Guide to Cocaine Overdose: Signs, Effects, & Treatment

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Medically Reviewed By: Diana Vo, LMFT

June 22, 2023

Table of Contents

Cocaine is a potent illicit narcotic and is especially dangerous because of the potentially life threatening complications like stroke, heart attack, and seizure that cocaine overdose can trigger.

A stimulant made from the leaves of the South American coca plant, cocaine delivers a short, exhilarating high.

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Cocaine is a Schedule II drug according to the Controlled Substances Act. Like all Schedule II drugs, cocaine has some medical applications but a high potential for abuse and addiction. 

Can You Overdose on Cocaine?

As soon as cocaine enters your system, the substance works on the pleasure centers of your brain, causing an increase in dopamine release. By trying to chase and maintain this feeling of euphoria, you increase your risk of overdosing. This could even occur the first time you use cocaine.

Cocaine overdose occurs if you use enough of the substance to induce serious adverse outcomes, possibly triggering life-threatening symptoms. Overdosing on cocaine can be fatal if untreated.

How Much Cocaine Does it Take to Overdose?

According to NIDA (National Institute on Drug Abuse), an overdose of cocaine occurs when you take enough of the drug for blood concentration levels of the substance to become toxic, leading to a serious physical reaction. Cocaine overdose essentially poisons your system.

Researchers believe that toxic levels of cocaine are not wholly dictated by dosage. Some reported cases of cocaine overdose involve a few hundred milligrams of the drug, while other people ingest several grams of powdered cocaine without overdosing.

Cocaine overdose toxicity, then, hinges largely on the individual using the substance and their susceptibility to those toxins.

Additionally, the purity of the cocaine plays a role in its overdose potential. Many drug traffickers adulterate cocaine with other substances and bulking agents to increase profits.

Mixing cocaine with other substances – particularly heroin and alcohol – heightens the risk of a fatal overdose.

What are the signs of cocaine overdose, then?

Cocaine Overdose Symptoms

If you or a loved one uses cocaine, it is worth familiarizing yourself with the symptoms of cocaine overdose. If you suspect cocaine overdose, call 911 immediately.

Look out for the following identifiable symptoms of cocaine overdose:

  • High body temperature
  • Increased blood pressure
  • Restlessness
  • Confusion
  • Agitated movements
  • Teeth chattering or grinding
  • Relentless energy

There are also many physical symptoms of cocaine overdose, including:

  • Increased sweating
  • Rapid heart rate
  • Blue tinge to the skin
  • Chest pain radiating through the arms and shoulders
  • Problems breathing
  • Increased heart rate
  • Loss of consciousness
  • Incontinence
  • Nausea
  • Vomiting
  • Tremors
  • Seizures

You should also monitor for the following psychological signs of overdose:

  • Hallucinations
  • Delirium
  • Confusion
  • Paranoia
  • Panic attacks
  • Severe anxiety
  • Rambling

Cocaine Overdose Treatment

If you feel you are experiencing or witnessing a cocaine overdose, request emergency medical care immediately.

After calling 911, do the following:

  1. Provide emergency responders with the following information: age, drug allergies, pre-existing health conditions, amount of cocaine consumed, history of drug and alcohol use.
  2. Ensure the person is laid on their side to encourage breathing and prevent choking on vomit.
  3. Keep the person away from any sharp objects in case they have a seizure.
  4. Apply cold compresses to the person if they appear overheated.
  5. Remain with the person until the emergency responders arrive.

A rapid response can sometimes reverse a cocaine overdose.

When the emergency responders arrive, they may continue the cooling method to ensure the person’s core body temperature reduces. Ice should not be left on the body for too long, though. This can lead to hypothermia.

During a cocaine overdose, the heart starts working overtime so do all you can to keep the person calm.

Helping the person to focus on controlled breathing can alleviate the risk of respiratory failure triggered by an overactive cardiovascular system.

There is no overdose antidote for cocaine. A successful medical intervention involves treating the primary symptoms of cocaine overdose.

In a hospital setting, treatment for overdose typically begins with the administration of a sedative to reduce heart rate and blood pressure levels. Benzodiazepines are used for this purpose. Taking benzos can also minimize the chance of stroke or heart attack in the person overdosing.

During overdose, vital organs are placed under extreme stress. It is imperative not to overdose again on cocaine to prevent further trauma. Given the powerfully addictive nature of cocaine, this can be challenging without the right cocaine addiction treatment.

Addiction Treatment for Cocaine

If you decide to engage with cocaine addiction treatment, you’ll first need to go through a cocaine detox program.

The detoxification phase for cocaine usually lasts only a few days. For more severe stimulant use disorders, cocaine withdrawal symptoms may persist for up to a week.

Once detoxed, you will be in better physical shape to continue with treatment for cocaine addiction.

You then need to choose whether to proceed with inpatient or outpatient rehab:

  • Inpatient rehab: Ideal for those with severe addictions, co-occurring disorders (addiction and mental health condition), or unstable home environments.
  • Outpatient rehab: Recommended for those with mild or moderate cocaine addictions. Also suitable for those with busy schedules and for those seeking the most cost-effective form of cocaine addiction treatment.

Unlike for the treatment of opioid use disorder or alcohol use disorder, there are no FDA-approved pharmacological interventions for cocaine addiction in the form of stimulant use disorder. Ongoing research in this area suggests that both buprenorphine and naltrexone show promise.

In the absence of approved medications to streamline recovery, cocaine addiction is mainly treated with behavioral interventions.

SAMHSA (Substance Abuse and Mental Health Services Administration) recommend these therapies for the treatment of cocaine addiction and other simulant use disorders:

  • Psychotherapies: Psychotherapy is the clinical descriptor for talk therapies like CBT and DBT. CBT (cognitive behavioral therapy) is proven effective for the treatment of addictions. Through CBT sessions, you’ll learn how to identify what triggers you to abuse cocaine. Your therapist will also help you to create healthy coping mechanisms, enabling you to deal with life’s stressors more effectively throughout your ongoing recovery from cocaine addiction.
  • Contingency management: Abusing a stimulant like cocaine interferes with the reward circuitry in the brain. Through contingency management, healthy behaviors like passing a drug screen are incentivized with small rewards like vouchers.
  • Motivational interviewing: In the early phase of cocaine addiction recovery, motivational interviewing can help you deal with feelings of negativity or ambivalence toward your recovery, hopefully leading to a more positive outlook.
  • Community reinforcement: Community reinforcement helps you to build a sober and supportive network that you can lean on during your recovery.

Don’t let the absence of medication prevent you from engaging with cocaine addiction treatment. Cocaine overdose and addiction is predominantly psychological. As such, behavioral interventions provide the most positive outcomes.

Renaissance Recovery’s Cocaine Treatment Program

If you or a loved one is struggling with a cocaine addiction problem and need help with treatment, Renaissance Recovery has a cocaine rehab in California that can help you or your loved one through every step of the addiction treatment process.

Call our team today to learn more about our treatment offerings.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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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