Signs of Cocaine Abuse

Content Overview

What Are Some Signs of Cocaine Abuse?

Signs of cocaine abuse include:


  • Excitability
  • Dilated pupils
  • Runny nose
  • Weight loss
  • Mood swings
  • Social isolation
  • Risky behaviors
  • Nosebleeds
  • Boost in confidence
  • Talkative habits
  • Changes in sleeping and eating patterns
  • White powder residue around the nose and mouth
  • Burn marks on the hands and lips
  • Deterioration in hygiene habits
  • Financial difficulties
  • Loss of interest in things that once brought joy
  • Increased need for privacy
  • Spoons, razor blades, plastic baggies and other drug paraphernalia in the person’s room or clothing pockets

Over 14 percent of all Americans age 12 and older have used cocaine in their lifetimes, the National Institute on Drug Abuse (NIDA) reports. Cocaine is a central nervous system stimulant that increases energy levels and keeps people awake while raising heart rate and blood pressure. Cocaine also makes people feel good by flooding the brain with dopamine, one of the chemical messengers that increase feelings of pleasure.

signs of cocaine useThere are two main types of cocaine: a powder that is snorted, injected, or smoked, and a rock form called crack cocaine that is generally smoked, although sometimes it is placed into body orifices. Cocaine abuse accounts for most of the emergency department visits related to illicit drug abuse or misuse at 40.3 percent, according to the Drug Abuse Warning Network (DAWN) report in 2011. There has also been a 29 percent rise in cocaine overdose deaths between 2001 and 2013, and close to 5,000 people died from an overdose on cocaine in 2013, NIDA publishes.


Cocaine is a highly addictive drug that can change the chemical makeup of a person’s brain with regular use, making it challenging to use the drug without help.


In order to prevent a potentially tragic outcome, it is beneficial to recognize the warning signs that a loved one or family member may be abusing cocaine.

What to Watch For

Cocaine has a short half-life, meaning that it takes effect quickly, in as little as a few minutes, and the high is generally short-lived, lasting from 5-30 minutes, depending on how cocaine is taken and how quickly the drug is absorbed into the bloodstream, Psychology Today publishes. The Genetic Science Learning Center at the University of Utah reports that the fastest way to send drugs into the brain is by smoking, and injection is the second fastest method. Smoking cocaine is the most popular method of ingestion, as NIDA reports that 72 percent of all admissions to substance abuse treatment centers for cocaine abuse involve crack cocaine abuse.

Cocaine creates its “high” by blocking dopamine from being recycled, therefore leaving a large amount of these “happy cells” in the brain at once. Users may be overly talkative, excitable, have fewer inhibitions and high confidence levels, and have lowered appetites or need for sleep when under the influence of cocaine. After coming down from the cocaine high, there is often a crash period, and users may eat and sleep more than usual during this time. Some other signs that someone may be abusing cocaine include:

  • White powder residue around the nose and mouth
  • Needle marks from injecting the drug
  • Burn marks on hands and lips
  • Drug paraphernalia in their personal effects (e.g., syringes, pipes, spoons, razor blades, small plastic baggies, etc.)
  • Change in sleeping and eating patterns
  • Weight loss
  • Mood swings
  • Increased risk-taking behaviors
  • More frequent sexual encounters
  • Dilated pupils that may be sensitive to light
  • Runny nose and/or frequent nosebleeds
  • Lack of concern for personal appearance and personal hygiene
  • Financial troubles
  • Social isolation

Since cocaine leaves the body quickly, some people may abuse cocaine in a binge pattern, taking several doses back to back, which may lead more quickly to physical and psychological dependence than other methods of taking the drug.

Other times cocaine abusers may take higher doses at once, which can lead to hostility, anger, irritability, and even violent outbursts. Long-term users of cocaine may start to experience negative side effects when taking the drug as well. Paranoia, anxiety, anger, and hallucinations may be signs of cocaine abuse in someone who has been using for a long period of time.

Cocaine and Other Drugs

Cocaine is often abused with other drugs or alcohol.

For instance, the Treatment Data Episode Set (TEDS) from 2002-2012, which details admissions to substance abuse treatment services in the United States, reported that 7 percent of all admissions for illicit drug use were for people primarily abusing cocaine, while double that number cited cocaine as a secondary or tertiary drug of abuse.

If cocaine is abused in conjunction with other drugs or alcohol, this is called poly-drug abuse and there may be additional noticeable physical and psychological side effects. For example, injection drug users may mix cocaine with heroin, which is called a “speedball.” Since cocaine is a stimulant and heroin is a central nervous system depressant, there may be a conflicting effect. Anxiety and stress are dampened by heroin, which may accompany the high energy and excitability indicative of cocaine abuse. Someone taking both of these drugs may have impaired motor functions and blurred vision in conjunction with suppressed appetite and lack of sleep.

All of the potential side effects from each drug may be multiplied by mixing them, and mental health issues may also be compounded.

When a large amount of cocaine is taken at once or in conjunction with other drugs or alcohol, the risk for an overdose or other negative health consequences increases also. An overdose occurs when too much of the drug is ingested at one time for the body to handle, and drug amounts reach toxic levels in the bloodstream. The signs of an overdose from cocaine include nausea, vomiting, tremors, seizures, elevated heart rate, chest pain, and a rise in blood pressure and body temperature. A cocaine overdose can result in a stroke or heart attack, and it is a medical emergency. If an overdose is suspected, call for professional help immediately.

When Abuse Turns into Addiction

Cocaine is considered a Schedule II drug in the United States by the Drug Enforcement Agency (DEA) in part due to its high potential for addiction. Cocaine makes people feel good by changing the way the brain feels pleasure, making it more difficult to feel as good without the drug.

Regular use of cocaine can cause someone to become tolerant to the drug, and higher doses must be taken in order to continue to feel the effects that are desired. More and more time may be spent trying to obtain the drug, using it, and then recovering from using cocaine as control over drug use becomes harder. Other duties such as schoolwork, familial obligations, or workplace responsibilities may be overlooked or neglected completely. It may be difficult to rely on people who are addicted to cocaine, and they may withdraw from loved ones and peers, and stop participating in activities or events that they used to enjoy.

Addiction is a disease affecting the motivation and reward circuitry in the brain. When people are addicted to cocaine, they may feel that they need the drug in order to feel any sort of balance. Someone addicted to cocaine may seek out the drug in order to feel some relief from physical and emotional withdrawal side effects that may occur as soon as the drug leaves the bloodstream. Withdrawal symptoms may include drowsiness and fatigue, increased appetite, depression, irritability, mood swings, nightmares, and drug cravings. Cocaine may not have the same physical withdrawal symptoms as other drugs; however, the emotional toll can be just as difficult to manage without help.

In 2013, the National Survey for Drug Use and Health (NSDUH) reported that 1.5 million Americans were considered current users of cocaine, and the Substance Abuse and Mental Health Services Administration (SAMHSA) published that 855,000 were classified with a substance use disorder due to cocaine abuse that same year. The physical and emotional side effects of cocaine abuse and addiction can generally be reversed with proper care and support.

Learn More

Early intervention and recognition of the signs of use or abuse of cocaine can be essential to getting someone on the right path toward recovery.


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