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Cocaine Addiction and Abuse

Cocaine is an illicit drug that is widely used across the United States.1,2 When used for extended periods of time, cocaine can lead to the development of addiction and dependence.1,3 However, with the appropriate levels of treatment and support for your individual needs, it is possible to overcome an addiction to cocaine.3 This page will provide more insight into cocaine as a drug, its addictive nature, its effects, signs of cocaine abuse, the dangers of mixing cocaine with other drugs, how cocaine addiction is treated, and whether you can use your insurance plan to obtain cocaine addiction treatment and rehab.

What is Cocaine?

Cocaine is a strong stimulant drug that is derived from the leaves of a plant indigenous to South America.1,4 It comes as a white powder that can be snorted or mixed with water and injected.1,4-6 Crack cocaine is a processed form of the drug that comes in “rocks” that can be smoked to give a more intense but short-lived high.4,6 Once any form of cocaine is ingested, it quickly causes strong feelings of euphoria and increased energy, activity, alertness, self-confidence, and talkativeness.1,5,6

According to the 2019 National Survey on Drug Use and Health 5.5 million Americans aged 12 or over had used cocaine in the last year.2 The 2020 Monitoring the Future Study also showed 1.6% of 8th and 10th graders and 4.1% of 12th graders in the U.S. reported using cocaine at some point in their life.7 As of 2019, 1 million Americans aged 12 or over had a cocaine use disorder (SUD) involving cocaine in the last year.2

An SUD, or addiction, is the inability to stop using a substance even after it has caused harm in one or more areas of your life.8,9 Cocaine’s addictive effect is thought to be that it results in a buildup of dopamine, chemicals in the brain’s reward pathway that are involved in feelings of pleasure as well as the regulation of emotions and motivation. Chronic use also creates changes in the brain that make it difficult to stop.3,4,9 The changes can last far into abstinence, making it harder to control your behaviors, manage stress in healthy ways, and avoid relapse. 3,4,9

Is Cocaine Addictive?

Cocaine is recognized to be highly addictive. Strong cravings can occur even after years of abstinence, making recovery difficult.1,4,5

When you take cocaine, your brain is exposed to much more dopamine than normal; this accounts for the euphoric feelings.4,6 The brain becomes accustomed to higher levels of dopamine over time. You develop “tolerance,” and use more cocaine to feel good, and you feel worse when you aren’t using it.4 Your brain may become develop a dependency to cocaine, this is characterized by experiencing physical and psychological withdrawal symptoms when you stop taking the drug.3,4

Signs of a cocaine use disorder can include an inability to stop using once you have started; continuing to use cocaine even after it has caused physical, mental, or legal problems; neglecting responsibilities; needing more cocaine to get high; or experiencing withdrawal symptoms when you stop using.1,3,8,10 Withdrawal symptoms can include very strong urges to use (i.e., cravings) as well as mood swings, extreme fatigue, depression, difficulty focusing, headaches, feeling achy, difficulty sleeping or sleeping too much, and eating more.6,10-12

Tolerance, Dependence & Addiction

Tolerance, dependence, and addiction are three terms that are interrelated but mean different things. Tolerance occurs when the brain and body adapt to the presence of cocaine to the point where the usual amount no longer has the same effect. You need to use more cocaine to get high, which may lead you to take larger doses and/or use more frequently.3,4,8,10

When a person is dependent, they are physiologically reliant on cocaine to function normally, and stopping or significantly reducing use causes uncomfortable withdrawal symptoms. 3,4,8 Addiction, or an SUD, is when you can’t stop using cocaine even after experiencing negative consequences in at least one area of your life—your physical or mental health, at work, at school, at home, or legally.3,8

Some people experience tolerance, dependence, and addiction all together. While you don’t necessarily have to have tolerance and dependence to be diagnosed with addition, the majority of people with a cocaine SUD do report experiencing tolerance and/or withdrawal symptoms.3 (p20), 10 (p561, 563)

Effects of Cocaine Use

Cocaine is a strong stimulant drug that can have a range of effects on your mind, body, and behavior.1,4 Users tend to engage in binge behavior, with initial feelings of euphoria and increased energy moving giving way to anxiety and irritability.4 Other effects include:1,4-6, 8,11-13

  • Increased activity and alertness.
  • Increased sociability.
  • Loss of appetite.
  • Increased sensitivity to sights, sounds, and touch.
  • Anxiety.
  • Dilated pupils.
  • Hallucinations.
  • Headaches.
  • Nausea.
  • Paranoid thoughts or behaviors.
  • Raised blood pressure, heart rate, and temperature.
  • Seizures.
  • Stroke.
  • Trouble thinking coherently.

Over time, cocaine use can damage the brain, heart, lungs, and digestive system.6,8,13 Snorting cocaine has been linked to damage to the nasal tissue. Injecting it can damage the veins and increase the risk of diseases such as HIV or hepatitis C, and smoking crack can damage the lungs.11,13

Behavioral Signs of Repeated Cocaine Use

Warning signs that a person might be using cocaine include:4,11,13,14

  • Changes in sleeping patterns.
  • Chronic cough, smelling like chemicals, or burns on the lips and/or fingers (from smoking crack cocaine)
  • Eating less than usual and losing weight very quickly.
  • Experiencing unexplained financial difficulties.
  • Frequent nosebleeds or runny or stuffy nose.
  • Mood swings.
  • Spending time with a new group of friends or isolating.
  • Stealing.
  • Talking and moving fast.
  • Track marks on the arms or wearing long sleeves even in warm weather (from injection use.

Take Our “Am I a Drug Addict?” Self-Assessment

Take our free, 5-minute “Am I A Drug Addict?” self-assessment below if you think you or someone you love might be struggling with drug addiction. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result.

Mixing Cocaine with Other Drugs

Cocaine is frequently used with other substances, such as marijuana, alcohol, or heroin.4,11 Mixing alcohol and cocaine causes a chemical reaction that can be especially damaging to the heart.4,13,16,17 Alcohol can slow down how fast your body can process the cocaine, which slows your coordination and reflexes.16 You may be unaware of these reactions, making it more difficult to perform tasks such as driving. Your risk of overdose and alcohol poisoning increases, and you may be more likely to behave violently.16-18 This combination can be fatal.17

Another dangerous combination is heroin and cocaine (speedball).4,17 These two drugs have opposing effects—heroin depresses your breathing while cocaine increases your body’s need for oxygen—but greatly increases the risk of experiencing a life-threatening overdose.4,17,18 Combining cocaine with opioids may be intentional or unintentional, as fentanyl and fentanyl-like substances are increasingly being used to cut cocaine. Synthetic opioids other than methadone (e.g., fentanyl) has been the main driver in the rise of cocaine-related overdose deaths and have been climbing steadily since 2014.15,21 Using opioids and cocaine together can also increase the risk of damage to the kidneys.19

Cocaine Addiction Treatment

While it can be difficult to overcome an addiction to cocaine, it can be effectively managed.3,4, 8 There is not one type of facility or program that is suitable for everyone.3 Addiction treatment is designed to address not just your substance use but all of the ways in which it has negatively affected your life, which may include your physical health, your mental health, your social functioning, your ability to work or attend school, and any legal issues you may have.3,4,8

Many different types of treatment options are available to address the wide range of needs that people experience.3 Programs typically provide an individualized treatment plan that is tailored to your unique needs. They often use a combination of different techniques to address your addiction and how it has affected you.3,20

These can include:

  • Residential treatment, where you live at a facility, and receive care and/or support around the clock.3,4,11,20 This is a structured setting with counseling, support, and a strong emphasis on peer and social interactions.3,4
  • Inpatient treatment typically involves a shorter stay at a facility—often around 4 weeks —with around-the-clock monitoring and care, intense group therapy, and individual counseling.3,20
  • Outpatient treatment offers less intensive group and individual counseling while you live at home. 3,20 This type of care allows you to work, attend school, and participate in daily life while learning how to adjust to stressors and receiving the support of peers and staff.3
  • Behavioral therapy in a group, individual, and/or family settings is highly effective for treating addiction to cocaine and other substances.3,4,11 These techniques can help you learn how to stay sober, improve your relationships with others, cope with stress in healthy ways, and participate in positive activities. 3,20
  • Contingency management is a type of treatment that’s often effective for stimulant use disorders; this is where incentives are provided that are contingent upon treatment attendance and/or verified drug abstinence in order to increase the likelihood of these behaviors.22
  • Treatment for co-occurring disorders, which addresses mental health disorders at the same time as a substance use disorder, is generally more effective than treating these issues separately.3,4 Therapy, medications, and other supportive services are commonly utilized in this type of treatment.3,20

If you are seeking cocaine treatment in the United States, you have a wide array of options including private rehab facilities, state-run treatment facilities, and local treatment programs. This allows you to find the treatment setting that is most likely to meet your needs.

Find Out If Your Insurance Plan Covers Alcohol Rehab

American Addiction Centers can improve treatment outcomes for those in recovery for cocaine addiction. To find out if your insurance covers treatment at an American Addiction Centers facility, click here or fill out the form below. Your information is kept 100% confidential.


  1. National Drug Intelligence Center. Powdered cocaine fast facts.
  2. Substance Abuse and Mental Health Services Administration. (2020). Key substance abuse and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  3. National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (Third edition).
  4. National Institute on Drug Abuse. (2016). Cocaine research report.
  5. U.S. National Library of Medicine. (2020). Cocaine.
  6. U.S. National Library of Medicine. (2021). Substance use – cocaine.
  7. National Institute on Drug Abuse. (2020). Cocaine trends and statistics.
  8. National Institute on Drug Abuse. (2018). The National Institute on Drug Abuse media guide.
  9. National Institute on Drug Abuse. (2018). DrugFacts: Understanding drug use and addiction.
  10. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  11. National Institute on Drug Abuse. (2021). Cocaine DrugFacts.
  12. National Institute on Drug Abuse. Effects of cocaine on brains and bodies.
  13. National Institute on Drug Abuse. (2020). Commonly used drugs charts.
  14. National Institute on Drug Abuse. Signs of cocaine use.
  15. Centers for Disease Control and Prevention. (2021). Other Drugs.
  16. Pennings, E.J., Leccese, A.P., & Wolff, F.A. (2002). Effects of concurrent use of alcohol and cocaine. Addiction, 97(7), 773-783.
  17. Government of South Australia. (2021). Dangers of mixing drugs.
  18. National Institute on Drug Abuse. (2021). Cocaine.
  19. Jaffe, J.A., & Kimmel, P.L. (2006). Chronic nephropathies of cocaine and heroin abuse: A critical review. Clinical Journal of the American Society of Nephrology, 1(4), 655-667.
  20. National Institute on Drug Abuse. (2019). DrugFacts: Treatment approaches for drug addiction.
  21. National Institute on Drug Abuse. (2021). Overdose Death Rates.
  22. Stitzer, M., Cunningham, C.S., Sweeney, M.M. (2021). Contingency management for substance use disorders: Theoretical foundation, principles, assessment, and components

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