Cocaine (A full guide)


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Page last updated: 22/11/2022


Cocaine, sometimes called coke, is a powerful stimulant that is most frequently used as a recreational drug.

In this blog piece, we will discuss what cocaine is, how it is used, short- and long-term health effects of taking the drug, and how cocaine addiction is treated. 

What is cocaine? 

Cocaine, sometimes called coke, is a powerful stimulant that is most frequently used as a recreational drug.

It can be snorted, inhaled as smoke, or dissolved and injected into the veins.

Taking cocaine usually results in euphoria (an intense feeling of happiness), agitation, and loss of contact with reality. 

Cocaine is made from the leaves of the coco plant that is native to South America.

Although it can be used for medical purposes such as local anesthesia, recreational cocaine use is illegal.

Dealers sell cocaine as a fine, white, crystal powder and sometimes mix it with cornstarch, talcum powder, or flour to increase the potential for profit. 

Cocaine can be mixed with other drugs such as amphetamine, which is also a stimulant, and synthetic opioids.

It is extremely dangerous to use cocaine that is mixed with synthetic opioids (i.e., fentanyl), and this may be one of the reasons why cocaine-related deaths have been increasing over the last several years. 

If you hear people use the words blow, coke, crack, rock, or snow, they are most likely referring to nicknames for cocaine. 

How is cocaine used?

People usually snort cocaine powder through the nose or rub it into their gums.

In rarer cases, people dissolve cocaine powder and inject it into the bloodstream through the veins.

A very dangerous form of cocaine use is an injection in combination with heroin, which is called a Speedball. 

How long does cocaine stay in your system?

Cocaine and its metabolites can be detected in a blood or saliva test for up to two days and in urine for up to three days.

If you are a heavy cocaine user, it can be detected in urine for two weeks. Interestingly, cocaine can be detected in your hair for months to years.

As always, your metabolism, weight, dose taken, and frequency of use all affect how long cocaine will remain in your system.

Cocaine (A full guide)

How does cocaine affect the brain? 

Cocaine increases the levels of the neurotransmitter dopamine.

A neurotransmitter is a chemical messenger that relays information to other neurons to control behavior, mood, appetite, sleep, and so on.

Dopamine is the major reward neurotransmitter in the brain, and increases in the levels of this chemical in certain brain areas causes an intense feeling of euphoria.

In addition, dopamine is also an important neurotransmitter that regulates movement. 

The mechanism of action of cocaine is to prevent dopamine from being degraded, thus increasing the levels of dopamine in the brain.

The increase in dopamine in the brain’s reward areas reinforces cocaine-seeking and drives people to crave that same feeling of intense euphoria.

The brain eventually adapts to those levels of dopamine, and thus people need to take more of the drug to get the same feeling. 

People also tend to “crash” or feel very unpleasant withdrawal symptoms when the high wears off.

Thus, they also keep taking the drug to alleviate the difficult withdrawal symptoms.

Withdrawal symptoms of cocaine will be discussed in greater detail below. 

What are the short-term effects of cocaine use?

Short-term use of cocaine can lead to the following behavioral effects: 

·     Extreme happiness (euphoria) and high energy levels

·     Increased levels of mental alertness

·     Hypersensitivity to sensory stimuli, such as sight, sound, and touch

·     Irritability

·     Paranoia, including extreme and unreasonable distrust 

The following health effects may occur during the duration of a high from cocaine: 

·     Constriction of blood vessels 

·     Dilated pupils

·     Nausea

·     Elevated body temperature and blood pressure

·     Tremors (shaking)

·     Muscle twitches

·     Restlessness

Cocaine can help some users perform physical and metal tasks faster, although some people report that it slows down their performance.

When people use large amounts of cocaine, they can become violent, erratic, and partake in bizarre behavior. 

People who use cocaine heavily end up having to replenish every 15-30 minutes.

The effects described above are felt almost immediately and can last from a few minutes to an hour.

Injection or smoking cocaine leads to faster onset of effects, but the effects disappear faster (within 5-10 minutes).

When snorting cocaine, the effects take longer to emerge, but the high lasts about 15-30 minutes. 

What are the long-term effects of cocaine use? 

The long-term health effects of cocaine use depend on the method of use.

Snorting cocain can result in the loss of sense of smell, nosebleeds, runny nose, and difficulty swalling. Smoking cocaine can lead to cough, asthma, respiratory distress, and increased risk for infection.

Consuming cocaine by mouth, which usually constitutes rubbing it into the gums, can lead to bowel decay due to reduced blood flow.

Injection of dissolved cocaine with a needle can increase risk for contracting bloodborne illnesses such as human immunodeficiency virus (HIV), and hepatitis C. Cocaine injection can also cause skin and soft tissue infections, as well as scarring or collapse of veins. 

Cocaine users who snort or smoke the drug are still at risk for HIV and other infections, because impaired judgement can lead to risky sexual behaviors. 

Other long-term effects of cocaine use include the following: 

·     Malnourishment due to suppression of appetite 

·     Movement disorders, including Parkinson’s disease

·     Severe paranoia that involves loss of touch with reality and auditory hallucinations (hearing noises that aren’t real)

·     Irritability and restlessness 

Ekbom’s Syndrome is also caused by consuming a lot of cocaine.

Is it possible to overdose on cocaine?

Yes, it is possible to overdose on cocaine either intentionally or unintentionally.

Cocaine overdose can lead to serious and sometimes fatal effects. Cocaine users can overdose on the first use or any use after that.

It is extremely dangerous to drink alcohol while using cocaine because the risk of overdose is greatly increased.

People who drink while using cocaine have a tendency to drink more because they don’t feel the depressant effects of the alcohol as heavily.

When cocaine and alcohol are used together, they combine in the liver to form cocaethylene, which intensifies the euphoric effects of cocaine and increases the strain on the heart.

Excess strain on the heart can cause sudden death. Mixing heroin with cocaine is also an extremely dangerous and deadly combination. 

Symptoms of overdose include the following: 

·     Cardiac arrhythmia (irregular heartbeat) 

·     Heart attack 

·     Seizures 

·     Stroke

·     Difficulty breathing

·     High blood pressure

·     Elevated body temperature

·     Hallucinations

·     Extreme agitation or anxiety 

Unfortunately, a cocaine overdose cannot be reversed.

If a person has a heart attack, stroke, or seizure, emergency room physicians and first responders can treat these conditions by restoring blood flow to the heart, restoring oxygenated blood to the brain areas affected by the stroke, or stopping the seizure.

Is cocaine addictive?

Cocaine is an extremely addictive drug.

Because cocaine works by hijacking the brain’s reward circuit, users need higher and higher doses to achieve the same high and to relieve negative withdrawal symptoms. 

Withdrawal symptoms of cocaine include depression, increased appetite, tiredness, slowed thinking, and sleep problems such as nightmares and insomnia. 

How can people who are addicted to cocaine get treated? 

The most common and effective treatment for cocaine addiction is behavioral therapy.

Cognitive behavioral therapy (CBT) can teach cocaine-addicted patients coping strategies and ways to disassociate the contexts where most drug use took place such as parties and certain friends’ houses.

People can also attend sober homes, which are drug-free residencies for people to recover from substance use disorders and engage in group therapy. 

Currently, there are no approved treatments for cocaine addiction, but scientists are testing drugs that treat other substance use disorders including the following:

·     Disulfuram, which is used to treat alcoholism

·     Modanifil, which is used to treat narcolepsy (a disorder that causes involuntary lapses into deep sleep) 

·     Lorcaserin, which is used to treat obesity 

·     Buprenorphine, which is used to treat opioid addiction 

Frequently asked questions (FAQs) about cocaine: 

1.   What does cocaine do?

Cocaine can be swallowed, snorted, injected, and inhaled.

There is no safe way to use cocaine in any form, except for approved medical use.

All methods of cocaine use can lead to acute cardiovascular or cerebrovascular emergencies as well as seizures.

These occurrences can lead to sudden death. 

2.   Does cocaine have medical uses?

Cocaine is illegal as a recreational drug, however, can be used for certain legitimate medical situations.

With both anesthetic and vasoconstrictive properties, cocaine can be used as a local anesthetic, to aid in upper respiratory procedures, and for topical use in the form of cocaine hydrochloride. 

3.   What are common side effects of cocaine use? 

Physiological effects of cocaine use include the following:

Constricted blood vessels

Dilated pupils

Increased body temperature 

Increased heartrate

Increased blood pressure

Weight loss


Abdominal pain



Psychological effects of cocaine use include:






Repetitive Behaviors

Poor Judgement



4.   What are the signs of cocaine use?

Someone you know might be using cocaine if you observe the following signs:

-Possession of drug paraphernalia such as syringes, razor blades, pipes, or small plastic baggies

-Unplanned weight loss

-Extreme mood swings and changes in behavior

-Avoidance of social situations

-Needle marks on the body

-Frequent nosebleeds or runny noses

-Changes in personal hygiene

-Financial problems

-Signs of withdrawal

-Lying or stealing 

5.   What are common myths regarding cocaine?

Cocaine use has been referred to as an epidemic, however, its use has been on the decline since its peak in the 1980s. 

Cocaine has been described as a performance-enhancing drug.

Some people who use cocaine report that the drug gives them feelings of power and confidence.

Many times, they think they are functioning on a higher level than they actually are. 

6.   How long does cocaine stay in your system?

The length of time that cocaine remains in the body depends on many different factors including body mass, metabolism, and levels of hydration.

Cocaine can be detectable for around 24 hours by blood test or up to three months by a hair follicle test.

In this blog post, you learned where cocaine comes from, how it works to induce feelings of intense euphoria, and the symptoms of cocaine addiction.

Want to learn more about cocaine? Try these books!

Cocaine: History and Culture

This book discusses why cocaine is so tantalizing and “so transcendently stimulating and clarifying to the mind”.

It goes into detail on the origin of cocaine, its legacy, and all of the history in between. 

An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug, Cocaine

Howard Markel, a renowned medical historian, writes in depth about the careers of two brilliant doctors, Sigmund Freud, a neurologist, and William Halsted, a surgeon.

Both of these physicians were addicted to cocaine, but their addictions helped shape their careers and contributions to psychology and medicine.

Markel discusses the physical and emotional damage caused to both Freud and Halsted and how each ultimately changed the world in spite of it—or because of it.

Freud is widely known as the father of psychoanalysis and Halsted is known as the father of modern surgery. 

Kings of Cocaine: Inside the Medellin Cartel- An Astonishing True Story of Murder, Money, and International Corruption

This fascinating book dives deep into the story of the most successful cocaine dealers in the world, including Pablo Escobar Gaviria.

In the 1980s, they controlled more than half the cocaine flowing into the United States.

Learn all about the Medellin cartel, how it became a 2 billion dollar system, and how the complexities of it led to manipulation of world leaders and horrible violence. 

Have more questions or comments about cocaine? Post below! 


Cocaine.National Institute of Drug Abuse. July 2018. 

What to Know About Cocaine Use.Very Well Mind. August 13th, 2019.