The facts on cocaine

What is cocaine?

• Cocaine is a highly addictive stimulant drug derived from the leaves of the coca plant, which is native to South America.
• In 2023 alone, 5 million people ages 12+ in the United States reported cocaine use within the last year.

Intended use

• Cocaine may be used as a topical local anesthetic for the upper respiratory tract or to reduce bleeding in mucous membranes.

Common names

• Blow, coca, coke, crack, flake, snow and soda cot

Forms

• Snorting ground powder up the nose (lasts 15–30 minutes)
• Rubbing ground powder on the gums (lasts 10–30 minutes)
• Dissolving powder and injecting it into the bloodstream (lasts 20–60 minutes)
• Smoking cocaine that has gone through a process that crystallizes it into a solid rock called crack (lasts 5–10 minutes)
• Cocaine is often taken in copious amounts or binges to maintain the level of high.

How cocaine works

• Cocaine raises the level of dopamine in the brain and then prevents the recycling of dopamine, resulting in a buildup between nerve cells.
• This buildup of dopamine interrupts signaling between nerve cells and creates a sensation of euphoria.

Short-term health effects

• Cocaine is often cut with other substances to maximize its volume. These added substances can increase the likelihood of an overdose. These substances often include laxatives, caffeine, laundry detergent, cornstarch, baking soda, creatine or fentanyl.
• Short-term effects include dilated pupils, extreme elation or energy, loss of appetite, insomnia, irritability, sensory hypersensitivity, paranoia, seizures, strokes, cardiac arrest and overdose.

Long-term health effects

Long-term consequences depend on the amount consumed and the method of use. They can include:

• Bowel decay from reduced blood flow.
• If applied through the nose, patients exhibit problems with swallowing, nasal lining decay, nosebleeds, loss of smell and constant runny noses.
• People who inject cocaine face a higher risk of developing diseases such as HIV or Hepatitis C through needle sharing.
• Inhaling cocaine can lead to respiratory distress, cough, increased chance of lung infection and asthma.
• Psychological impacts include panic attacks, paranoia, anxiety and psychosis.
• Increased dependence, tolerance and the risk of overdose.
• Serious adverse effects such as irregular heartbeat, ischemic heart conditions, sudden cardiac arrest, convulsions, stroke and death.

Withdrawal

• Symptoms: Depression, fatigue, increased appetite, slowed thinking and insomnia.
• A person may need medical supervision to ensure their safety during the withdrawal process.

Overdose

• An overdose is a serious, life-threatening emergency that requires an immediate medical response.
• An overdose occurs when a person consumes a large enough amount of cocaine or a too-concentrated form of cocaine, causing serious adverse health effects, life-threatening symptoms or even death.
  • Overdose symptoms include seizures, difficulty breathing, bluish skin, high blood pressure, high body temperature, hallucinations and extreme agitation or anxiety.
• Overdose is more likely when cocaine is used in combination with other drugs such as heroin, alcohol and many more.

Addiction treatment

• Therapeutic interventions include cognitive behavioral therapy, contingency management, community-based recovery groups and therapeutic communities.
• Currently, there are no medications specifically designed for the treatment of cocaine addiction, but such medications are in development.

References

• National Institute on Drug Abuse. Cocaine. 2025. Accessed October 21, 2025.
• Department of Justice/Drug Enforcement Administration. Drug Fact Sheet. Cocaine. 2024. Accessed October 21, 2025.
• PubChem. National Library of Medicine, National Center for Biotechnology Information. 2025. PubChem Compound Summary for CID 446220, Cocaine. Accessed October 21, 2025.
• MedlinePlus. National Library of Medicine Medline. Cocaine Intoxication. 2025. Accessed October 21, 2025.
• Alcohol and Drug Foundation. Withdrawal. 2025. Accessed October 21, 2025.
• Substance Abuse and Mental Health Services Administration. 2024. Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health (HHS Publication No. PEP24‑07‑021, NSDUH Series H‑59). Accessed October 21, 2025.