingested (often alcohol). The addition of alcohol to cocaine increases the risk of sudden death 25-fold.8


Treatments for Overdose

getting treatment When an individual receives emergency medical treatment at a hospital due to cocaine overdose, symptoms are treated as they appear, and treatment is based on the severity of the symptoms.

Typical hospital treatments for a cocaine overdose include:7,8

  • Exams and tests such as cardiac enzymes, chest X-ray, CT scan, electrocardiogram (ECG), toxicology screen, and urinalysis.
  • Medications such as benzodiazepines to stop or reduce seizures and to treat pain, agitation, nausea, anxiety, and high blood pressure.
  • Breathing support through intubation or a ventilator.
  • An ice bath for hyperthermia.
  • IV fluids.

 
Besides death, an overdose can lead to:7

  • Seizures, stroke, and paralysis
  • Persistent anxiety and psychosis.
  • Impaired mental functioning.
  • Heart irregularities and poorer heart function.
  • Kidney failure requiring dialysis.
  • Destruction of muscles, which can lead to amputation.

Help After an Overdose

At this time, there are no FDA-approved medical treatments for cocaine addiction.11 Although several medications are being examined as possible treatments, none are currently recommended.

If a person has suffered a cocaine overdose, emergency medical care is needed to stabilize the individual. Once the person is stable, comprehensive substance abuse treatment is needed. This will address the issues that led to cocaine abuse, ensuring overdose doesn’t occur again. Treatment consists of behavioral therapies such as contingency management, cognitive behavioral therapy, and 12-step programs. These treatments help change the person’s thoughts and behaviors related to drug use and allow them to receive support from peers.11

Sources

[1]. Substance Abuse and Mental Health Services Administration. (2018). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.

[2]. National Institute on Drug Abuse. (2018). Overdose Death Rates.

[3]. Scaccia, A. (2018). How Fentanyl Is Contaminating America’s Cocaine Supply. Rolling Stone.

[4]. National Institute on Drug Abuse. (2016). What are the short-term effects of cocaine use?

[5]. Alcohol and Drug Foundation. Cocaine.

[6]. National Institute on Drug Abuse. (2016). What are the long-term effects of cocaine use?

[7]. National Library of Medicine: Medline. (2018). Cocaine intoxication.

[8]. Burnett, L.B. (2018). Cocaine Toxicity. Medscape.

[9]. DrugBank. Cocaine.

[10]. The Atlantic. (2007). Drugs and Toxicity.

[11]. National Institute on Drug Abuse. (2016). How is cocaine addiction treated?