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Cocaine Addiction Signs and Symptoms

Cocaine addiction was once considered an ever-growing problem in the United States. There is some evidence, however, that this trend might be changing. The use of cocaine over the past few years in the U.S. has been relatively stable. In 2013, the percentage of individuals ages 12 and older using cocaine in the U.S. was 1.6%. This figure is, however, substantially lower than the percentage of that same demographic using cocaine in 2006. Fewer young people have reported cocaine as being easy to obtain, and the use of cocaine among high-school students has been roughly cut in half since 2006.The numbers of individuals who currently use cocaine still call for attention, however. Cocaine is a deadly drug that can lead individuals to addiction even after one experimental use.

Perhaps someone you know and love may be addicted to cocaine. Perhaps the struggle is yours alone. This article will help you to define and identify—in either yourself or someone close to you—the signs and symptoms of cocaine addiction. Recognizing whether or not an addiction is present is the first step towards getting the help you need to get out of an addiction and get your health and life back on track.

Signs of Cocaine Addiction

Since cocaine users sometimes may not be able to identify their own addiction, it may be up to family and friends to look for signs of cocaine use. With early detection, you might be able to stop your loved one’s cocaine experimentation from turning into cocaine addiction. If your loved one is using cocaine, you may recognize some of these classic signs of cocaine use:2

  • Enlarged pupils so dilated that eyes look almost entirely black.
  • Restlessness, increased alertness, and energy.
  • Loss of interest in food; weight loss.
  • Loss of interest in sleep; insomnia.
  • Talkativeness, fast speech, or scattered speech—skipping from topic to topic.
  • Dramatic mood changes: elated, irritable, depressed, argumentative, aggressive.
  • Increased heart rate.
  • Nasal congestion.

It is important to note that many of the indicators of the use of cocaine and other stimulants can be present in the mania phase of bipolar disorder; if these signs and symptoms are present and substance use has been ruled out, a psychiatric evaluation may be warranted.

Additional Physical and Psychological Changes

Additional short-term effects of cocaine may also become apparent in your loved one. You may notice or may hear your loved one complain of:3

  • Muscle twitches, tremors.
  • Dizziness.
  • Abnormal heartbeat.
  • Increased blood pressure.
  • Increased body temperature.
  • Panic, paranoia.
  • Heart attack.
  • Nausea, abdominal pain.
  • Headaches.
  • Seizures.
  • Strokes.
  • Coma, death.

Some people who abuse cocaine find that they seem to catch colds or other infectious illnesses more frequently than they did before they started using cocaine. Cocaine can suppress the immune system, meaning that the body has lowered defenses while you’re under the influence.4 Frequent or chronic illnesses can be a direct result of cocaine use.

Paraphernalia: Clues Left Behind

While some people with cocaine addictions are adept at hiding the evidence of their use, others may leave telltale paraphernalia behind that can also point to cocaine use. These items may include:

  • Small spoons.luxury-shutter656081-cocaine-paraphernalia
  • Razor blades.
  • Mirrors.
  • Powdery residue.
  • Tightly rolled up dollar bills
  • Glass, metal or plastic straws.
  • Pipes, vaporizers, or tubing.
  • Tourniquets.
  • Hypodermic needles.

Behavioral Changes

Addiction is commonly defined as compulsive use of a drug, no matter the consequences. If you are addicted to cocaine, it can often feel impossible to stop using the drug—no matter how much you might like to do so.

These strong feelings and urges can often lead to changing and compulsive behavior that can sometimes tip off potential cocaine abuse:

  • Spending rent or grocery money on cocaine.
  • Skipping work or school in order to use cocaine.
  • Choosing to spend time with friends who support your cocaine use.
  • Refusing to discuss how much cocaine you take.
  • Wishing you could stop using cocaine but feeling that you’re unable to stop.

Binge use of cocaine can lead to a number of startling psychological developments, such as mood changes and social isolation. Cocaine abuse is responsible for a number of health scares and emergency room visits, but what many might not know is that some of these trips to the ER are due to cocaine-related episodes of psychosis. Examples of these psychotic symptoms brought on by cocaine abuse include delusions (false beliefs) and visual hallucinations.You might feel as though bugs are crawling on your skin, for example. Or you might become convinced that people are trying to hurt or kill you.

Continued use after experiencing episodes like this is illustrative of the addiction process. The arrival of psychotic features might indicate that you’re progressing towards extremely high doses of the drug as a result of becoming tolerant to previously used amounts.

What to Do When You Recognize Signs of Addiction

If you notice any of these signs of cocaine use—or if your family has noticed these signs yet you still don’t feel as though you can quit using cocaine—it might be worth considering that addiction is the cause. Continuing to use cocaine in the face of mounting evidence that such use is dangerous is a hallmark of addiction, and it shouldn’t be overlooked.

Treatment Can Help

Reading about cocaine addiction—and perhaps identifying cocaine addiction in yourself—can be terrifying. There is a silver lining, however. With medications and therapy, you can learn to control your addiction and leave compulsive drug use behind.

A Story of Hope from a Former Cocaine User

“I used cocaine for years, and I always maintained that I wasn’t addicted and I could stop whenever I wanted to stop. When I finally gave up lying to myself like that, and I actually entered treatment, I learned that I had no control over my cocaine use. It controlled me. Through therapy and a lot of help from my friends in my support group, I learned why I used, and I learned what I could do instead of using. It’s hard work, and I still have to struggle with cravings every day, but I’ve been sober for a year now. I wouldn’t have it any other way.”

Treatment Facility Types

When you are ready to start exploring your treatment options, you will find a few different types of addiction treatment facilities that will be at your disposal to choose from:

  • Luxury rehab facilities offer residential addiction treatment alongside a range of high-end, resort-like amenities provided to make your recovery process as comfortable as possible.
  • Executive rehab facilities offer the same residential addiction treatment and plush amenities also offered by luxury programs, only they also cater to busy professionals, providing them with the resources and structure that allow them to maintain an active involvement in the workplace during rehabilitation.
  • Standard rehab facilities offer both inpatient (residential) and outpatient (non-residential) addiction treatment services. While the amenities at these facilities are not as extensive or lavish as those offered at luxury or executive facilities, standard rehab programs do come at a lower, more affordable price point.

How Cocaine Causes Addiction

Some people develop a persistent addiction to cocaine from the very first time they start using the drug. So what is it about cocaine that causes this addiction to take hold so quickly?

Dopamine: the Pleasure Chemical

luxury-shutter311949818-brain-scansCocaine’s addiction mechanism appears to operate on the dopamine reward system in the brain.6

Dopamine is a neurotransmitter involved in the brain’s reward system that contributes to the positive feelings you feel in response to pleasurable activities such as eating.

This dopamine “addiction pathway” plays a role in addictions to heroin, prescription drugs, and even gambling and other addictive behaviors. When the brain is exposed to high levels of dopamine that can result from drugs or from pleasurable behaviors that are repeated, the individual feels a surge of euphoria that is hard to forget.

Over time, the brain will begin to more frequently prompt the behaviors that led to the pleasurable experiences to begin with. It is at this point that tenacious cocaine cravings begin, gradually intensifying and becoming hard to ignore.

Corticosterone: the Stress Hormone

Interestingly, researchers have also found a possible involvement of the body’s primary stress hormone—corticosterone—in cocaine’s addiction mechanism. Studies have indicated that individuals who are more stressed, with higher levels of corticosterone, are also more sensitive to low doses of cocaine.7

This increased vulnerability to cocaine’s effects in the brain makes addiction particularly hard for these stressed individuals to overcome. When people are stressed, cocaine might seem even more relaxing and more powerful. This effect could result in cravings being even stronger and more intense for these individuals.

Prefrontal Cortex: the Brain’s Self-control Center

Over time, cocaine abuse has been associated with white matter deterioration in the prefrontal cortex, the portion of the brain that regulates decision-making and self-control.8 These are precisely the parts of the brain that need to be functioning at full capacity when faced with temptations to use cocaine, yet these portions of the brain might be dulled by the damage caused by drugs.

Understanding Addiction Cravings

People who have addictions often have to deal with strong urges, or cravings, to take the drug again.

If you’ve never struggled with an addiction in your own life, it can be hard to understand how strong a craving really can be. In the absence of firsthand knowledge, you might be tempted to compare drug cravings to food cravings you normally feel from time to time. However, the truth is that cravings for cocaine can be incredibly powerful, and they can feel nearly impossible to ignore.

One study in the Journal of Psychopharmacology found that people under the influence of cocaine tended to report preferring the drug over food. Yet while in a sober state, these same individuals reported preferring food over drugs.9 These aren’t cravings people can simply get over or ignore without help.

Cocaine addiction produces very powerful urges that can easily drive a person to use again and again—regardless of cocaine’s many destructive consequences.


  1. United Nations Office on Drugs and Crime. (2015). World Drug Report 2015.
  2. Schneider, K. E., Krawczyk, N., Xuan, Z., Johnson, R. M. (2018). Past 15-year trends in lifetime cocaine use among US high school students. Drug Alcohol Depend, 183, 69–72.
  3. Mayo Clinic. (2017). Drug addiction (substance use disorder).
  4. National Institute on Drug Abuse. (2016). Cocaine: What are the short-term effects of cocaine use?
  5. Zickler, P. (2004). NIDA Notes: Cocaine May Compromise Immune System, Increase Risk of Infection.
  6. Williamson, S., Gossop, M., Powis, B., Griffiths, P., Fountain, J., Strang, J. (1997). Adverse effects of stimulant drugs in a community sample of drug users. Drug Alcohol Depend, 44(2-3), 87-94.
  7. Dackis, C.A., O’Brien, C.P. (2001). Cocaine dependence: a disease of the brain’s reward centers. J Subst Abuse Treat, 21(3), 111-117.
  8. Goeders, N.E. (2002). Stress and cocaine addiction. J Pharmacol Exp Ther, 301(3), 785-789.
  9. Magalhaes, A.C. (2005). Functional magnetic resonance and spectroscopy in drug and substance abuse. Top Magn Reson Imaging, 16(3), 247-251.
  10. Goldstein, R. Z., Woicik, P. A., Moeller, S. J., Telang, F., Jayne, M., Wong, C., Wang, G.J., et al. (2010). Liking and wanting of drug and non-drug rewards in active cocaine users: the STRAP-R questionnaire. J Psychopharmacol, 24(2), 257-266.

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