How to Tell if Someone is on Cocaine: Signs of Cocaine Use

Signs and Symptoms of Cocaine Use

Cocaine allows dopamine to build up in the brain, producing an intense high that subsides quickly – usually within a few minutes to an hour.[2] It causes euphoria, high energy, alertness, and hypersensitivity to sight, sound, and touch.

Here’s how to tell if someone is on coke based on physical signs:

• Dilated pupils
• Weight loss
• Increased blood pressure
• Bizarre, erratic, or violent behavior
• Irritability
• Anxiety or panic
• Paranoia
• Tremors and muscle twitches
• Decreased Appetite
• Difficulties Sleeping (Restlessness)[3]

The person using cocaine may experience short-term symptoms like:

• Increased body temperature
• Increased heart rate
• Increased blood pressure
• Feelings of panic
• Vertigo
• Nausea and stomach pain
• Loss of sense of smell
• Decreased need for food or sleep

With long-term use of cocaine, the symptoms and side effects may include:

• Permanently increased blood pressure
• Chronic sinus infections
• Damage to the membranes in the nose
• Extreme weight loss
• Blood clots
• Heart attacks
• Headaches
• Seizures
• Strokes
• Gastrointestinal complications
• Psychological changes like auditory hallucinations
• Lung damage (crack cocaine)
• Impaired cognitive function[4]

Signs of Cocaine Addiction

Cocaine is a Schedule II drug, according to the Drug Enforcement Agency (DEA).[5] This is largely due to its high risk of addiction. Cocaine makes people feel good by changing the way the brain experiences pleasure, leading to repeated use to achieve the same euphoric effects.
Regular cocaine use builds a tolerance, causing the user to take higher and higher doses to continue to feel the same effects. Over time, this leads to addiction. If the user tries to cut back or stop using cocaine, intense withdrawal symptoms often follow.

Cocaine addiction is classified as a stimulant use disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The symptoms of cocaine addiction include:

• Using cocaine more frequently, for longer periods, or in higher amounts than intended
• Trying to reduce or stop using cocaine unsuccessfully
• Spending a lot of time sourcing, using, or recovering from cocaine use
• Experiencing intense cravings for cocaine
• Having problems in daily life due to cocaine use
• Continuing to use cocaine despite problems
• Using cocaine despite physical or mental health effects
• Developing a tolerance for cocaine
• Experiencing withdrawal symptoms from stopping or reducing cocaine use[6]

Cocaine Addiction Treatment

Cocaine addiction isn’t a moral failing but a complex disease that involves changes in the brain.[7] Treating cocaine addiction requires not only stopping cocaine use and managing withdrawal but addressing the disease in its entire context – including possible co-occurring disorders like depression or anxiety.

Often, the first step in treating cocaine addiction is medical detox. Though not usually life-threatening, cocaine withdrawal can be intense and may cause relapse. Medical detox in a treatment center provides a safe space to allow the drug to clear the system, as well as medications to manage symptoms like insomnia or nausea.

After detox, cocaine addiction is treated with a range of traditional and behavioral therapies in either an inpatient hospital setting or on an outpatient basis, depending on the individual’s needs.

Traditional substance use disorder therapies like peer groups and individual counseling can be effective. However, the best outcomes occur when these therapies are combined with evidence-based behavioral therapies like contingency management.[8] This type of therapy relies on incentives to reward patients for abstinence.

Cognitive behavioral therapy (CBT) may also be used to help people develop critical skills to recognize their relapse risks and cope with the issues surrounding drug use.[9]