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How Is Cocaine Used? Methods of Use and the Dangers of Each

3 min read · 7 sections
Cocaine is an illegal stimulant drug with a high potential for misuse. People typically use cocaine by smoking, snorting, or injecting it to experience the drug’s stimulant effects, such as increased mental alertness and euphoria. Unfortunately, cocaine can potentially bring about short-term and long-term health risks to a user that are not only caused by the drug’s typical mechanisms, but also the user’s method of administration.1,2
What you will learn:
The dangers of smoking, snorting, and injecting cocaine.
How you can help yourself or your loved one get treatment for cocaine addiction.

What is Cocaine?

Cocaine is a Schedule II stimulant drug that is highly addictive, dangerous, and illegal.3 Drug dealers often mix cocaine with other substances, called “fillers,” concealing the entirety of the concoction’s ingredients. Dealers sometimes dilute cocaine with fentanyl, a dangerous opioid drug responsible for numerous overdose deaths.People can use cocaine in a variety of ways, such as snorting it, injecting it into their veins, and smoking it. Smoking cocaine is usually done after it has been crystallized, and this form is commonly referred to as “crack”.5

Dangers of Smoking Cocaine

Someone who smokes cocaine may experience an almost-instantaneous high that is more intense than the high they’d experience through snorting a powder form of cocaine. This rapid and concentrated effect can make smoking cocaine a more alluring method of consumption and account for some of the reasons why people may choose this method of cocaine use.6

When someone buys cocaine on the street, it comes in a white powdery substance that isn’t easily smoked without first changing its formula and consistency. This can be done in one of two ways — freebasing cocaine or smoking crack cocaine.8

Freebasing cocaine involves a lengthy, and potentially dangerous, extraction process that eventually results in a purified and very potent form of cocaine.Crack cocaine does not involve a purification process and is usually less pure, carrying along with it any additives and dilutants alongside as a result, with only about 40% (on average) of it being pure.8

After inhaling the smoke from crack cocaine, it only takes about 10-15 seconds before someone experiences an intense rush of euphoria. Someone may experience certain respiratory side effects within minutes or hours after smoking cocaine, including:9

  • Cough.
  • Shortness of breath.
  • Wheezing.
  • Chest pain.
  • Hemoptysis, or coughing up blood.
  • Exacerbation of asthma.
  • Pulmonary edema, an abnormal buildup of fluid in the lungs.
  • Collapsed lung.
  • Pulmonary hemorrhage.
  • Pneumomediastinum, a condition where air gets trapped in the space between the two lungs, called the mediastinum.
  • Thermal airway injury.

There are potentially some long-term complications associated with smoking cocaine, too. Various respiratory issues are associated with chronic cocaine smoking, such as a chronic cough with chest pain and blackened sputum (blackened phlegm). Some people may even experience lung scarring and reduced lung capacity, making it difficult for some people to breathe normally.

Dangers of Snorting Cocaine

If someone snorts cocaine, they risk irreversible damage to their nose, mouth and throat. Snorting cocaine can cause severe tissue and bone degeneration, which may result in a perforation of the nasal septum, which is the divider between the two nostrils, or perforations in the roof of the mouth. Other potential risks include.3

  • Loss of smell.
  • Frequent nosebleeds.
  • Chronic runny nose.
  • Difficulty swallowing.
  • Sores, lesions, and ulcers in the nose and throat.

Dangers of Injecting Cocaine

Injecting cocaine involves dissolving the powdery substance with water, then injecting it into a vein. Intravenous injection allows for the drug to be absorbed into the system quickly, providing an almost immediate high.two people share a needle of cocaine.

When someone injects themselves with cocaine, they put themselves at increased risk for blood-borne diseases, such as hepatitis C and HIV/AIDS. Many people who use drugs share needles, a primary method of spreading HIV/AIDS and hepatitis C.9

Contracting IV-related diseases and infections are not the only dangers of injecting cocaine. There is a risk for vein collapse, scarring, and soft tissue infections, too.10

Signs of Cocaine Addiction

Regardless of the method of use, individuals who use cocaine risk developing an addiction to it. Signs that indicate a person may be suffering from or developing a cocaine addiction include: 10

  • Unusual paranoia.
  • Changes in sleep or eating patterns.
  • Agitated or edgy mood.
  • Continual runny nose.
  • Going through times of extreme depression.
  • Frequent upper respiratory infections.
  • Loss of interest in things usually enjoyed.
  • Experiencing visual or auditory hallucinations.
  • Going through large amounts of money or having large amounts of cash without explanation.
  • Lack of care for personal hygiene.
  • Weight loss.

If you recognize these signs in yourself or someone you love, reach out for help immediately. With the proper treatment, you can begin the journey to healing and vacate from a life ruled by cocaine use. Although the first step may be difficult, with effective, evidence-based treatment you can overcome a cocaine addiction and live a healthier life.

Short- and Long-Term Effects of Cocaine Use

Cocaine, no matter how someone ingests it, may induce changes in a person’s brain that encourage repetitive use and can lead to addiction.11 In fact, evidence suggests that up to 1 in 6 persons, who use cocaine, will develop a moderate or severe stimulant use disorder. Heavier use through smoking and injection is more heavily associated with developing a stimulant use disorder than lighter use or use through the intranasal and oral pathways.12

Other short- and long-term health risks associated with chronic cocaine use that extend well after a person stops using cocaine include:4,12,13

  • Cognitive impairment.
  • Persisting intermittent psychosis.
  • Seizures (even in those without a preexisting seizure disorder).
  • Irregular heartbeat (cardiac arrhythmia).
  • Organ ischemia or infarction, which can result in kidney failure, gastrointestinal problems, and liver damage.
  • Skin and muscle vasculitis and lesions.

Though cocaine use, alone, is dangerous, analyzing the risks associated with an individual’s cocaine use is incomplete without the full examination of their method of use. Heavier users and those who inject or smoke cocaine are more likely to become addicted than lighter users or those who snort or ingest cocaine orally.12 Although any cocaine use carries with it a risk of addiction as well as neurological and cardiovascular complications, each manner of ingestion has its own associated and unique health risks.

Treatment for Cocaine Addiction

If you or a loved one struggle with cocaine use, help is available. Treatment is tailored to your unique needs, which may include simultaneous treatment for co-occurring mental health disorders and other underlying health issues.

While there are currently no medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of cocaine addiction, other therapeutic interventions used include education, individual and group counseling, and behavioral therapies—such as cognitive-behavioral therapy and contingency management—delivered in outpatient settings, inpatient programs, or long-term residential facilities.13

Aftercare, or ongoing treatment, continues after the formal treatment ends and helps you sustain lasting recovery and avoid relapse by encouraging continued counseling, sober living environments, and participation in mutual-help groups such as Cocaine Anonymous.13

If you think you or a loved one suffer from a cocaine misuse problem or addiction, call American Addiction Centers (AAC) at

We will answer your questions and connect you with a compassionate admissions navigator, who can help you get started on the road to recovery.

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