Are you or someone you love struggling with cocaine use? Do you find it harder and harder to stop using the drug despite financial, relationship, and health problems? Are you looking for answers but not sure where to turn?

Many cocaine users have been through similar struggles. Without warning, the drug takes over their lives. Even though they see their relationships, finances, and health deteriorate, the behavior continues.

This is because addiction is a mental disorder. While some people don’t realize this, addiction is a mental illness just like depression, anxiety, and even schizophrenia. Addiction can be managed and a sober life can be reclaimed.

Contacting our cocaine hotline may be the first step in accessing the knowledge and resources you need to finally stop using this powerful drug.

Substance Overview: Cocaine




Around $100 per gram

Annual deaths


Side effects

High body temperature, high blood pressure, anxiety, psychosis

Also known as

coke, blow, powder, candy, rocks, base

What is Cocaine?

Cocaine is a highly addictive stimulant drug derived from coca leaves indigenous to South America, where it has been used for over 3500 years 1 In countries like Colombia, Bolivia and Peru, coca leaves are still chewed or used in tea to treat maladies like altitude sickness and fatigue.

Through the early 1900s, cocaine was used in elixirs and tonics that treated a wide variety of maladies including sexual dysfunction, depression and fatigue. It was even famously an ingredient in early versions of Coca-Cola. Surgeons used the drug to block pain before other local anesthetics were developed.

In 1855, Friedrich Gaedcke, a German chemist, became the first person to isolate purified cocaine from coca leaves, naming it “erythroxyline.” Four years later, Germany graduate student Albert Niemann improved the extraction process and re-named it cocaine, which resulted in the drug used today.

Street names for cocaine include coke, blow and powder, while crack cocaine is also known as candy, rocks and base.

How Cocaine Works in the Body

Cocaine works by increasing the presence of dopamine in the brain. Dopamine is known as a pleasure chemical because it is largely responsible for the high that drug users experience. Dopamine is what causes users to feel happy, energized and euphoric when they take cocaine. 2

Cocaine blocks specific neurons which are responsible for reabsorbing excess dopamine in the brain, causing it to accumulate. Research conducted by the University of Colorado at Boulder shows that cocaine also binds to glial cells, which are cells found in the central nervous system. 3

The way that cocaine binds to these cells causes an inflammatory response, tricking the brain into releasing more dopamine. The result is that dopamine is continuously released for up to 30 minutes after the drug is taken, at which point people often take more to sustain the euphoric effects. 4 5

These combined effects in the brain help explain why cocaine impacts dopamine levels so much, and also why it is such an addictive substance. Because high levels of dopamine create pleasurable feelings, this brain chemical is most closely linked to addiction.

Drugs like cocaine that greatly increase dopamine active reward centers in the brain. Over time, drug use causes a reward pathway in the brain (also called an addiction pathway) to form, which creates strong drug cravings and makes it harder for the user to stop using the drug.

The Forms of Cocaine

Cocaine as a drug of abuse comes in two main forms: a white powder that’s usually snorted and a crystallized form called crack that’s smoked 6 Cocaine results in a high that lasts up to 30 minutes, while crack is a much shorter high, lasting only about 5 minutes. Crack is sometimes still preferred because it is cheaper and because while short, the high is more intense than powder cocaine.

The white powder version of cocaine is made from dried and ground coca leaves which have been chemically treated to extract cocaine hydrochloride. This is an extensive process which involves the use of many chemical solvents, some of which are highly toxic like gasoline, sulfuric acid and ammonia. While many of these are removed during the process, cocaine is often cut with other powders like corn starch, baking soda, or sugar to dilute it and increase profits.

To create crack cocaine, the hydrochloride is removed from the product, which makes it possible to inhale by smoking. This is accomplished by heating the mixture to create a hard substances that can be broken into pieces and sold. This form is called crack because of the crackling sound that it makes when it is heated for the purposes of smoking.

Health Effects

Cocaine has a number of short-term and long-term health effects, including elevated body temperature, high blood pressure, anxiety and psychosis.

Short-Term Health Effects of Cocaine Usage

The disturbing part about cocaine usage is that it can have some serious short-term health effects. While much of what a user experiences immediately after taking the drug is a euphoric feeling, there are also negative things they may experience as well.

While they may feel more alert mentally and more energetic physically, they also might become more talkative as well as hypersensitive to touch, sound and sight. 7 People using cocaine may also experience irritability or paranoia. Cocaine’s stimulating effects also reduce appetite and can create insomnia.

Cocaine usage can also result in serious health complications, even if a person is using it for the first time or doesn’t use it often. These include increased body temperature, blood pressure and heart rate, constricted blood vessels, and dilated pupils. Not surprisingly, these maladies could cause more serious health issues. These can be cardiovascular in nature, including heart attacks and a disturbance in one’s heart rhythm.

Other health complications can include strokes, seizures and headaches. There can also be complications in the gastrointestinal tract, resulting in nausea, abdominal pain and issues with ulcers. Muscle tics and twitches, vertigo and/or body tremors can also arise, even from short-term cocaine usage. 8

Taking too much cocaine can even lead to a fatal overdose. Most deaths that are attributed to cocaine usage come from a seizure or heart attack. Also, cocaine is commonly cut with other drugs like opioids to increase the high or increase the profits, which further heightens the risk of overdose.

Using cocaine with other substances can be highly dangerous. When combined with alcohol, the body produces cocaethylene. This chemical is believed to accelerate toxic effects that both alcohol and cocaine are known to have on the heart. 9

Using cocaine in combination with either opioids, alcohol, or any other drug with sedative properties is especially dangerous. The stimulating effects that cocaine has can actually be offset by the sedating effects of other drugs. This can seem to reduce the effects of both substances, which often causes the user to take more, even leading to an overdose. 10

Long-Term Health Effects of Cocaine Usage

Cocaine usage can have many long-term effects on not only the brain but on the entire body. Studies in animals have shown that continuous exposure to cocaine can cause significant neuroadaptations in neurons that release the excitatory neurotransmitter glutamate. 11

Animals that are consistently exposed to cocaine experience a change in how much of the receptor protein is released into the reward pathway of the brain. Over time, the brain becomes less sensitive to natural reward reinforcers, which then signals to the person to use more cocaine. 12

The double-whammy of cocaine usage is that while it makes the brain less sensitive to these natural reinforcers, it also causes the brain’s circuits to become increasingly sensitive to stress. When cocaine isn’t in the body’s system, therefore, a person can become increasingly displeased and have extreme negative moods.

The body also can build up a tolerance to cocaine over time, and will need more to achieve the same level of pleasure as initially experienced. 13While the body builds this tolerance to the drug, the brain also becomes increasingly sensitive to potential toxic effects such as convulsions or anxiety. 14

Typical side effects of long-term cocaine usage are paranoia, panic attacks, irritability, restlessness and potentially even psychosis. The more cocaine a person uses, and the longer he or she uses it, the more damaging the effects can be. 15

Continued cocaine usage doesn’t just negatively affect the brain, but also major organs in the body. Some people experience tears or ulcers in the gastrointestinal tract, since cocaine reduces blood flow in that area of the body. Many long-term users of cocaine experience a loss of appetite, which can lead to malnourishment and significant weight loss.16

Cocaine use also leads to a significantly higher risk of experiencing a stroke or heart attack. Even users who would be considered recreational have been found to have higher blood pressure, thicker heart muscle walls and harder arteries. They’re also 35 times more susceptible to getting a hardened aorta when compared to people who’ve never used cocaine.


• There were around 7,000 cocaine overdose deaths in 2015

• Around 2,500 cocaine deaths per year are attributable to straight cocaine use, while the remaining 4,500 involve cocaine used with an opiate. 17

The Effects of Cocaine Withdrawal

Because of the negative effects a person feels when not taking cocaine, it is considered highly addictive. These negative effects are termed withdrawal symptoms, and they occur when one either quits using the drug altogether, or even reduces the amount of use. Those who are considered heavy users of cocaine can even experience withdrawal symptoms before the drug is completely out of their body. 18

Dopamine released when a person uses cocaine can produce a strong craving for the drug, especially with regular use. It’s doubly damaging because a “crash” period follows almost immediately when usage stops. This causes the brain to want more cocaine right away, which makes the withdrawal more serious and the abstinence more difficult. 19

For people who are trying to quit cocaine, the first month tends to be the most difficult. It often consists of swings between high and low cravings for the drug, paranoia, long periods of sleep and anxiety.

Unlike withdrawal associated with alcohol or opioids, there aren’t any physical symptoms associated with cocaine withdrawal, such as shaking or vomiting. This is because cocaine is a psychologically-addictive drug and not a physically-addictive one.

The most common symptoms of cocaine withdrawal are fatigue, general feelings of discomfort, increased appetite, vivid and unpleasant dreams, a depressed mood, agitation and restless behavior, and slowing of activity.

Those who have injected cocaine are likely to experience more severe withdrawal symptoms than those who abused the drug by either smoking or snorting it.

The History and Regulation of Cocaine in the United States

Cocaine was initially developed as an anesthetic in 1884 for use in a cataract operation.20

While it was being developed as an anesthetic, many doctors had hoped it would also provide a cure for people who were addicted to morphine. Morphine was so freely given to soldiers during the Civil War that many became addicted to the drug. 21 Even Sigmund Freud recommended cocaine for use in treating melancholia and opiate addiction.22

Eventually, it was discovered that cocaine use had negative psychological effects, which worsened with repeated use. In the 1920s, cocaine quickly become one of the most feared illicit drugs, with many states around America enacting laws against its use. 23President William Taft even proclaimed the drug as “Public Enemy No. 1.”

The first official regulation on cocaine in the United States came in 1906 with the Pure Food and Drug Act. That law required products that contained cocaine to include it on the label. The Harrison Narcotics Tax Act of 1914 imposed further restrictions on cocaine use and the use of other drugs. It also banned physicians from prescribing the drug or other narcotics to addicts.

It wasn’t until the Narcotics Drugs Import and Export Act of 1922 that cocaine was officially outlawed in the United States for any and all non-medical uses. It’s listed as a Schedule II drug today. This means it has high abuse potential, but gives doctors the ability to use it for legitimate medical uses such as local anesthesia.

The Abuse of Cocaine in the United States

The majority of the cocaine available in the US is sourced from Colombia and trafficked into the US by drug cartel networks. Most of enters the country via the US/Mexico land border, and some is transported by air or sea. The consumption of cocaine by people in the US creates a demand that keeps cartels in business and plays a role in the violent crime epidemics in Mexico and other South American nations.

The 2019 National Drug Threat Assessment report found that cocaine ranked third behind only methamphetamine and cannabis/THC on the list of the top 25 most frequently identified drugs. In fact, it was the second most commonly-reported drug by federal laboratories, behind only methamphetamine. In total, cocaine represented 14 percent of all reports that year. The report found that cocaine production has sustained at record-high levels recently, which has increased its presence in the United States.

In 2017, almost 6 million people in the United States over the age of 12 said they used cocaine. 24 About 1 million people report using cocaine for the first time every year.

The highest rate of cocaine use is within the 18-to-25 bracket, with more than 1.9 million people saying they abused cocaine in the last 30 days. The next highest grouping was between the ages of 26 to 34, with 1.5 million people reporting cocaine use in the past 30 days.

Men are twice as likely as women are to abuse cocaine, with 2.5 percent of men reporting cocaine abuse compared to 1.3 percent of all women. Men were also hospitalized for cocaine abuse twice as often as women — 12,500 men in 2015 compared to 6,386 women. Men also die at a much higher rate than women — 7,400 compared to 2,882.

Cocaine usage occurs the most among people who identify as being white, with approximately 3.36 million users. The next closest ethnicity is Hispanic (768,000) followed by Black (612,000), Asian (101,000), Native American (31,000) and Pacific Islander/Hawaiian (18,000).

The U.S. Centers for Disease Control and Prevention said approximately 18,558 people for every 100,000 people in the country were hospitalized in 2016 because of a cocaine overdose. 25That totals almost 600,000 people in the United States who went to a hospital for a cocaine overdose in only one year. More than 10 percent of all drug overdoses that year were due to cocaine.

Part of the reason for the increase in cocaine overdoses in recent years is the emergence of the dangerous drug fentanyl. Not surprisingly, cocaine usage has been reported to be the highest in regions of the country that are also experiencing surges in heroin and fentanyl usage.

Some users have begun to mix multiple drugs together. “Speedballs” are a mixture of cocaine and heroin, and “super speedballs” are cocaine, heroin and fentanyl mixed together. By combining cocaine with the opioids, the user gets the high of the cocaine and the depressant effects of the opioids. The desired outcome is to reduce the sharp comedown after the effects of the cocaine subside.

A recent problem, however, has been that many users do not know ahead of time that multiple drugs are being mixed. This has resulted in more drug overdoses, as typical cocaine users may not have the tolerance for opioids than typical opioid users do, thereby leading to serious health consequences.

According to the DEA report, laboratories from Puerto Rico, Washington, D.C., and 36 states have reported an increase of almost 15,000 percent of reports involving “speedballs” and “super speedballs” between 2013 and 2017. In 2013, there were only a total of 18 reports of these kinds. That number skyrocketed to 2,695 in 2017. 26

The DEA states in its report that most of these mixtures of cocaine and fentanyl, specifically, probably occurred at the dealer level — without knowledge from the users about what they were getting. Because fentanyl is a viable adulterant, and because it is inexpensive, dealers often use it to cut the cocaine to gain more product, without weakening the drug’s effects.

Getting Help

According to the 2015 National Survey on Drug Use and Health, 8.1 percent of all people in the U.S. 12 years and older needed treatment for substance abuse in the last 12 months.27 However, only 2.5 million people received treatment that year, leaving many people still in need of help.

Cocaine was responsible for 10 percent of all visits to drug treatment centers that were publicly funded in 2015. That ranked fourth behind alcohol (21 percent), marijuana (14 percent) and heroin (13 percent). 28More than 18 percent of admissions into these facilities came from people who reported abusing one of the above-mentioned drugs and alcohol together.

When to Call a Cocaine Addiction Hotline

If you are worried about how cocaine is impacting your–or a loved one’s–life, calling a cocaine addiction helpline can be a crucial step in getting the help you need. You don’t have to wait until problems become unmanageable. Even if you are simply looking for information, these hotlines are a valuable resource.

Many people fail to realize how powerful addiction is. They make excuses, and rationalize their use. They postpone calling thinking their drug use will “magically” disappear. The fact is, when the brain’s pleasure centers are altered due to cocaine use, you aren’t thinking clearly. Your brain is in a constant loop of desiring the drug, getting that “high”, coming down, then wanting that drug again.

This is how lives are destroyed.

While asking for help may be embarrassing or uncomfortable, it may be the only option for finally getting your life back.

Many cocaine addiction hotline numbers allow you to remain anonymous, protecting your identity. They will also help you determine the next steps that are right for you, and can help you get connected to treatment if you want it. With professional treatment, it is possible to recover from cocaine addiction and regain control over your life.

What to Expect When Making the Call

Deciding to call a cocaine hotline for addiction is a brave step towards improving your future. While you may be hesitant, know that someone is ready to help you and will listen to your story without judgement. They won’t make you feel ashamed or inferior. These hotlines helped countless others going through similar situations.

While you are free to talk about anything when calling a cocaine helpline, here are some of the more common topics:

  • How cocaine use has impacted your life
  • Questions about a loved one’s cocaine use
  • Tips for preventing cocaine abuse
  • Types of treatment available
  • Specific resources for finding the help you need including links to websites and phone numbers

Remember, you are never alone. Many others dealing with cocaine addiction reluctantly made the call, and may have even changed their life thanks to a cocaine abuse hotline.

Last updated: September 25, 2020

About the author

Hailey Shafir
Hailey Shafir, M.Ed., LCMHCS, LCAS, CCS

Hailey Shafir is a licensed addiction specialist and mental health counselor. She graduated from North Carolina State University with a master of education in clinical mental health counseling in 2012, and has developed deep expertise in the areas of mental health, behavioral addictions and substance abuse. She is passionate about using this knowledge to raise awareness, provide clear and accurate information, and to improve the quality of treatment for these disorders.

Hailey is an LCMHCS (license number: S9539) under the North Carolina Board of Mental Health Counselors, and an LCAS (ID: LCAS-21333) and CSS (ID: CCS-20721) under the North Carolina Addictions Specialist Professional Practice Board.

Medical Reviewer

Dr. Abe Malkin
Dr. Abe Malkin

Dr. Abe Malkin is the founder and medical director of Concierge MD LA, a provider of high-end medical care in Los Angeles. He graduated with a combined MD/MBA under a joint program from Tufts University School of Medicine and The Heller School for Social Policy and Management at Brandeis University.

Dr. Malkin is the medical director of Grace Recovery and 1 Method Center, and is a contracted physician for Avalon Malibu. He is also the founder and medical director of Elite Home Detox, a personalized addiction and recovery service. He completed his 3-year family residency for Kaiser Permanente in 2016, and is board certified in the state of California (license number: A 133110).


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