Cocaine Overdose Signs, Symptoms & Treatment

Cocaine is an addictive stimulant that is derived from the leaves of the coca plant.1 In the U.S., it is a Schedule II substance, which means that while it does have some medicinal applications, it has a high potential for misuse.¹ 

Illicit sources of cocaine are commonly encountered in one of two chemical varieties—as a hydrochloride salt or a free base form. The hydrochloride salt is what most powdered cocaine sources contain. This form that can be snorted or dissolved in water and injected. Crack cocaine is manufactured from a process that results in a water-insoluble free base form of the drug, which is most commonly smoked.¹ The effects of cocaine may be felt nearly immediately when the drug is injected or smoked and takes a few minutes when it is snorted.¹ People may use cocaine for the feeling of euphoria the drug induces as well as to experience increased energy and alertness and a decreased need for food and sleep.¹

Can You Overdose on Cocaine?

Yes, you can overdose on cocaine. In addition to the potential for toxicity with the drug itself, cocaine is frequently adulterated with other substances, including the highly potent opioid fentanyl, which is a major contributor to the rising number of overdose deaths.^1,4 Individuals who use cocaine containing fentanyl are at an increased risk of overdose.⁴

In 2022, 57,497 people in the U.S. died from stimulant-related overdoses.² Nearly 18,000 of those reported overdoses were due to stimulants only, not stimulants that were combined or adulterated with opioids.²

It is crucial to be able to recognize the signs and symptoms of a cocaine overdose; knowing how to respond quickly and appropriately can help save a life.

Signs & Symptoms of Cocaine Overdose

It’s important to note that someone who has overdosed purely on stimulants such as cocaine alone, is often still conscious.³ Some of the signs and symptoms that a person may have overdosed on cocaine include:³

How Much Cocaine Does it Take to Overdose?

There is no clear-cut answer to the question of how much cocaine it takes to overdose, as it varies widely from person to person depending on various factors.³ Some of the factors involved in how much cocaine it would take for a person to overdose include:^3.4

• Purity or potency of the drug. While cocaine itself can be toxic and lead to an overdose, it is often combined with other drugs that increase its lethality, including fentanyl and heroin.
• Individual health factors. Sleep patterns, age, height, and weight can impact how much cocaine it takes to overdose.
• Route of administration. How a person uses cocaine (e.g., snorting versus injecting) can be a factor in overdose.
• Polysubstance use. Some who use cocaine often combine it with other drugs or alcohol, often to offset or enhance the effects of cocaine. Combining cocaine with other drugs or with alcohol increases the risk of an unintentional overdose.

Dangers of a Cocaine Overdose

Some of the potentially devastating health effects of a cocaine overdose can include:¹

• Adverse psychological issues such as hallucinations, paranoia and other features of acute psychotic episodes.
• Erratic, bizarre, and/or violent behavior, placing both the user and those nearby at risk of harm.
• Gastrointestinal tract injury from vasospasm/infarction.
• Catastrophic cardiovascular events such as heart attack, stroke, and potentially fatal cardiac arrhythmias.
• Neurological dangers such as seizures and the consequences of stroke.
• Sudden death from cardiac arrest or neurological events.

Cocaine is often mixed with other substances, notably alcohol and opioids.¹ In particular, when cocaine is combined with alcohol, the combination produces cocaethylene, which amplifies both substances’ cardiotoxic effects.¹ Mixing cocaine with opioids like heroin or fentanyl can mask their individual effects, increasing the risk of fatal overdose.¹

What to Do if You or Someone You Know is Overdosing on Cocaine?

An overdose is a medical emergency. If you suspect someone has overdosed, call 911 right away. While waiting for emergency services to arrive, there are several things you can do:⁴

• Administer naloxone, the opioid overdose reversal drug, if you suspect opioids may be involved in the overdose (even if you’re unsure). Naloxone is a safe medication, even if the person hasn’t taken opioids.
• Stay with the person and try to keep them safe and comfortable.
• Reduce noise, limit touch, and help them stay as calm as possible.
• Offer cool fluids and a cold washcloth to help regulate body temperature to avoid overheating.

Cocaine Addiction Treatment

There are currently no medications specifically approved to treat cocaine addiction (or stimulant use disorder); however, some therapeutic modalities have proven effective at helping people learn how to quit cocaine use and begin to recover from their stimulant use disorder.⁴ Some of these include:⁴

• Contingency management (CM), for example, is a form of therapy that utilizes a reward- or prize-based system.
• Cognitive-behavioral therapy (CBT) helps a person understand their triggers and risk factors for use so that they learn to cope with a range of problems they may face in recovery.
• Community reinforcement which is a personalized treatment approach that empowers people to make positive lifestyle changes for lasting recovery.

American Addiction Centers (AAC) offers various levels of care for people who are seeking cocaine addiction treatment. Whether you or someone you love is seeking outpatient treatment or feel more comfortable starting your journey in a more structured level of care, such as inpatient or residential treatment, our admissions navigators can help. Contact us today at and find out how to begin the journey toward a rich and rewarding life in recovery.