Cocaine Overdose: Symptoms, Warning Signs, and What to Do

Understanding Cocaine Overdose

Cocaine is one of the most commonly used illicit stimulants in the U.S. Despite its reputation as a “party drug,” it presents many serious risks, including death due to overdoses. Cocaine-associated overdoses have dramatically increased in recent years, with the Centers for Disease Control and Prevention reporting a significant rise in overdose deaths due to the fact that cocaine is increasingly contaminated with synthetic opioids, such as fentanyl.

By understanding the signs and symptoms of cocaine overdose, and being aware of how to respond to it immediately, you can save a person’s life.

Why Is Cocaine So Dangerous?

Cocaine is a powerful stimulant drug derived from the coca plant. It works by flooding the brain with dopamine, stimulating the reward center, and giving users feelings of pleasure, euphoria, energy, and self-confidence.[1] However, those effects come with risk to the body, especially the cardiovascular system, and to the brain.

Whether snorted, injected, or smoked as crack cocaine, using cocaine can result in a significant increase in heart rate, blood pressure, and body temperature, and puts strain on the heart and other organs.[2] Because of this, the risk of suffering a heart attack or stroke from even one use is significant, even if the user is otherwise healthy.[3]

The risk of overdose increases depending on how cocaine is ingested, how much is ingested, and if it has been mixed with additional substances.[4]

What Is Cocaine Toxicity?

Cocaine toxicity, sometimes referred to as “cocaine toxidrome” or “cocaine syndrome, ” is a state of dangerous physiological and psychological overstimulation caused by too much cocaine in the body.[5] It is not always the result of intentionally taking a high dose of the substance and can happen even in experienced cocaine users if the cocaine they use is unexpectedly potent or has been adulterated with other substances.

Cocaine toxicity affects multiple body systems at the same time, including the cardiovascular system and the central nervous system. Left untreated, it can quickly escalate into a life-threatening cocaine overdose.

Cocaine Overdose Symptoms: What to Look For

Being able to quickly recognize the signs and symptoms of a cocaine overdose is vital due to the fast-acting nature of the drug and the narrow time window available to provide effective intervention.[6]

Some common signs to watch for are listed below:

Cardiovascular symptoms:

• Chest pain or tightness
• Rapid pulse (tachycardia) or irregular heart rate (arrhythmia)
• Dangerously high blood pressure
• Cardiac arrest (heart stops beating)

Neurological and psychological symptoms:

• Severe agitation, anxiety, or panic
• Disorientation and confusion
• Seizures
• Psychosis (paranoia, hallucinations, or loss of reality)
• Stroke symptoms (abnormal weakness, slurred speech, or vision changes)

Additional physical symptoms:

• Hyperthermia, which is a dangerous spike in body temperature
• Profuse sweating
• Nausea and vomiting
• Tremors or uncontrolled muscle movements
• Pale or bluish skin

In severe cases:

• Respiratory failure (breathing is inadequate or stops)
• Loss of consciousness
• Cardiac arrest and death

Contamination in the current cocaine supply is one of the most significant dangers for people using cocaine. The US Drug Enforcement Administration (DEA) and the National Institute of Drug Abuse report that cocaine is frequently cut or adulterated with fentanyl or other synthetic opioids or contaminants.[7] This increases the risk of a fatal overdose as fentanyl can produce respiratory failure even in very small quantities, and many users of cocaine have no opioid tolerance.

How to Respond to a Suspected Cocaine Overdose

A cocaine overdose is an emergency. If you suspect someone may be overdosing, every second counts. Below are the steps you should take:

1. Call 911 immediately. Do not wait to see if the person gets better on their own. Call 911 and, as accurately as possible, describe what has happened, including what substances were used. Most states have Good Samaritan laws that provide legal protection for people calling for emergency services; do not let fear of arrest prevent you from saving a life.
2. Administer naloxone (Narcan). Because cocaine is frequently contaminated with fentanyl or other synthetic opioids, having naloxone available can save lives. Naloxone works by reversing the effects of opioids and will not cause harm if there are no opioids present. It is available without a prescription at many pharmacies.
3. Keep the person calm and safe. If the person is awake and agitated or is having a psychotic episode, speak calmly. Remove anything that could hurt them if they fall. Do not forcibly hold the person down. Keep yourself safe.
4. If the person is not breathing, or has no pulse, begin CPR. Do not stop until emergency personnel arrive.
5. Do not leave the person alone(if you are safe). A cocaine overdose can lead to rapid deterioration. Remain with them, observing their breathing, pulse, and level of consciousness until a medical professional arrives.

How Is Cocaine Overdose Treated?

Medical intervention for a cocaine overdose works to stabilize the vital systems of the body and to control any of the dangerous complications.

There is no specific antidote for cocaine. Because of this, treatment is largely supportive and based on symptoms.[8] Depending upon the severity, medical staff may provide:

• Cooling measures for hyperthermia (dangerously high body temperature)
• Medications to control arrhythmia or support the cardiovascular system
• Medication for seizures or agitation
• Oxygen therapy or ventilation support for respiratory failure
• IV fluids and electrolytes
• Monitoring for stroke, heart attack, or kidney damage
• Naloxone in the case of possible opioid contamination

Following stabilization, medical teams will assess underlying health conditions, withdrawal symptoms, and the need for further mental health evaluation.

How to Prevent a Cocaine Overdose

The only way to effectively protect yourself against a cocaine overdose is to stop cocaine use entirely. There is no safe level of cocaine use.

The unpredictability of today’s drug supply, including potential contamination with fentanyl and other synthetic opioids, means that you are risking a fatal overdose every time you use, regardless of how many times you’ve done it before.

If a person finds that they can’t stop cocaine use, this is not a reflection of their character or willpower, but a symptom of addiction that requires medical treatment.

Cocaine use disorder (CUD) is a very serious condition that carries an increased risk of death from overdose and other consequences through continued use. The most important thing a person can do is seek out a licensed addiction treatment program. Doing so could save their life.

Signs of Cocaine Addiction

• Loss of control: Using more than intended, trying to cut down or wanting to stop but being unable to
• Compulsive focus on cocaine: Intense cravings, significant time spent obtaining, using, and recovering from the substance
• Negative impact on daily functioning: Problems at work, school, or home, neglecting responsibilities, withdrawing from hobbies or relationships
• Continued use despite harm: Using even though it causes problems
• Tolerance: Needing more of the drug to get the same effect
• Withdrawal symptoms: Depressed mood, irritability or anxiety, intense cravings, agitation, fatigue, sleep disturbance, poor concentration, increased appetite, paranoia
• Behavior changes: Secrecy, lying about consumption, change in routines, neglecting appearance
• Legal or financial consequences: Arrests or legal trouble related to possession or behavior while using, charges such as DUI or disorderly conduct, job loss or disciplinary action, debt from spending on cocaine, selling personal items to support use

Cocaine Addiction Treatment at Paramount Wellness

No cocaine use is safe. If you can’t stop cocaine use, or you have already suffered an overdose, it is time to seek professional assistance. At Paramount Wellness we offer evidence-based addiction treatment tailored to each individual, from medical detox and inpatient care to outpatient programs and ongoing mental health services.

Cocaine addiction affects many aspects of your life beyond your physical health. It negatively impacts relationships, mental health, career, and overall quality of life. Our team of caring professionals will partner with each person and their family members to create a roadmap towards achieving lifelong recovery.

Recovery is possible. Reach out to Paramount Wellness today to take the first step.