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Cocaine Use

Cocaine is an illicit stimulant drug people commonly use for its effects on the central nervous system, like increased energy and feelings of self-confidence. Cocaine is highly addictive but is often mistakenly perceived to be less dangerous than other illicit drugs.  But this is not the case since cocaine is often tampered with or added to more potent drugs (like heroin or fentanyl) that can lead to an overdose.

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Why Do People Use Cocaine?

The immediate effects of cocaine may prompt the first use of the drug. People may like how they feel when using cocaine and seek these effects.

Short-term side effects of cocaine lead to:

  • Increased energy
  • Euphoria (from the cocaine high, also known as a ‘rush’)
  • Talkativeness
  • Being more alert
  • Hypersensitivity to light, sound, and touch

However, people may seek cocaine for many other reasons, such as:

  • To escape reality
  • In an attempt to self-medicate mental health issues, such as depression
  • To experiment or try something new in a social setting
  • Avoiding withdrawal symptoms after forming a cocaine use disorder
  • Staving off cravings due to cocaine addiction
  • To counteract the effects of drugs with opposing effects, like opioids

It may be difficult to understand why people continue using cocaine after learning that it has dangerous side effects.

Know this: people who continue cocaine use—even if they recognize its side effects—often face an addiction to the drug, which hijacks their ability to make logical decisions.

How Do People Use Cocaine?

People use white powder cocaine in several ways, from snorting and injecting cocaine to plugging the drug.

The solid, rock-like form of the drug, called crack cocaine or freebase cocaine, is smoked.

At first, people may snort powdered cocaine, believing this to be the ‘safest’ method. However, with continued cocaine abuse and developing a drug addiction, they may begin injecting cocaine to get a faster onset of desired effects.

People seeking increased effects from drugs may use two or more drugs at once, such as cocaine and heroin, commonly known as a speedball.

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Why Is Cocaine Use So Dangerous?

Cocaine disrupts the brain’s normal processes, affecting its neurotransmitters (chemical messengers communicating throughout the body). It binds to dopamine transporters and stops the removal of dopamine from the synapse, or the gap between two neurons.

This buildup of dopamine produces the rush of euphoria people experience when they use cocaine. While this may not seem dangerous at first, with time and repeated cocaine abuse, a person’s brain can no longer produce dopamine, or pleasurable feelings, on its own.

This inability to produce dopamine without the help of cocaine is known as cocaine addiction and drives continued use despite negative consequences.

Other dangers and risks of cocaine use include:

  • Increased body temperature
  • Constricted blood vessels
  • Increased heart rate
  • Increased blood pressure
  • Chest pains
  • Mood swings
  • Feelings of restlessness, anxiety, irritability, and paranoia
  • Tolerance to cocaine, leading to higher doses and increased risk of overdose
  • Cocaine withdrawal, which prompts continued use
  • Cocaine toxicity, or poisoning the body with the substance
  • Cocaine overdose, which can be fatal when it involves a heart attack or seizure
  • Effects on mental illness, such as depression and anxiety
  • Cardiovascular effects: changes to heart rhythm, heart attack
  • Neurological effects: headaches, seizures, psychosis, and stroke
  • Coma

Long-term cocaine users may also experience other effects specific to the method of use.

Snorting cocaine affects the nose and nasal passages and could lead to ‘saddle nose’ (where the septum collapses), a chronic runny nose, or nosebleeds.

Injecting cocaine increases a person’s risk of infections at the injection site and contracting certain diseases from shared needles, such as HIV and Hepatitis C.

When Did People Start Using Cocaine?

Cocaine is one of the oldest drugs of abuse.

People in the Andes Mountains have used the coca plant (the leaves of which are the main ingredient in cocaine) for at least 15 centuries, according to the U.S. Department of Justice Office of the Inspector General.

Since its origins, cocaine has been used for medicinal and recreational purposes. People would chew the plant’s leaves to get the desired effects.

Cocaine as Medicinal Remedy

Albert Niemann of the University of Gottingen in Germany first processed cocaine hydrochloride from coca leaves in 1859.  Doctors hailed this refined form of cocaine as a wonder drug and used it to treat toothaches, headaches, and other common health conditions.

Over the next several decades, cocaine became a common ingredient in everyday products for consumption, from elixirs to Coca-Cola.

Cocaine abuse came to light as a problem when respected members of the medical community and high society began to face cocaine addiction. In 1910, then-President Taft named cocaine a national threat.

Two World Wars and the Great Depression tempered the use of cocaine, but it soon found a new audience and the capacity for mass production as South American drug cartels seized power. Cocaine drug abuse picked up again in the 1960s and saw a dramatic surge in the 1980s. Today, cocaine remains one of the most widely used drugs worldwide.

Legal Consequences for Cocaine Use

Cocaine is illegal for use and sale in the United States at the federal and state levels. Here are the laws for cocaine and penalties for cocaine-related charges.

Laws and Regulations

One form of cocaine is still in use in the medical community, which is why the drug is a Schedule II drug under the Controlled Substances Act.

All other use, sale, or possession of cocaine in the U.S. is illegal.

Penalties for Cocaine Use, Sale, and Possession

Penalties for using, selling, or possessing cocaine are as follows for first convictions:

  • Cocaine possession (500-4,999 g): no less than 5 years/no more than 40 years in prison; up to $2 million fine
  • Cocaine possession (5 kg or more): no less than 10 years/up to life in prison; up to $4 million fine
  • Crack cocaine possession (5-49 g): no less than 5 years/no more than 40 years in prison; up to $2 million fine
  • Crack cocaine possession (50 g or more): no less than 10 years/up to life in prison; up to $4 million fine
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Cocaine Rates of Use in the U.S.

The following rates show the scope of cocaine drug use in the United States:

  • About 5.2 million people used cocaine in 2020 (NIDA). This number included adolescents ages 12 and older.
  • This is almost 2% of the U.S. population (CDC).
  • About 1.3 million had a cocaine use disorder in 2020 (NIDA).
  • More than 19,000 people died from a drug overdose involving cocaine in 2020 (NIDA).
  • Cocaine was involved in 1 in 5 overdose deaths in 2019 (CDC).

Treatment Options to Help Someone Stop Cocaine Use

Substance abuse treatment for cocaine use comes in various levels, from support groups for people in recovery to drug detox to long-term care for people with substance use disorders.

If someone you know needs cocaine addiction treatment, here are effective options:

  • Drug detox programs: A cocaine detox program allows a person to rid their body of the substance prior to entering a behavioral health program, such as residential treatment.
  • Matrix Model recovery: The Matrix Model treats addiction to stimulants like cocaine and methamphetamine and involves various therapies and treatments.
  • Inpatient treatment: Cocaine rehab programs provide 24-hour health care and support to help people enter recovery.
  • Support groups: People may find support in Cocaine Anonymous and other support groups during treatment and long-term recovery.
  • Continuing care: Cocaine addiction recovery is a long-term process, so continuing recovery through counseling, therapy, and step-down levels of care is important.

Find Help for Someone You Love Who’s Facing Cocaine Use

If you or your loved one are battling cocaine use, help is available, and people can and do recover.

First, seek some help from a trusted health professional. They can perform an assessment and help you understand if you or your loved one has a cocaine substance use disorder.

Then, you can seek treatment providers via the Substance Abuse and Mental Health Services Administration (SAMHSA) treatment locator website.

Finally, look for a local Cocaine Anonymous chapter by visiting the website and using their navigator to search for meetings near you to connect with others in addiction recovery.

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FAQs about Cocaine Use

What are common symptoms of cocaine use?

People using cocaine may display certain signs and symptoms, such as talkativeness, high energy, agitation, paranoia, and acting erratic and impulsively. In addition to these behavioral signs and symptoms, they may also suffer from constant nose bleeds and sniffle regularly as if they have a common cold that never goes away.

How many people use cocaine?

In 2020, 5.2 million people (i.e., 1.9% of the population) had used cocaine in the past 12 months, according to the National Survey on Drug Use and Health reported by the NIDA.

How many teens use cocaine?

A reported 0.5% of 8th graders, 0.3% of 10th graders, and 1.5% of 12th graders used cocaine in 2022, according to the Monitoring the Future Survey.

What do drug dealers use to cut cocaine?

Drug dealers may cut (or mix) cocaine with several substances, such as baking soda, caffeine, lidocaine, and levamisole. Cocaine-cutting agents can be dangerous to a person’s health. Cocaine’s purity is also never guaranteed, so there is always a risk of cocaine containing harmful substances such as fentanyl.

What are health issues related to long-term cocaine use?

Long-term cocaine use is associated with several health issues, including risks of cardiovascular issues like heart attack, stroke, seizures, coma, and nasal problems, among others.

What is considered heavy cocaine use?

The definition of ‘heavy’ cocaine use may differ among different people. In general, heavy use of any drug is what leads to addiction.

Heavy drug use may look like using the substance daily, using large amounts, bingeing to maintain a continuous high, or using cocaine with other drugs to amplify its effects.

Jessica Miller is the Content Manager of Addiction HelpWritten by:

Editorial Director

Jessica Miller is the Editorial Director of Addiction Help. Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction. Informed by her personal journey to recovery and support of loved ones in sobriety, Jessica's empathetic and authentic approach resonates deeply with the Addiction Help community.

  1. ScienceDirect (2021 October). Forensic Science International. “Cutting agents in cocaine: A temporal study of the period 2015–2017 in the Northern Region of Colombia.”

  2. Centers for Disease Control and Prevention (2021 November 18). “Other Drugs | Drug Overdose.” Retrieved February 12, 2023, from

  3. National Institute on Drug Abuse (2016 May). “What are some ways that cocaine changes the brain?” Retrieved February 12, 2023 from

  4. National Institute on Drug Abuse (2016 May). “What are the long-term effects of cocaine use?” Retrieved February 12, 2023, from

  5. National Institute on Drug Abuse (2016 May). “What are the short-term effects of cocaine use?” Retrieved February 12, 2023, from

  6. National Institute on Drug Abuse (2016 May). “What is the scope of cocaine use in the United States?” Retrieved February 12, 2023, from

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