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Cocaine Chest Pain

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Medically Reviewed By: Diana Vo, LMFT

March 22, 2024

Table of Contents

Chest pain after using cocaine use is commonly reported. Those affected by cocaine chest pain are predominantly young males who smoke and have a history of cocaine use. Read on to learn more about cocaine chest pain.

Why Can Cocaine Cause Chest Pain?

Cocaine is among the most frequently abused illicit drugs in the United States, accounting for one-third of emergency department visits associated with substance abuse. Data from NSDUH 2022 show that 2 million U.S. adults reported past-month cocaine use in 2022, with 1.4 million of those developing a diagnosable addiction. Among those who seek emergency care following cocaine use, acute cardiopulmonary issues are commonplace, with chest pain being the leading complaint reported in 40% of these cases.

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Cocaine can cause chest pain due to its potent effects on the heart and blood vessels. When someone uses cocaine, it leads to a significant increase in heart rate and blood pressure, placing extra stress on the cardiovascular system. This CNS stimulant also causes the blood vessels to constrict, reducing the flow of oxygen-rich blood to the heart muscle. This reduction can result in chest pain – described clinically as angina – as the heart struggles to receive enough oxygen to function properly.

Additionally, cocaine can trigger the development of coronary artery spasms, a condition where the arteries that supply blood to the heart suddenly narrow. These spasms can temporarily cut off the blood supply to the heart, causing severe chest pain and, in some cases, provoking a heart attack.

Cocaine use can promote blood clot formation that further increases the risk of heart attack in those using the drug. Cocaine use has also been associated with the accelerated development of atherosclerosis, a condition that’s characterized by the hardening and narrowing of arteries due to plaque buildup. This condition further impedes blood flow and increases the risk of chest pain and heart attacks.

Cocaine’s effects are not limited to the cardiovascular system, though. It can also cause increased anxiety and panic attacks, which may contribute to sensations of chest pain and discomfort, even in the absence of direct heart damage. This can result in chest pain days after cocaine use.

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How Long Does Cocaine Chest Pain Last?

The duration of chest pain induced by cocaine use can vary dramatically depending on factors like the amount of cocaine used, overall health status, and the presence of underpinning cardiovascular conditions. Generally, the chest pain associated with acute cocaine use may last anywhere from a few minutes to several hours.

For some people, especially those experiencing coronary artery spasms, chest pain can be transient, resolving as the effects of the cocaine wear off and blood flow to the heart muscle improves. These episodes can last from a few minutes to an hour.

That said, if cocaine use leads to more serious complications such as a heart attack or myocardial infarction, the associated chest pain can be more prolonged and severe. In such cases, the pain persists until medical intervention is provided to restore blood flow to the affected area of the heart.

Additionally, individuals with existing cardiovascular diseases or those who frequently use cocaine may experience longer-lasting and more intense chest pain episodes. The repeated stress on the cardiovascular system can inflame underlying conditions, prompting chronic chest pain and discomfort.

Any chest pain following cocaine use should be considered a medical emergency. Given the drug’s potential to cause significant and life-threatening cardiac events, anyone experiencing chest pain after using cocaine should seek immediate medical attention. Prompt intervention can help mitigate severe outcomes and provide necessary care for any heart-related issues.

Cocaine-Induced Chest Pain Treatment

Treating chest pain induced by cocaine use involves addressing both the immediate symptoms and the underlying causes of the discomfort. The approach to treatment may vary based on the severity of the symptoms and the presence of any complications. Here’s an overview of some common treatment strategies for cocaine-induced chest pain:

  • Initial assessment and stabilization: The first step in treating cocaine-induced chest pain is to assess the person’s vital signs and stabilize their condition. This may include administering oxygen, monitoring blood pressure and heart rate, and providing intravenous fluids if necessary.
  • Pain management: Pain relief is a core aspect of treating cocaine chest pain. Nitroglycerin, a medication that helps to dilate blood vessels and improve blood flow to the heart, is often employed. However, some medications normally used for chest pain may have adverse effects in the context of cocaine use.
  • Anxiety reduction: Because cocaine can cause significant anxiety, which may worsen chest pain, treatment may include the use of benzodiazepines. These medications can help to reduce anxiety and decrease the heart rate, so alleviating some of the stress on the heart.
  • Addressing complications: If the person shows signs of a heart attack or other serious cardiac events, treatment will focus on managing these conditions according to standard protocols. This may involve the use of medications to dissolve blood clots, procedures to restore blood flow to the heart, or other interventions deemed necessary by medical professionals.
  • Observation: Those with cocaine-induced chest pain are often observed in a hospital setting for a period of time to monitor for any complications or worsening of their condition. This observation period allows healthcare providers to respond quickly if the person’s condition deteriorates.
  • Referral for substance abuse treatment: Addressing the underlying issue of cocaine use will help prevent future episodes of chest pain and improve overall health. Individuals should be referred to substance abuse treatment programs to receive counseling, support, and therapy aimed at cocaine cessation.
  • Education and support: Educating people about the risks associated with cocaine use, including its potential to cause life-threatening cardiac events, is a core component of treatment. Providing support and resources for those seeking to quit cocaine can also contribute to improved health outcomes.

Anyone experiencing chest pain, especially if they have used cocaine, should seek immediate medical attention. Timely treatment can significantly reduce the risk of severe complications and improve the chances of a successful recovery.

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Get Treatment for Cocaine Addiction at Renaissance Recovery

The effects of cocaine abuse include addiction and overdose. We can help you stabilize and move beyond chronic substance abuse at Renaissance Recovery in Southern California.

We treat cocaine addictions in an outpatient setting at our luxury facility in Huntington Beach, CA. Maintain your everyday commitments while engaging with outpatient therapy at a suitable level of intensity.

Cocaine addiction is mainly psychological, and you will access the following evidence-based treatments at Renaissance:

Get immediate help when you’re ready to move beyond cocaine addiction by calling 866.330.9449.



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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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