Signs and Symptoms
Overdose severity depends on the purity and potency of the drug, how much is ingested in a given period, and whether it is smoked, inhaled, injected, or taken orally.
Cocaine overdose may include symptoms such as:
- Dangerously high body temperature.
- Increased sweating.
- Increased heart rate and blood pressure.
- Chest pains.
- Hyperactivity and irritability.
- Nausea and vomiting.
- Acute mental health changes including depression, paranoia, and other psychotic features. 3,4,5
If you use cocaine and are experiencing these effects, or observe someone else having them, call 911 right away.
Helping an Overdose Victim
Since you may not be aware of all the drugs involved, follow these generic tips for helping overdose victims: 6
- Reassure the person.
- Loosen any tight clothing.
- When possible, monitor pulse and breathing rates, and check blood pressure.
- If there are no signs of breathing or a pulse is absent, begin CPR immediately after calling 911.
- If the person is having seizures, clear away any objects that may cause injury, turn the person on his/her side to ease breathing, and continue reassuring him or her in a calm voice. Do not offer food or water or try to hold the person in one place. 7
- Injecting cocaine, especially with heroin. 3
- Sniffing cocaine after smoking crack. 3
- Mixing alcohol and cocaine, which can produce a toxic substance called cocaethylene. 4
- Inability to control the dose and purity of the drug.
- Tolerance, which requires the user to take larger amounts of the drug to achieve the same effect.
Medical personnel in the emergency room will take a number of steps to assess and treat a cocaine overdose.
- Tests: Along with whatever information the user or loved ones may provide, tests will be run to check for levels of cocaine and its metabolite chemicals, as well as for any other drugs present in the system. Urine and blood analyses also test for kidney and liver function, cardiac enzymes, blood acidity levels, and complete blood count. 5
- Medication: Cocaine overdose treatment involves the use of drugs for different possible complications. A benzodiazepine (sedative) such as lorazepam may be administered intravenously (IV) if needed to manage the hyperexcitable state associated with cocaine overdose. 4
- Harm prevention: In rare cases, to prevent further physiological damage, drug-induced paralysis and mechanical ventilation can help prevent severely agitated people from further harm. If elevated blood pressure does not respond to benzodiazepines, physicians may employ an IV nitrate like nitroprusside. 4
- Cooling: Ice packs, IV saline, and sedation are used to control dangerously high body temperatures. 4
- Heart evaluation: Chest pain is often associated with cocaine abuse and, if present, will necessitate a full cardiac evaluation. Chest X-rays, cardiac enzymes, electrocardiogram, echocardiography, and other diagnostics can help rule out any damage to the heart. 4
- Psychiatric evaluation: Prior to leaving the emergency room, the physician may order a psychiatric evaluation for further diagnosis and treatment. A social worker may explore post-discharge treatment options.
Can You Die From a Cocaine Overdose?
Overdosing on cocaine can be fatal. Seizures, cardiac arrhythmias, and respiratory arrest are the primary causes of death from cocaine overdose. Kidney failure, stroke, brain hemorrhage, and hyperthermia are other fatal consequences. 3
Even when an overdose does not kill, the effects of cocaine addiction can be devastating. Snorting causes chronic nasal inflammation, nosebleeds, and damage to one’s sense of a smell. Damaged lungs and worsened asthma result from crack smoking. Injecting cocaine significantly increases the risk of acquiring HIV and hepatitis C. Allergic reactions to the drug itself or mixed impurities can be life-threatening. 8
A whole gamut of serious health issues results from chronic cocaine abuse. For example, cocaine:
- Increases the risk of stroke.
- Inflames and damages the heart.
- Causes weight loss from destruction of the gastrointestinal system.
- Damages the brain and leads to memory loss, poor judgment, attention span deficit, and movement disorders such as Parkinson’s disease. 8
Recovering From an Overdose
With prompt treatment, cocaine overdose is survivable. But overdosing on cocaine is a strong indicator that a person may have a substance abuse problem. To prevent another overdose and avoid the consequences of long-term drug dependence, you or someone you care for should seek treatment at a recovery center.
In some instances, people are using multiple drugs in addition to cocaine. Many who struggle with drug abuse may also be dealing with various mental health issues. Assessment of and treatment for these other conditions is vital to success.
Depending on the user’s treatment needs, addiction treatment can be sought through either residential or outpatient settings.
- Inpatient or residential programs range from 3 to 6 weeks or more and offer intensive treatment. Many incorporate the 12-step treatment method and offer detox, therapy, holistic techniques, and planning for follow-up care. 9
- Outpatient treatment programs can follow discharge from residential rehab treatment centers or be a person’s primary mode of treatment, depending on the circumstances. Ranging from drug education to intensive day treatment, many outpatient rehab programs focus on relapse prevention in the real world. Some will require regular monitoring to assess for recovery setbacks and to help with accountability. 9
- 12-step programs such as Narcotics Anonymous or Cocaine Anonymous offer members peer support and a structured program of recovery that includes completing a series of steps.
Therapies for Addiction
No medications exist to treat cocaine addiction. However, behavioral treatments have proven effective.
One behavioral method relies on points and rewards. When users pass drug-screening tests, this “contingency management” system rewards success with concrete incentives such as movie tickets or gift cards.
Cognitive behavioral therapy helps users learn to avoid situations that trigger cocaine use, as well as how to cope with problems that may contribute to drug use. 8
Find a Recovery Center
After recovery from the acute dangers of cocaine overdose, it is important to seek treatment as soon as possible to prevent relapse. Search our online directory for more information on rehab programs in your city or another area.
. Centers for Disease Control and Prevention. (2017). ANNUAL SURVEILLANCE REPORT OF DRUG-RELATED
RISKS AND OUTCOMES UNITED STATES, 2017.
. National Institute on Drug Abuse (2018). Overdose Death Rates.
. The University of Arizona. MethOIDE: Cocaine Overdose.
. Merck Manual (2016). Cocaine.
. National Institutes on Health: U.S. National Library of Medicine (2015). MedlinePlus Medical Encyclopedia: Cocaine Intoxication.
. National Institutes on Health: U.S. National Library on Medicine (2014). MedlinePlus Medical Encyclopedia: Drug Abuse First Aid.
. U.S. Centers for Disease Control and Prevention (2015). Seizure First Aid.
. National Institute on Drug Abuse (2016). Cocaine.
. National Institute on Drug Abuse (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.