Signs of Cocaine Addiction: What to Look For

Cocaine addiction can be devastating for the person who uses cocaine, severely impacting their lives and relationships. Keep reading to learn more about what cocaine is, signs of cocaine use and how to tell if someone is on cocaine, signs of cocaine addiction, statistics, and how to find addiction treatment near you.

Understanding Cocaine Addiction

Cocaine is a highly addictive, illegal stimulant drug that is derived from coca leaves, a plant native to South America.¹ Cocaine is listed as a Schedule II substance because it has a high potential for misuse but it can be legally administered by a doctor for certain medical purposes.¹

People typically use cocaine by snorting the powder, rubbing the powder on their gums, dissolving the powder and injecting it into the bloodstream, or smoking the rock or crystalline form of the drug (i.e., crack cocaine). All of these methods can produce a range of effects, including an intense but short-lived euphoria, increased energy and alertness, as well as a variety of negative consequences.¹

Cocaine is addictive because it directly impacts the brain’s  reward pathway, a system that reinforces pleasurable experiences and motivates us to repeat them. Normally when a person experiences pleasure, such as from natural rewards like eating or sex, dopamine is released by a neuron into the synapse where it attaches to specialized proteins called dopamine receptors on nearby neurons. Another specialized protein, a dopamine transporter, removes the dopamine and recycles it for future use. Cocaine blocks this transporter from removing dopamine, leading to the accumulation of dopamine in the synapse and producing an amplified signal to receiving receptors. It also creates a powerful association between cocaine use and the feelings of euphoria it causes, making the user more likely to want to repeat the experience.¹

Over time, long-term, regular cocaine use can cause lasting changes in the brain and behavior that can lead to cocaine addiction.¹

Recognizing Cocaine Use

The effects of coke use are almost instantaneous, with signs and symptoms of coke use appearing within a few minutes to a hour.¹

The physiological effects of cocaine use include:¹

• Dilated pupils
• Constricted blood vessels.
• Increased body temperature.
• Elevated heart rate.
• High blood pressure.

Signs someone is using cocaine might include:^1,2

• Restlessness (being unable to sit still.
• Seeming confused or disoriented.
• Appearing exhausted, even if they haven’t done any physical activity.
• Being unable to recall facts or events.

The symptoms of cocaine use and their severity can vary from person to person and how much they’ve used, the purity of the cocaine, their level of tolerance, the way they’ve taken it, and whether they’ve used any other substances.^1,2

People may experience symptoms of coke use such as:¹

Some people, especially those who use large amounts of cocaine, display symptoms such as bizarre, erratic, highly paranoid, or violent behavior.^1,2

Statistics on Cocaine Use

• The 2022 National Survey on Drug Use and Health reports that, among those aged 12 or older in 2022, 5.3 million people used cocaine in the past year.³
• This percentage was highest among young adults aged 18-25, with 1.3 million people reporting cocaine use in this age bracket.³
• 1.4 million people aged 12 and older had a cocaine use disorder, the term used by the NSDUH for cocaine addiction, in the previous year.³
• From 2019 to 2022, cocaine-involved overdose deaths rose 73.5%, from 15,883 to 27,569 deaths.⁴
• Cocaine in combination with synthetic opioids, primarily fentanyl, is the main driver of cocaine-related overdose deaths.⁴

Recognizing a Cocaine Addiction

One can use cocaine and not be addicted to it, however there are a number of health risks associated with both short-term and long-term use. One of the biggest risks of chronic cocaine use is developing a cocaine addiction. An addiction is a medical disease characterized by the uncontrollable use of a substance despite significantly negative consequences.⁷

Cocaine addiction is diagnosed as a stimulant use disorder.⁵ The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, FIfth Edition (DSM-5) provides the diagnostic criteria that medical professionals use to guide their diagnosis.⁵ It can be helpful to know cocaine addiction symptoms and signs so you know when it might be time for you, or someone you care about, to seek help. These can include:⁵

• Using a stimulant such as cocaine in larger amounts or over a longer period than intended.
• A persistent desire or unsuccessful efforts to cut down or control stimulant use.
• Spending a great deal of time engaging in activities necessary to obtain the stimulant, use the stimulant, or recover from its effects.
• Craving, or a strong desire or urge to use the stimulant.
• A failure to fulfill major obligations at work, school, or home due to recurring stimulant use.
• Continued stimulant use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the stimulant’s effects.
• Giving up or reducing important social, occupational, or recreational activities because of stimulant use.
• Recurrent stimulant use in situations where it is physically hazardous.
• Continued stimulant use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the stimulant.
• Tolerance, meaning a need for markedly increased amounts of the stimulant to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of the stimulant.
• Withdrawal, as manifested by either displaying a characteristic withdrawal syndrome for the stimulant, or use of the stimulant (or a closely related substance) to relieve or avoid withdrawal symptoms.

People displaying at least 2 of the above-listed criteria within a 12-month period can be diagnosed with a stimulant use disorder.⁵ A stimulant use disorder can vary in severity, with 2-3 symptoms indicating mild severity, 4-5 being moderate, and 6 or more indicating a severe disorder.⁵ If you notice 2 or more of these criteria in yourself or a loved one, it’s a good idea to talk to your doctor about your concerns so you can receive a proper diagnosis and get help.

Finding Cocaine Addiction Treatment Near You

Cocaine addiction is a chronic yet treatable medical condition.⁷ While there are no FDA-approved medications to treat addiction to stimulants, psychosocial interventions and behavioral therapies can be effective, including:¹

• Contingency management (CM), which is based on principles of positive reinforcement and involves providing tangible rewards to reinforce desired behavioral changes.
• Cognitive-behavioral therapy (CBT), which helps people change unhelpful thoughts and behaviors related to cocaine or other substance use, teaches skills that are needed for long-term abstinence, and helps them learn to cope with problematic situations and triggers to use cocaine.

Treatment can involve various levels of care, depending on a person’s unique needs.⁶ A person will first receive a comprehensive evaluation to determine the appropriate setting and to formulate an individualized treatment plan.⁶

Rehab can take place in inpatient or outpatient settings.⁶

• Inpatient treatment means you’ll live onsite for the duration of treatment.
• Outpatient treatment allows you to live at home, but you’ll travel to a rehab to participate in treatment.
• Aftercare, which is a form of ongoing support to help people maintain long-term recovery and minimize the risk of return to cocaine use.

American Addiction Centers is a leading provider of stimulant addiction treatment in the U.S., with treatment centers located across the nation. If you or a loved one are struggling, there is always hope, and it’s never too late to start the path to recovery. Please call us at to learn more about your treatment options or to ask any questions you may have about rehab.